24. Anxiety and anxiolytics Flashcards

1
Q

What are the different types of anxiety disorders?

A
Panic disorder
Agoraphobia
Social phobia - social anxiety disorder
Simple phobia
Obsessive compulsive disorder
Post-traumatic stress disorder
Generalised anxiety disorder
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2
Q

Which neurological structures are involved in anxiety disorders?

A

Amygdala - involved in the control of fear and anxiety potentially thought to be perceived as a type of fear
HPA axis - some abnormalities in the stress response

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3
Q

Which neurotransmitters are involved in anxiety disorders?

A
Monoaminergic systems (5-HT, dopamine)
GABAergic systems
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4
Q

Explain the role of the amydala in anxiety

A

There is a hyperactivity of the limbic structures i.e. the amygdala and there is an accompanied inability of cortical structures to control this hyperactivity

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5
Q

What are the different types of anxiolytics and give specific examples?

A

Benzodiazepines - clonazepam, alprazolam
5-HT1a agonists e.g. buspirone, ipsapirone
B-adrenoreceptor antagonist e.g. propranolol
SSRIs e.g. fluoxetine, escitalopram, paroxetine

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6
Q

What are barbiturates?

A

These are anxiolytics which are no longer used as they were associated with a lot of issues

These were positive allosteric modulators at the GABAa receptors and they caused these channels to remain open for longer

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7
Q

What were the issues associated with barbiturates?

A

Very strong CNS depressants so many adverse effects
Major risk of drug dependence
Development of tolerance
Fatal toxicity in overdose - respiratory depression
Accumulation causes drowsiness, disorientation, ataxia, slurred speech

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8
Q

At what receptor do benzodiazepines have an effect?

A

These are positive allosteric modulators at GABAa receptors

These cause the channels to open more frequently than normal

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9
Q

How is benzodiazepine overdose managed?

A

Flumazenil
This acts as an antagonist at the benzodiazepine binding sites
Has a short half life

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10
Q

What are the complications of benzodiazepine use in the elderly?

A
Psychomotor impairment
Risk of falls
Daytime drowsiness
Intoxication
Amnesia
Depression
Respiratory problems
Abuse and dependancy
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