1
Q

What is anxiety?

A

β†’ extreme worry

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

When is anxiety normal?

A

β†’ When it is intermittent

β†’ when there is a particular source that triggers it

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

When is anxiety abnormal?

A

β†’ When it is chronic and irrational

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

What can anxiety cause?

A

β†’ Social disturbances
β†’ Avoidance behaviour
β†’ Incessant worry
β†’ Concentration/memory problems

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

What are the physiological symptoms of anxiety?

A
β†’ Tachycardia
β†’ Hyperventilation
β†’ Feeling dizzy
β†’ headaches
β†’ flushing
β†’ sweating
β†’ Nausea
β†’ insomnia
β†’ diarrhoea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the psychological symptoms of anxiety?

A

β†’ stress
β†’ worry
β†’ foreboding

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

What are the 6 causes of anxiety?

A
β†’ childhood experience
β†’ diet 
β†’ physical or mental health
β†’ everyday life and habits
β†’ drugs and medication
β†’ genetics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What medication can increase anxiety?

A

β†’ antimalarias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What foods increase anxiety?

A

β†’ high sugar and caffeine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is generalised anxiety disorder?

A

β†’ psychological and physiological with no real stimulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are 5 types of anxiety disorder?

A
β†’ specific phobias
β†’ social phobias
β†’ OCD
β†’ PTSD
β†’ panic disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are obsessions?

A

β†’ recurrent intrusive thoughts, images, ideas or compulsions

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

What are compulsions?

A

β†’ repetitive behaviors or mental acts performed to reduce anxiety associated with the obsessions

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

What is PTSD?

A

β†’ Re living unpleasant memories
β†’ flashbacks
β†’ nightmares

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

What is panic disorder?

A

β†’ An individual suffers from panic attacks with no apparent trigger

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

What receives the stress or fear stimulus?

A

β†’ The amygdala

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

describe how cortisol is released?

A

β†’ amygdala receives stress or fear stimulus
β†’ transmits information to the bed nucleus of the stria terminalis
β†’ which transmits the information to the HPA axis
β†’ it releases CRH which induces the release of ACTH and eventually cortisol

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

What are the 4 treatments for anxiety?

A

β†’ Benzodiazepines
β†’ 5-HT1A receptor agonists
β†’ beta adrenoceptor antagonists
β†’ antihistamines

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

What type of drugs are barbiturates?

A

β†’ positive allosteric modulators

20
Q

Where do benzodiazepines bind?

A

β†’ alpha gamma interface in the GABA receptor

21
Q

What is the usual binding site for GABA?

A

β†’ alpha beta interface

22
Q

What do benzodiazepines do to the GABA receptor?

A

β†’ they make it more stable
β†’ the binding site can’t close
β†’ the receptor is more receptive to GABA
β†’ more GABA can bind at lower concentrations

23
Q

What do barbiturates do to GABA?

A

β†’ they keep GABA receptors open for longer

24
Q

What receptors do benzodiazepines work on and why?

A

β†’ only 1,2,3, or 5

β†’ they have histidine

25
Q

What is used in benzodiazepine overdose?

A

β†’ Flumazenil

26
Q

How does the dose response curve change with benzodiazepines?

A

β†’ dose response curve shifts left

27
Q

What are 3 long acting benzodiazepams?

A

β†’ Clonazepam
β†’ Diazepam
β†’ Chlordiazepoxide

28
Q

What is a short acting benzodiazepam?

A

β†’ Midazolam

29
Q

What are 2 medium acting benzodiazepams?

A

β†’ Temazepam

β†’ Lorazepam

30
Q

Why are long acting benzodiazepams not given during the night?

A

β†’ it will make you drowsy during the day

β†’ unable to wake

31
Q

What does withdrawal of BZDs cause?

A

β†’ severe seizures

β†’ Sudden inhibition of inhibitory GABA

32
Q

What does the body do when given BZD?

A

β†’ upregulates the excitatory receptors

33
Q

What is the most commonly prescribed drug for GAD?

A

β†’ Buspirone

34
Q

Describe how buspirone works?

A

β†’ 5-HT1A autoreceptors presynaptically
β†’ when someone takes buspirone (5-HT1A agonist)
β†’ Desensitisation of auto 5-HT1A receptors
β†’ supra activation of 5-HT1A receptors
β†’ extreme inhibition of serotonin release
β†’ body downregulates the 5-HT1A receptors
β†’ less inhibition of serotonin release
β†’ enhanced release of serotonin

35
Q

Describe how SSRIs work?

A

β†’ SERT transporter gets blocked
β†’ lots of serotonin in the synapse
β†’ induces desensitisation of 5HT1A receptors
β†’ body downregulates the 5-HT1A receptors and the postsynaptic receptors

36
Q

Why is buspirone preferred over SSRI?

A

β†’ SSRIs decrease the post synaptic receptors as well as the pre synaptic ones

37
Q

What do adrenoceptor antagonists do?

A

β†’ reduce peripheral symptoms of anxiety

38
Q

What do anti-histamines do?

A

β†’ hypnotic and sedative effects

39
Q

What is GAD?

A

β†’ Characterised by an ongoing state of excessive anxiety lacking clear reason or focus
β†’ Excessive anxiety for at least 6 months

40
Q

What are panic attacks?

A

β†’ Sudden feelings of overwhelming fear with marked somatic symptoms

41
Q

What does continuous exposure to cortisol do in the brain?

A

β†’ Neuronal degeneration in the hippocampus

β†’ Decrease in hippocampal volume

42
Q

What are the 5 effects of barbiturates?

A

β†’ direct GABA A agonist
β†’ stabilises the open channel - glycine receptor
β†’ nACHR and 5-HT3 receptor blockade
β†’ AMPA/Kainate receptor blockade
β†’ Blockade of Ca2+ dependent neurotransmitter release

43
Q

What is the structure of a 5-HT1A receptor?

A

β†’ Venus flytrap domain
β†’ Cysteine rich domain
β†’ 7 TM domain
β†’ C terminal domain

44
Q

What is the function of beta 1 receptors?

A

β†’ Increases HR, contraction, ejection

β†’ Increases renin release

45
Q

Why do people develop tolerance to BDZ?

A

β†’ Increased glutamate receptor trafficking to the membrane