anxiety Flashcards
opens Na or Ca channels / influx—–depolarization [more positive] —–nerve impulse
EXCITATORY NEUROTRANSMITTERS
opens Cl channels——hyperpolarization [more negative] —–No nerve impulse
INHIBITORY NEUROTRANSMITTERS
Examples of Excitatory Neurotransmitters
Glutamate
Acetylcholine
Norepinephrine
Dopamine
Aspartate
Examples of Inhibitory Neurotransmitters
Glycine
Gamma amino-butyric acid [GABA]
It is a drug used to produce mental relaxation, and to reduce the desire for physical activity.
SEDATIVE
It is a drug to induce and maintain sleep.
HYPNOTICS
It is a common psychiatric condition
ANXIETY
It refers to many states in which the sufferer experiences a sense of impending [or upcoming] threat, or doom that is not well defined or reastically based.
ANXIETY
Anxiety is usually accompanied by symptoms such as:
Tachycardia, Palpitations, Tachypnea, Sweating, Trembling and Weakness.
Types of Anxiety
Panic Disorder
Specific Phobia
Social Phobia
Generalized Anxiety Disorder
Post-Traumatic Stress Disorder
Obsessive-Compulsive Disorder
It refers to recurrent unexpected panic attacks that can occur with agoraphobia in which patients fear places in which escape might be difficult.
PANIC DISORDER
It refers to intense fear of particular objects or situations [e.g. Snakes, heights] - most common disorder.
Specific Phobia
It refers to intense fear of being scrutinized in social or public situations [e.g. speaking in class, giving a speech.]
SOCIAL PHOBIA
It refers to intense pervasive worry over virtually every aspect of life.
GENERALIZED ANXIETY DISORDER
It refers to persistent re-experience of a trauma, efforts to avoid recollecting the trauma, and hyper arousal.
POST-TRAUMATIC STRESS DISORDER
It refers to recurrent obsessions and compulsions that cause significant distress and occupy a significant portion of one’s life.
OBSESSIVE-COMPULSIVE DISORDER
Treatment for Anxiety
Psychotherapy
Drugs - Benzodiazepines, Beta-blockers, SSRIs, TCAs
It is the most widely used anxiolytic
BENZODIAZEPINES
It has benzene ring [A] fused to a seven-membered diazepine ring [B]
BENZODIAZEPINES
It is called minor tranquilizers
BENZODIAZEPINES
Short-Acting Benzodiazepines Duration of Action
2-8 hours
Examples of Short-Acting Benzodiazepines
Clonazepam [Klonopin, Rivotril] Oxazepam [Serax]
Triazolam [ Halcion]
Midazolam [Versed, Dormicum]
Intermediate-Acting Benzodiazepines Duration of Action
10-20 hours
Examples of Intermediate-Acting Benzodiazepines
Lorazepam [Ativan]
Alprazolam [Xanax, xanor] Termazepam [Restoril]
Long-Acting Benzodiazepines Duration of Action
1 to 3 days
Examples of Long-Acting Benzodiazepines
Diazepam {Valium, Anxionil} Flurazepam {Dalmane}
Chlordaiazepoxide
Drugs for Anxiety (Benzodiazepines)
Alprazolam, Diazepam
Drugs for Seizures (Benzodiazepines)
Diazepam, Clonazepam, Lorazepam
Drugs for Seizures (Benzodiazepines)
Diazepam, Clonazepam, Lorazepam
Drugs for Insomnia (Benzodiazepines)
Flurazepam, Midazolam
Drugs for Pre-Operative Sedation (Benzodiazepines)
Midazolam
Side Effects of Benzodiazepines
Drowsiness, Dependence
Respiratory depression [_+ethanol other CNS depressants]
Antidote [For overdose]
Flumazenil [Anexate] - which is GABA receptor antagonist
It is the former DOC for anxiety, and insomnia
BARBITURATES
The derivative of barbituric acid is 2&4
BARBITURATES
BARBITURATES MOA -
Barbiturates increase the duration of GABA mediated chloride ion channel opening.
