anxiety

Question 1

generalised anxiety disorder is…

Answer 1

excessive anxiety and worries > 6 months

Question 2

fear circuit regulated by

Answer 2

amygdala

Question 3

worry circuit regulated by

Answer 3

cortico striatal thalamic loop

Question 4

medical conditions associated with anxiety

Answer 4

cvs - CHF, MI, IHD
endo - hyperthyroidism, hyperparathyroidism, hypoglycaemia
neuro - dementia, delirium
pulmonary - asthma, COPD

Question 5

drug induced anxiety

Answer 5

sympathomimetics, stimulants, caffeine, levothyroxine, corticosteroids, antidep, dopamine agonists, beta-adrenergic agonist

Question 6

panic attack definition

Answer 6

discrete period of intense fear and discomfort, at least 4 sx and reached a peak within 10 mins.

Question 7

GAD definition

Answer 7

at least 3 symptoms for more days than not for the past 6 months

Question 8

how long must the obsessions/compulsions last?

Answer 8

at least 1hr a day / significantly impairs functioning

Question 9

what does CBT help in

Answer 9

PTSD, PD, OCD

Question 10

drugs of choice for GAD

Answer 10

SSRIs, venlafaxine, pregabalin

Question 11

drugs of choice for PD, SAD, PTSD

Answer 11

SSRIs

Question 12

OCD drugs

Answer 12

SSRIs, clomipramine

Question 13

when does full response of serotonergic antidep occur

Answer 13

generally 3 months

Question 14

anxiolytics/hypnotics

Answer 14

bzd (loraz, alprazolam, clonazepam, diazepam), hydroxyzine, propranolol, pregabalin for GAD (anticonvulsant)

Question 15

avoid bzd with?

Answer 15

opioids –> increased mortalityw

Question 16

ntm promoting sleep

Answer 16

gaba

Question 17

wakefulness promoting ntm

Answer 17

ne, da, ach, histamine, orexin

Question 18

preferred benzos for anxiety

Answer 18

lorazepam, alprazolam, diazepam, clonazepam

Question 19

insomnia disorder definition

Answer 19

at least 3 nights per week, at least 3 months

Question 20

bzd moa

Answer 20

potentiates gaba

Question 21

bzd se

Answer 21

sedation, drowsiness, amnesia, muscle weakness

Question 22

preferred bzd for elderly

Answer 22

lorazepam (shorter half life than diazepam)

Question 23

z hypnotics moa

Answer 23

binds to bzd binding sites with gamma and a1 subunits, causing sedation

Question 24

z hypnotics se

Answer 24

taste disturbance (zopiclone)

Question 25

antihistamine se

Answer 25

anticholinergic effects -> urinary retention, prostatic hypertrophy, angle closure glaucoma

Question 26

antihistamine examples

Answer 26

hydroxyzine, promethazine

Question 27

lemborexant moa

Answer 27

ox1 and ox2 orexin receptor antagonist

Question 28

lemborexant se

Answer 28

somnolence, nightmare

Question 29

lemborexant contraindicated in

Answer 29

NARCOLEPSY, severe hepatic impairment, strong cyp3a inhibition/induction

Question 30

trazodone moa

Answer 30

inhibit 5ht2a, h1, alpha 1 receptors

Question 31

trazodone se

Answer 31

sedation, orthostatic hypot, priapism??

Question 32

precautions for bzd/z-hypnotics

Answer 32

respiratory depression
myasthenia gravis
acute narrow angle glaucoma
acute pulmonary insufficiency