Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BB2 > Anxiety > Flashcards

Anxiety Flashcards

1
Q

What are the clinical uses of hypnotics and anxiolytics?

A

Relief of anxiety states
Induction of sleep
Sedation and amnesia before medical procedures
Control of withdrawal states in addiction (e.g. delirium tremens)
Muscle relaxation
Severe behavioural disturbance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What may benzodiazepines also be used for?

A

Epilepsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What controls the 24 hour rhythm?

A

Suprachiasmatic nucleus in the hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the two main factors that regulate the sleep wake cycle?

A

Homeostatic sleep drive – low in the morning, increases during the day
Circadian alerting signal – increases during the day until about 9pm, then starts to decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the neuronal projections involved in the control of wakefulness?

A

Cholinergic systems (pedunculopontine and laterodorsal tegmental nuclei)

Monoaminergic projections (locus coeruleus, raphe nuclei, tuberomamillary nucleus)

These project to the cortex.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the neuronal projections involved in the control of sleep?

A

GABA and galanin neurons (ventrolateral preoptic nucleus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which transmitters promote sleep? (3)

A

GABA
Melatonin
Adenosine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which transmitters maintain wakefulness? (6)

A 
Noradrenaline
Dopamine
Serotonin
Histamine
Acetylcholine
Orexin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which agents promote wakefulness? (6)

A 
GABA antagonists
Adenosine antagonist
NA uptake blockers
Dopamine stimulants
Serotonin uptake blockers
H3 antagonists
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which agents promote sleep? (6)

A 
GABA agonists
M1 and M2 agonists
Dopamine agonists 
5-HT2 antagonists
H1 antagonists
OR1/2 antagonists
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which agents cause sedation? (4)

A

GABA agonists
Alpha-1 noradrenergic antagonists
H1 antagonists
Muscarinic antagonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How long does each sleep cycle last?

A

90 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What do REM, NREM and SWS stand for?

A

Rapid eye movement phase
Non-rapid eye movement phase
Slow wave sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

The sleep cycles are identical in the ratio NREM/REM sleep. True or false?

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How are sleep stages assessed?

A

Polysomnography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How many stages of sleep are there? What are they?

A

Awake - normal wakefulness (beta waves, 13-30 Hz) OR awake and relaxed (alpha waves, 8-12 Hz)
Stage 1 – theta waves (3.5-7.5 Hz)
Stage 2 - theta waves with sleep spindles and K complex
Stage 3 – delta waves, less than 3.5 Hz
Stage 4 – delta waves, less than 3.5 Hz
REM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Zif-268 expression level changes after experience in a sleep stage manner. When is it usually high? What happens in an enriched environment?

A

Sleep can consolidate memories through gene expression changes.
It is usually high during wakefulness and low in REM sleep, but with an enriched environment, it is high during REM sleep.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the three types of insomnia?

A

Transient (e.g. jet lag)
Short-term (e.g. associated with illness, bereavement, stress)
Chronic (lasts longer than 3 weeks)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What may sleep disorders may be a prodromal sign of?

A

Neurodegeneration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What causes 50% of insomnia cases?

A

Psychiatric disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

At present, which drugs are used to treat insomnia?

A

Benzodiazepines (short-acting) and Z-drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which anxiolytics/hypnotics are given for short-term use? (2)

A

Lorazepam, temazepam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which anxiolytics/hypnotics are given for long-term use?

A

Eszopiclone and extended release zolpidem (chronic insomnia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which have a longer half-life - benzodiazepines or Z-drugs?

A

Benzodiazepines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the Z-drugs? (3)

A

Zaleplon, zolpidem, zopiclone

26
Q

What are the unwanted effects of benzodiazepines as hypnotics? (5)

A

Change in sleep patterns (suppress deep sleep and REM sleep)
Daytime sedation
Rebound insomnia
Tolerance
Dependence (withdrawal syndrome characterised by anxiety, nausea, muscle cramps, seizures)

27
Q

What does pregabalin bind to?
What is its benefit for the treatment of insomnia?
What can it also be used to treat?

A

Alpha-2 delta sub-unit of voltage gated calcium channels
No disruption of sleep architecture and no tolerance
Used as an anxiolytic

28
Q

Why should prolonged prescription of hypnotics be avoided?

A

This can create a spiral of dependence

29
Q

How can chronic insomnia be treated non-pharmacologically?

A

CBT

30
Q

What is orexin/hypocretin? What are the two forms?

A

A peptide produced in the hypothalamus

Orexin A and orexin B (or hypocretin 1 and 2)

31
Q

What do orexin OX1 and OX2 receptors mediate?

A

The effects of the wide distribution of projections. They regulate arousal, appetite, and wakefulness.

32
Q

What does a deficiency in orexins cause?

A

Narcolepsy (condition characterised by excessive

sleepiness; increased frequency of falling asleep in daytime)

33
Q

What is suvorexant?

