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Pharm Y3S2 > Anxiety > Flashcards

Anxiety Flashcards

1
Q

What are the 6 main groups of anxiety disorder?

A 
GAD
Panic disorder
Social anxiety
OCD
PTSD
Agoraphobia
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2
Q

Give some psychological symptoms of anxiety.

A 
Worrying thoughts
Fearful anticipation
Poor memory
Insomnia
Avoidance
Irritability
Poor concentration
Sensitivity to noise/lights
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3
Q

Give some physical symptoms of anxiety.

A 
Palpitations
Shortness of breath
Tremor
Fatigue
Sexual difficulties
Dizziness
Headache
Dry mouth
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4
Q

What is GAD?

A

Excessive worry about a number of issues most of the time for at least 6 months

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5
Q

What is panic disorder?

A

Worrying thoughts and fearful anticipation

Panic attack followed by one month of persistent worry about recurrence

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6
Q

What is social anxiety?

A

Persistent and overwhelming fear of social situations that is out of proportion for at least 6 months

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7
Q

What is the first line psychological therapy for GAD?

A

Self help and group education

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8
Q

What is the second line psychological therapy for GAD?

A

High intensity intervention such as CBT or applied relaxation

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9
Q

What is the first line pharmacological therapy for GAD?

A

SSRIs

Sertraline is not licensed

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10
Q

What is the second line pharmacological therapy for GAD?

A

Alternative SSRI or SNRI

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11
Q

What is the third line pharmacological therapy for GAD?

A

Pregabalin

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12
Q

What is the first line psychological therapy for panic disorder?

A

Individualised CBT

2 hours weekly for up to 4 months

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13
Q

What is the first line pharmacological therapy for panic disorder?

A

SSRI

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14
Q

What is the second line pharmacological therapy for panic disorder?

A

Imipramine or clomipramine

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15
Q

What is the first line pharmacological therapy for social anxiety disorder?

A

SSRI- sertraline or escitalopram

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16
Q

What is the second line pharmacological therapy for social anxiety disorder?

A

Alternative SSRI or SNRI

Venlafaxine or fluvoxamine

17
Q

What is the third line pharmacological therapy for panic disorder?

A

MAOI- moclobemide or phenelzine

18
Q

What is the first line psychological therapy for social anxiety disorder?

A

Individualised CBT

Or CBT self help

19
Q

When may BZDs be used in anxiety?

A

Short term use in GAD crisis

20
Q

What ADRs must be considered for antidepressants in anxiety?

A

Anxiety

Suicidal thoughts

21
Q

What is the indication for propranolol in anxiety?

A

Used in physical symptoms

Good for situational stress

22
Q

When is buspirone used in anxiety? What is its MoA?

A

GAD

Partial agonist at 5-HT1

23
Q

Give examples of BZDs with a short half life.

A

Lorazepam

Oxazepam

24
Q

Give examples of BZDs with a long half life.

A

Diazepam

Clonazepam

25
Q

Which BZD is most appropriate for use in anxiety?

26
Q

Which BZDs are not used in anxiety? Why?

A

Lorazepam and clonazepam

Potency, increased risk of tolerance and dependence

27
Q

What major interaction must be considered with antidepressant used in anxiety?

A

Fluvoxamine and warfarin

28
Q

What are the withdrawal symptoms of BZDs?

A

Flu like symptoms
Agitation
Muscle weakness

29
Q

What are the dependence symptoms of BZDs?

A

Unsteadiness
Drowsiness
Speech disorder
Nystagmus

30
Q

Describe the site of action of anxiolytics.

A

Attention focussed on limbic system, particularly to hippocampus and amygdala
Bilateral destruction of amygdala results in calm and tranquil animal in some species
Studies suggest BZDs selectively impair discharges from amygdala and amygdalo-hippocampal transmission

31
Q

Describe the action of GABA receptors.

A

Ionotropic GABA is most prevalent receptor subtype and demonstrate ubiquitous distribution in the brain
Five subunits to form integral transmembrane ion channel
When open, channel predominantly conducts chloride ions causing hyperpolarisation
Two alpha subunits and two beta subunits, particular composition vaires among brain regions and species
Apart from binding site for GABA, receptor possesses sites of action for clinically important drugs

32
Q

Describe the mechanism of action of BZDs.

A

Binds to BZD site on GABA receptors, not GABA binding site
Increases affinity for GABA
Channel is more likely to open with BZD bound, increasing chloride flux and hyperpolarisation- inhibition
BZD potency limited by availability of GABA

33
Q

How does the action of anxiolytics differ between different GABA receptors?

A

BZDs with high activity at alpha 1 are associated with amnesia, sedation, ataxia
Those with greater activity at alpha 2/3 subunits show greater anxiolytic activity

Pharm Y3S2 (29 decks)

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