Anxiety and insomnia Flashcards
what is anxiety?
- It is a feeling of fear , worry and uneasiness
What are the three interrelating anxiety response system?
- Physical - fight/flight response
- Cognitive - when activated causes nervouness
- Behavioural - leads to aggression
what are the symptoms of behavioral, physical and cognitive anxiety?
- Behavioural - crying and screaming
- Cognitive - thoughts of monsters, lack of concentration
- Physical - increased heart rate, palpitations
Anxiety can occur even in the absence of danger. TRUE OR FLASE?
- TRUE
Fear occurs in the phae of danger and marked by strong escape tendecies. TREU OR FLASE?
TRUE
Panic is a group of physical symptoms of fight of flight. TRUE OR FLASE?
TRUE
What are the common causes of anxiety?
- Life circumstances
- Fight or fligh response (overactive)
- Brain biochemistry
- Personality
- Genetics
some drugd can cause symptoms of anxiety either from withdrawal or side effects. TRUE OR FLASE?
TRUE
A tunour of the adrenal gland can lead to anxiety. TRUE OR FLASE?
-TRUE
The primary neurotransimitter involved in anxiety disorder is GABA-ergic. TRUE OR FALSE?
TRUE
Serotonine and dopamine are related to anxiety. true or flase?
TRUE
The entire anxiety response system is contolled by interrelated to produce anxiety. true or false?
true
What are the different systems involved in anixety disorider?
- Hippocampus axis
- Lymbic system
- Brain stem
- Cortical and subcoritcal structures
- Velateral and frontal cortex
What is generalised anxiety
- Obessive compulsive disorder
- Panic disorder
- Phobias
- Acute stress reactions
- Post traumatic stress disorder
- Mixed anxiety and depressive disorder
- generalised anxiety - excessive anxiety
- Obessive compulsive disorder - ritual e.g fear of contamination
- Panic disorder - attack of fear
- Phobias - strong anxiety aganst e.g snakes
- Acute stress reactions - physical and physchologial stress
- Post traumatic stress disorder - anxiety caused by recall of past experience
- Mixed anxiety and depressive disorder - anxiety and depression
What are the different treatments for anxiety disorder?
- Psychological e.g relaxation
- Pharmacological e.g anxiolytics (Benzodiazepines), e.g antidepressants (SSRI’s) and antipsychotics e.g propranolol (B antagonist)
- Psychosurgery (extreme cases for example OCD)
What is cognitive behavoiral therapy?
- Teaches patients copying mechanism on how to deal with stressful situations
What is included in psychological therapy?
- Cognitive behavioral therapy
- Exercise
How does benzodiazapines work?
- They are anxiolytics
- They are selective agonist for the GABAa receptors
- They enhance the response of GABA by opening the GABA-activated chloride channels
- They block exitability
What are benzodiapines indicated for?
- Anxiety and depression
- Insomnia (seadtive abiltiites)
Benzodiazepije sare not analgesic or antychotic. TRUE OR FALSE?
TRUE
What are the ADRs of benzodiazipines?
- Causes respiratory stress
- Life threatning with other CNS depressants
- Drowsiness
- Tolerance and depedency
What are the cautions witn benzodiazapine?
- Avoid with alcohol
- Avoid liver disease
- avoid in pregneacy
What are benzodiazipnes drug interactions?
- CNS depressants
Give an example of a benzodiazepine?
- Lorazepam
What are the withdrawal symptoms of benzodiazepines?
- Insomnia, anxiety, vivid dreams
- Can be mistaken for reccurence of the disease
How should withdarwal occur with benzodiazepines?
- Gradual withdrawal
- First switch to longer acting benzo’s
- Takes years
What is the antidote for benzo’s?
- Romazicon - has a shorter half life than benzo’s
Buspirone is an anxiolytic. TRUE ORFLASE?
TRUE
How does Buspirone work?
- It is a partial 5HTa1 agonist
- It inhibits 5HT release
- which has delayed anxiolytic effects
Buspirone undergoes first pass metabolism. true or flase?
- true
what are the ADRs of Buspirone?
- Nausea, dizziness, restlessness
Why does Buspirone have better ADRs benzodiazepines?
- Does not cause drwosiness
- No sedation
- No withdrawal effects
What is insomnia?
- Insomnia is the perception of having indequate amount of sleep that leads to distress or impaired function
Anxiety and insomnia come together. TRUE OR FLASE?
TRUE
You are considered to be insomniac if it takes you ore thn 30 to 45 minutes to sleep. TRUE OR FLASE?
TRUE
What are the different types of insomnias?
- transient - caused due to excitement
- Short term - caused due to stress at home or work
- Chronic - ongoing sleeplessness causeddue to anxiety or medications
What are the causes of insomnia?
- Napping during the day
- caffeine and CNS depressants
- Medical conditions
- changes in sleeping pattern
what are the treatments for insomniac?
- Cogntive behavoiral therapy
- Drug therapy
- ALternative treatments
What is the aim of cognitive behavoiral therapy?
- The aim is to enhace the stimuli between sleep and bed, bedtime and bedroom surroundings
CBT is not effective when insomnia is correlated with other psychological disorders. TRUE OR FALSE?
TRUE
What is the mechnism of action of Z drug (drug therapy for insomnia?
- Binds to GABAz causing an incresae CL- influx
Z drugs are chemically unrelated to benzo’s true or flase?
TRUE
Benzo’s can be used for the treatment of insomnia. true or flase/
true
Provide an example of a Z drug?
zoldipem
Z drugs have a rapid onset of action. TRUE OR FLASE?
TRUE
What are the ADRs of Z drugs?
- they cause drowsiness, headaches, dizziness
Where is melatonin produced and what does it promote?
- In the peneal gland in the brain
- it promotes sleep
Antihistamines (H1 antagonists) are normally used to treat allergies but they have common sedation side effects. true or false?
true
Give an example of a antihistamine drug?
- Diphenhydrramine
Some antidepressants have sedative effects. TRUE OR FLASE?
TRUE
Antidepressants improve the quality of sleep unlike benzo’s that decrease it. TRUE OR FALSE?
TRUE
What is an exmple of antidepressant for the treatmentof insomnia?
- Serotonine antagonists and reuptake inhibitors
Give an example of a tricyclic antidepressant?
- Doxepin
What is hypnotherapy aimed to do?
- Uses the mind to breakdown bad habbits or coping with stress