A

A dual orexin receptor antagonist (treatment of insomnia)

34
Q

What are the benefits of orexin antagonists over some other insomnia medication?

A 
Orexin antagonists don’t have:
Anticholinergic effects
Orthostasis
Respiratory depression
Rebound insomnia
Dependence
Amnesia

(Although they can cause morning sedation, hallucinations and sleep paralysis.)

35
Q

What are the types of anxiety disorder? (7)

A 
Panic disorder
Agoraphobia
Social phobia
Simple phobia
OCD
PTSD
Generalised anxiety disorder
36
Q

How many % of mental disorders in the EU are anxiety disorders?

A

10%

37
Q

Is panic disorder more common in men or women?

A

Women (2:1)

38
Q

Is OCD more common in men or women?

A

Women (3:2)

39
Q

Is agoraphobia more common in men or women?

A

Women (8:3)

40
Q

Which structures and transmitters are involved in anxiety disorders? (4)

A

Amygdala, insula, anterior cingulate, prefrontal cortex, thalamus
Abnormalities of the HPA axis
Monoaminergic systems
GABAergic systems

41
Q

Hyperactivity of what structures is a common feature of anxiety disorders?

A

Hyperactivity of limbic structures (e.g. lateral and central amygdala) and the inability of higher cortical structures to control this hyperactivity

42
Q

What are the symptoms of panic? (7)

A

Heart rate, blood pressure (lateral hypothalamus)
Bradycardia, ulcers (dorsal vagal nucleus)
Panting, respiratory distress (parabrachial nucleus)
Arousal, vigilance, attention (basal forebrain)
Increased startle response (pontis caudalis)
Freezing, social interaction (central grey area)
Corticosteroid release (paraventricular nucleus)

43
Q

There are indications that what transmitter is involved in the genetic risk for anxiety disorders?

A

5-HT transmission

44
Q

What genes are associated with specific anxiety disorders? (6)

A 
COMT
Cholecystokinin
CCK B receptor
Adenosine A2 receptor
MAOA
5-HT2 receptor
45
Q

What does KF-1 ubiquitin ligase act as?

What is co-localised with this protein?

A 
An anxiety suppressor (knock out animals have increased fear/anxiety behaviour)
Presenilin proteins (involved in Alzheimer’s disease)
46
Q

KF-1 expression is increased after ___ or ___.

A

Chronic administration of SSRIs

After ECT

47
Q

What are the types of anxiolytics?

A 
Benzodiazepines
5-HT1A agonists
β-adrenoceptor antagonists
SSRIs 
Barbiturates
48
Q

Give two examples of benzodiazepines.

A

Clonazepam and alprazolam

49
Q

Give two examples of 5-HT1A agonists.

A

Buspirone and ipsapirone

50
Q

Give three examples of SSRIs.

A

Fluoxetine, escitalopram and paroxetine

51
Q

Give an example of a beta-adrenoceptor antagonist.

A

Propranolol

52
Q

What problems are associated with the use of barbiturates? (6)

A

Drug dependence
Tolerance
Induction of liver microsomal enzymes
Fatal toxicity in overdose (respiratory depression)
Accumulation causes drowsiness, disorientation, ataxia, slurred speech
Withdrawal syndrome: agitation, insomnia, depression, feeling of tension, seizures

53
Q

Why is the GABAergic synapse important clinically?

A

Key target of several hypnotic and anxiolytic drugs, e.g. benzodiazepines target GABA A

54
Q

Benzodiazepines are positive allosteric modulators at what receptor complex?

A

GABA A receptor complex

55
Q

What does diazepam potentiates?

A

GABA-induced hyper-polarization

56
Q

Benzodiazepines and barbiturates increase what in relation to the GABA A channel?

A

Frequency of the open state and the opening duration of the GABA A channel

57
Q

How do you manage a benzodiazepine overdose?

A

Flumazenil (antagonist at the benzodiazepine binding sites)

58
Q

Generalised anxiety disorder is one of the most common psychiatric disorders. How is it treated?

A

Buspirone (5-HT1A agonist)
venlafaxine, duloxetine (SNRI)
fluoxetine, escitalopram (SSRI)
risperidone, quetiapine, olanzapine (APD)

59
Q

What are the non-pharmacological treatments for anxiety?

A

Individual psychotherapy, family therapy, CBT, rational emotive therapy, hypnosis, meditation, acupuncture, yoga

60
Q

What are the complications of benzodiazepine use in the elderly? (8)

A 
Psychomotor impairment
Risk of falls
Daytime drowsiness
Intoxication
Amnesia
Depression
Respiratory problems
Abuse and dependence
61
Q

What is the target of Z-drugs?
Which subunit is linked to anxiolytic effects?
Which subunit is linked to hypnotic role?

A

α subunits of GABA A receptor
α3 subunits
α1 subunit (e.g. zaleplon and zolpidem)

BB2 (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions