Anxiety and depression Flashcards

1
Q

Name some common anxiety disorders

A

generalised anxiety disorder
post traumatic stress disorder
phobias
obsessive compulsive disorder OCD

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2
Q

Describe the symptoms of anxiety

A

palpitations, tachycardia, SOB, dizzieness, sweating, tremor, panic

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3
Q

name some non pharmalogical treatments of anxiety

A

CBT, meditation, mindfullness, relaxation techniques

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4
Q

Which main 2 pharmacological approach is used to treat anxiety

A

beta blockers - propanol

benzodiazepine

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5
Q

what must you be careful of if you take this regularly

A

stopping immediately - has a rebound effect

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6
Q

Name 7 effects of valium

A
sedative
anticonvulsive 
hypnotic 
muscle relaxant 
decreases aggresion 
anxiolytic 
amnesic
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7
Q

Valium

  1. DWT?
  2. SEs?
  3. be careful when prescribing to ?
  4. two other positives
A
  1. dependance, withdrawal, tolerance, therefor abuse potential
  2. can cause aggression rarely (paradoxical seizures)
  3. elderly people
  4. safe in overdose and doesnt have any drug interactions
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8
Q

What would you prescribe benzodiazepine with a short half life for and one with a long half life for

A

short - hypnotics

long - anti anxiety

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9
Q

How do benzodiazepines work?

A

increase GABA receptor affinity for Cl- hyperpolerisation of neurones

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10
Q
  1. Two more drugs that can be used to treat anxiety?

2. -ve to using one of them

A

buspirone and SSRis

takes a long time to work

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11
Q

What must you have to diagnose depression

A
Must include 
1. depressed mood
2. loss of interest 
and 3 from.. 
weight change, altered sleep, agitation, fatigue, suicidal thoughts, worthless feeling, cant concentrate
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12
Q

how do you treat bipolar + mechanism

A

lithium salts - inhib Glycogen synthase kinase 3

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13
Q

genetics vs environment in depression?

A

sever depression mostly genetics

mild depression mostly environment

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14
Q

Describe the 3 theries of depression

A
  1. amine dysfunction - reduced NA/5ht (or receptor down reg)
    althered dopamine function - reward pathways?
  2. HPA axis dysfunction - to much cortisol
  3. neurotropic and neuroplasticity hypothesis - physical changes in cortical areas
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15
Q

What evidence leads us to believe HPA theory of depression

A

insensitivity to DEX (usually suppresses cortisol)

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16
Q

Name 3 non pharamological treatments to depression

A

CBT, Electroconvulsive shock treatment , St johns wort

17
Q

TCAs - mechanisms

A

block amine reuptake
H2 antag (sedative SE)
M antag (CV SE)
block amine reuptake peripheraly (CV SE)

18
Q

what are ipronizid, phenelzine, tranylcypromine, moclobemide?

A

MAOi’s

19
Q

Problems with MAOis

A

initial euphoria, slow onset, some Muscarinic SE, insomnia, weight gain and liver damage

20
Q

What interaction must you be careful of if taking a MAOi

A

cheese reaction - tyramine is usually broken down by MAO - if not can get into head and cause increased dopamine = hypertension

21
Q

Side effects to SSRIs

A

neausea, loss of libido, akathisia (restless) agitation

22
Q

what does akathisia mean

A

restless

23
Q

Why do all antidepressants take so long to work

A

10/20 days. autoreceptors turn down the amount of amines released - decrease APs and block further release of NT

24
Q

SSRI SNRI NaSSA NARI mean?

A

selective seritonin reuptake inhibitor
seratonin and noradrenaline reuptake inhibitor
Noradrenergic and specific serotinergic
noradrenaline reuptake inhibitor

25
Q

Benefits of using a selective

  1. 5HT2 antag
  2. 5HT1 antag
A
  1. less sexual side effects

2. less nausea