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Sem 3 Neuro > Anxiety > Flashcards

Anxiety Flashcards

1
Q

What is anxiety?

A

→ extreme worry

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2
Q

When is anxiety normal?

A

→ When it is intermittent

→ when there is a particular source that triggers it

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3
Q

When is anxiety abnormal?

A

→ When it is chronic and irrational

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4
Q

What can anxiety cause?

A

→ Social disturbances
→ Avoidance behaviour
→ Incessant worry
→ Concentration/memory problems

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5
Q

What are the physiological symptoms of anxiety?

A 
→ Tachycardia
→ Hyperventilation
→ Feeling dizzy
→ headaches
→ flushing
→ sweating
→ Nausea
→ insomnia
→ diarrhoea
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6
Q

What are the psychological symptoms of anxiety?

A

→ stress
→ worry
→ foreboding

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7
Q

What are the 6 causes of anxiety?

A 
→ childhood experience
→ diet 
→ physical or mental health
→ everyday life and habits
→ drugs and medication
→ genetics
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8
Q

What medication can increase anxiety?

A

→ antimalarias

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9
Q

What foods increase anxiety?

A

→ high sugar and caffeine

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10
Q

What is generalised anxiety disorder?

A

→ psychological and physiological with no real stimulus

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11
Q

What are 5 types of anxiety disorder?

A 
→ specific phobias
→ social phobias
→ OCD
→ PTSD
→ panic disorder
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12
Q

What are obsessions?

A

→ recurrent intrusive thoughts, images, ideas or compulsions

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13
Q

What are compulsions?

A

→ repetitive behaviors or mental acts performed to reduce anxiety associated with the obsessions

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14
Q

What is PTSD?

A

→ Re living unpleasant memories
→ flashbacks
→ nightmares

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15
Q

What is panic disorder?

A

→ An individual suffers from panic attacks with no apparent trigger

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16
Q

What receives the stress or fear stimulus?

A

→ The amygdala

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17
Q

describe how cortisol is released?

A

→ amygdala receives stress or fear stimulus
→ transmits information to the bed nucleus of the stria terminalis
→ which transmits the information to the HPA axis
→ it releases CRH which induces the release of ACTH and eventually cortisol

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18
Q

What are the 4 treatments for anxiety?

A

→ Benzodiazepines
→ 5-HT1A receptor agonists
→ beta adrenoceptor antagonists
→ antihistamines

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19
Q

What type of drugs are barbiturates?

A

→ positive allosteric modulators

20
Q

Where do benzodiazepines bind?

A

→ alpha gamma interface in the GABA receptor

21
Q

What is the usual binding site for GABA?

A

→ alpha beta interface

22
Q

What do benzodiazepines do to the GABA receptor?

A

→ they make it more stable
→ the binding site can’t close
→ the receptor is more receptive to GABA
→ more GABA can bind at lower concentrations

23
Q

What do barbiturates do to GABA?

A

→ they keep GABA receptors open for longer

24
Q

What receptors do benzodiazepines work on and why?

A

→ only 1,2,3, or 5

→ they have histidine

25
Q

What is used in benzodiazepine overdose?

A

→ Flumazenil

26
Q

How does the dose response curve change with benzodiazepines?

A

→ dose response curve shifts left

27
Q

What are 3 long acting benzodiazepams?

A

→ Clonazepam
→ Diazepam
→ Chlordiazepoxide

28
Q

What is a short acting benzodiazepam?

A

→ Midazolam

29
Q

What are 2 medium acting benzodiazepams?

A

→ Temazepam

→ Lorazepam

30
Q

Why are long acting benzodiazepams not given during the night?

A

→ it will make you drowsy during the day

→ unable to wake

31
Q

What does withdrawal of BZDs cause?

A

→ severe seizures

→ Sudden inhibition of inhibitory GABA

32
Q

What does the body do when given BZD?

A

→ upregulates the excitatory receptors

33
Q

What is the most commonly prescribed drug for GAD?

A

→ Buspirone

34
Q

Describe how buspirone works?

A

→ 5-HT1A autoreceptors presynaptically
→ when someone takes buspirone (5-HT1A agonist)
→ Desensitisation of auto 5-HT1A receptors
→ supra activation of 5-HT1A receptors
→ extreme inhibition of serotonin release
→ body downregulates the 5-HT1A receptors
→ less inhibition of serotonin release
→ enhanced release of serotonin

35
Q

Describe how SSRIs work?

A

→ SERT transporter gets blocked
→ lots of serotonin in the synapse
→ induces desensitisation of 5HT1A receptors
→ body downregulates the 5-HT1A receptors and the postsynaptic receptors

36
Q

Why is buspirone preferred over SSRI?

A

→ SSRIs decrease the post synaptic receptors as well as the pre synaptic ones

37
Q

What do adrenoceptor antagonists do?

A

→ reduce peripheral symptoms of anxiety

38
Q

What do anti-histamines do?

A

→ hypnotic and sedative effects

39
Q

What is GAD?

A

→ Characterised by an ongoing state of excessive anxiety lacking clear reason or focus
→ Excessive anxiety for at least 6 months

40
Q

What are panic attacks?

A

→ Sudden feelings of overwhelming fear with marked somatic symptoms

41
Q

What does continuous exposure to cortisol do in the brain?

A

→ Neuronal degeneration in the hippocampus

→ Decrease in hippocampal volume

42
Q

What are the 5 effects of barbiturates?

A

→ direct GABA A agonist
→ stabilises the open channel - glycine receptor
→ nACHR and 5-HT3 receptor blockade
→ AMPA/Kainate receptor blockade
→ Blockade of Ca2+ dependent neurotransmitter release

43
Q

What is the structure of a 5-HT1A receptor?

A

→ Venus flytrap domain
→ Cysteine rich domain
→ 7 TM domain
→ C terminal domain

44
Q

What is the function of beta 1 receptors?

A

→ Increases HR, contraction, ejection

→ Increases renin release

45
Q

Why do people develop tolerance to BDZ?

A

→ Increased glutamate receptor trafficking to the membrane

Sem 3 Neuro (21 decks)

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