Classifications of Benzodiazepines
SHORT-ACTING
INTERMEDIATE-ACTING
LONG-ACTING
Classifications of Barbiturates
Ultra-Short Acting
Short-Acting
Long-Acting
Ultra Short-Acting Barbiturates Duration of Action
20 mins
Short-Acting Barbiturates Duration of Action
3-8 hours
Long-Acting Barbiturates Duration of Action
1-2 days
Examples of Ultra Short-Acting Barbiturates
Thiopental [Pentothal]
Examples of Short-Acting Barbiturates
Pentobarbital [Nembutal]
Amobarbital [Amytal]
Examples of Long-Acting Barbiturates
Phenobarbital [Luminal]
Barbiturates used for the Induction of anesthesia
Thiopental
Barbiturates used for Seizures in children
Phenobarbital
Barbiturates used for anxiety
Phenobarbital
Amobarbital
Barbiturates Side Effects
Drowsiness, Dependence, Respiratory Depression, Paradoxical Excitation
It is a serotonin agonist
- non-sedating, no dependence
BUSPIRONE [Buspar]
It is not a Bz but acts on Bz receptor
Zolpidem [Ambien, Stilnox]
- Knock out drops
- Converted to trichloroethanol [active]
- For preoperative sedation
CHLORAL HYDRATE
Examples of Antihistamines
- Diphenhydramine [Benadryl]
- Doxylamine [Unison]
- Hydroxyzine [Atarax, Iterax]
It is a condition that affects the way your brain processes information. It causes you to lose touch with reality.
PSYCHOSIS
Psychosis is a symptom, not an illness. A mental or physical illness, substance abuse, or extreme stress or trauma can cause it.
It involves psychosis that usually affects you for the first time in the late teen years or early adulthood. Young people are especially likely to get it, but doctors don’t know why.
Psychotic Disorders like Schizophrenia
Even before what doctors call the first episode of psychosis (FEP), you may show slight changes in the way you act or think. This is called the ____ and could last days, weeks, months, or even years.
PRODROMAL PERIOD
Sometimes you can lose touch with reality even when you don’t have a primary psychotic illness such as schizophrenia or bipolar disorder. When this happens, it’s called ____
SECONDARY PSYCHOSIS
Hearing voices when no one is around
AUDITORY HALLUCINATIONS
Strange sensations or feelings you can’t explain.
TACTILE HALLUCINATIONS
You see people or things that aren’t there, or you think the shape of things looks wrong.
VISUAL HALLUCINATIONS
Beliefs that aren’t in line with your culture and that don’t make
sense to others.
DELUSIONS
Causes of Psychosis
Genetics
Drugs
Trauma
Injuries and Illnesses
Overall Cause
You can have the genes for it, but that doesn’t always mean you’ll get psychosis.
Genetics
Triggers include some prescription medications and abuse of alcohol or drugs like marijuana, LSD, and amphetamines.
Drugs
The death of a loved one, a sexual assault, or war can lead to psychosis. The type of trauma and the age you were when it happened also play a role.
TRAUMA
Traumatic brain injuries, brain tumors, strokes, Parkinson’s disease, Alzheimer’s disease, dementia, and HIV can all bring on psychosis.
Illnesses and Injuries
A disturbance in Dopamine, which is a neurotransmitter of the basal ganglia responsible for movement and skeletal muscle tone.
Overall Cause
Butyrophenones antipsychotic drugs
Haloperidol
- antipsychotic; antimanic
Dibensoxazepines antipsychotic drugs
Loxapine
- antipsychotic
Dihydroindolones antipsychotic drugs
Molindone
- antipsychotic
Phenothiazines antipsychotic drugs
Chlorpromazine
- antipsychotic, antiemetic
Prochlorperazine
- antiemetic
Promethazine
- antihistaminic (colds, motion sickness)
Thioridazine
- antipsychotic
Trifluoperazine
- antipsychotic
Triflupromazine
- antipsychotic, antiemetic
Thioxanthenes antipsychotic drugs
Chlorprothixene
- antipsychotic
Thiothixene
- antipsychotic
It is the first phenothiazine discovered
CHLORPROMAZINE
Therapeutic effects of Phenothiazines are:
- Anticholinergic
- Antihistaminic
- Alpha-adrenergic blocking
- Antiemetic
Minor Adverse Effects of Phenothiazines???
Dry mouth [Xerostomia]
Constipation
Visual disturbances [anticholinergic effects]
Major Adverse Effects of Phenothiazines??? (Concerns Neurological Conditions)
Akathisia
Dystonic Reaction
Parkinsonism
Tardive Dyskinesia
It refers to continuous movement where the individual is restless and
continuously paces about.
Akathisia
It is characterized by muscle spasms, twitching, facial grimacing
and torticollis [wryneck].
Dystonic Reaction
It is referred as extrapyramidal symptoms involves development of
muscular rigidity, tremors and other disturbances of movement.
Parkinsonism
It is referred as extrapyramidal symptoms involves development of
muscular rigidity, tremors and other disturbances of movement.
Parkinsonism
It usually develops after long term antipsychotic therapy that involves involuntary movements of the lips, jaw, tongue and extremities.
Tardive dyskinesia
