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BB CC > Anxiety > Flashcards

Anxiety Flashcards

1
Q

Suprachiasmatic nucleus

A

Hypothalamus
Controls 24h circadian rhythm
Neurones here increase activity during the light phase, and decrease it during the night phase

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2
Q

Melatonin

A

Increased during dark (sleep) phase

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3
Q

Wakefulness

A 
Cholinergic system (pedunculopontine and laterodorsal tegmental nuclei)
Monoaminergic projections (locus coeruleus, raphe nuclei, tuberomammillary nucleus)
Dopamine
Noradrenaline
Serotonin
Histamine
ACh
Orexin
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4
Q

Sleep

A

GABA and galanin neurones (ventrolateral preoptic nucleus)
Melatonin
Adenosine

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5
Q

Sleep cycles

A

Each cycle lasts approx. 90 mins

Cycles not identical in ratio NREM/REM sleep

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6
Q

REM

A

rapid eye movement phase

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7
Q

NREM

A

non-rapid eye movement phase

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8
Q

SWS

A

slow wave sleep (NREM-3 and 4)

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9
Q

How to assess sleep stages

A

Polysomnography

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10
Q

Normal wakefulness EEG

A

Beta waves

13-30 Hz

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11
Q

Awake + relaxed EEG

A

Alpha waves

8-12Hz

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12
Q

Stage 1 NREM EEG

A

Theta waves

3.5-7.5Hz

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13
Q

Stage 2 NREM EEG

A

Theta waves with sleep spindles and K complex

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14
Q

Stage 3 + 4 NREM EEG

A

Delta waves
Less than 3.5Hz
Stage 3- less than 50%
Stage 4- more than 50%

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15
Q

Types of Insomnia

A

Transient- jet lag
Short-term- bereavement, stress
Chronic- 3 weeks +

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16
Q

Ideal drug for insomnia

A

Benzodiazepines (short-acting)

Z drugs

17
Q

Short term use Insomnia

A

Lorazepam

Temazepam

18
Q

Long term use Insomnia

A

Eszopiclone

Extended release Zolpidem

19
Q

Benzodiazepines SE

A 
Change in sleep patterns
Daytime sedation
Rebound insomnia
Tolerance
Dependence
20
Q

Orexin system

A

Orexin (hypocretin)= peptide produced in hypothalamus
Orexin A
Orexin B
Effects mediated by Orexin 1 + 2 receptors
Regulates arousal, appetite, wakefulness

21
Q

Orexin deficiency

A

Narcolepsy- excessive sleepiness, increased frequency of falling asleep in daytime

22
Q

Suvorexant

A

Dual orexin receptor antagonist

Used to treat insomnia

23
Q

Types of anxiety disorders

A 
Panic disorder
Agoraphobia
Social phobia
Simple phobia
Obsessive compulsive disorder
Post-traumatic stress disorder
Generalised anxiety disorder
24
Q

Structures involved in anxiety

A 
Amygdala
Insula
Anterior cingulate
Prefrontal cortex
Thalamus
HPA axis abnormalities
Monoaminergic systems
GABAergic systems
25
Q

Genetics + anxiety

A

5HT transmission involved in genetic risk for anxiety disorders

26
Q

Genes + panic disorder

A 
COMT
CCK
CCKb receptor
Adenosine A2 receptor
MAOa
5HT2 receptor
27
Q

KF1

A

If don’t have it, increased fear/anxiety

28
Q

Benzodiazepines

A

Clonazepam

Lorazepam

29
Q

5HT1a agonists

A

Buspirone

Ipsapirone

30
Q

SSRIs

A

Fluoxetine

Escitalopram

31
Q

SNRIs

A

Venlafaxine

Duloxetine

32
Q

Beta adrenoreceptor antagonists

A

Propanolol

33
Q

Barbiturates problems

A 
Drug dependence
Tolerance
Induction liver microsomal enzymes
Fatal toxicity in overdose- resp. depression
Speech drowsiness
Withdrawal syndrome
34
Q

Benzodiazepine MOA

A

GABAa receptor
Positive allosteric modulators
Potentiates GABA-induced hyperpolarisation

35
Q

Flumazenil

A

Antagonist of benzodiazepines
Used in benzodiazepine overdose
Short half life

36
Q

Generalised anxiety disorder treatment

A

Buspirone
Venlafaxine, duloxetine (SNRI)
Fluoxetine, escitalopram (SSRI)
Risperidone, quetiapine, olanzapine (APD)

37
Q

Benzodiazepine complications in elderly

A 
Psychomotor impairment
Risk of falls
Daytime drowsiness
Intoxication
Amnesia
Depression
38
Q

Z drug targets

A

Alpha subunits of GABAa receptors
Zaleplon + zolpidem bind to alpha 1 subunit- hypnotic role
Alpha 3 subunit- linked to anxiolytic effects

BB CC (29 decks)

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