Anxiety and insomnia

Question 1

what is anxiety?

Answer 1

• It is a feeling of fear , worry and uneasiness

Question 2

What are the three interrelating anxiety response system?

Answer 2

• Physical - fight/flight response
• Cognitive - when activated causes nervouness
• Behavioural - leads to aggression

Question 3

what are the symptoms of behavioral, physical and cognitive anxiety?

Answer 3

• Behavioural - crying and screaming
• Cognitive - thoughts of monsters, lack of concentration
• Physical - increased heart rate, palpitations

Question 4

Anxiety can occur even in the absence of danger. TRUE OR FLASE?

Answer 4

• TRUE

Question 5

Fear occurs in the phae of danger and marked by strong escape tendecies. TREU OR FLASE?

Answer 5

TRUE

Question 6

Panic is a group of physical symptoms of fight of flight. TRUE OR FLASE?

Answer 6

TRUE

Question 7

What are the common causes of anxiety?

Answer 7

• Life circumstances
• Fight or fligh response (overactive)
• Brain biochemistry
• Personality
• Genetics

Question 8

some drugd can cause symptoms of anxiety either from withdrawal or side effects. TRUE OR FLASE?

Answer 8

TRUE

Question 9

A tunour of the adrenal gland can lead to anxiety. TRUE OR FLASE?

Answer 9

-TRUE

Question 10

The primary neurotransimitter involved in anxiety disorder is GABA-ergic. TRUE OR FALSE?

Answer 10

TRUE

Question 11

Serotonine and dopamine are related to anxiety. true or flase?

Answer 11

TRUE

Question 12

The entire anxiety response system is contolled by interrelated to produce anxiety. true or false?

Answer 12

true

Question 13

What are the different systems involved in anixety disorider?

Answer 13

• Hippocampus axis
• Lymbic system
• Brain stem
• Cortical and subcoritcal structures
• Velateral and frontal cortex

Question 14

What is generalised anxiety

• Obessive compulsive disorder
• Panic disorder
• Phobias
• Acute stress reactions
• Post traumatic stress disorder
• Mixed anxiety and depressive disorder

Answer 14

• 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

Question 15

What are the different treatments for anxiety disorder?

Answer 15

• 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)

Question 16

What is cognitive behavoiral therapy?

Answer 16

• Teaches patients copying mechanism on how to deal with stressful situations

Question 17

What is included in psychological therapy?

Answer 17

• Cognitive behavioral therapy

- Exercise

Question 18

How does benzodiazapines work?

Answer 18

• 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

Question 19

What are benzodiapines indicated for?

Answer 19

• Anxiety and depression

- Insomnia (seadtive abiltiites)

Question 20

Benzodiazepije sare not analgesic or antychotic. TRUE OR FALSE?

Answer 20

TRUE

Question 21

What are the ADRs of benzodiazipines?

Answer 21

• Causes respiratory stress
• Life threatning with other CNS depressants
• Drowsiness
• Tolerance and depedency

Question 22

What are the cautions witn benzodiazapine?

Answer 22

• Avoid with alcohol
• Avoid liver disease
• avoid in pregneacy

Question 23

What are benzodiazipnes drug interactions?

Answer 23

• CNS depressants

Question 24

Give an example of a benzodiazepine?

Answer 24

• Lorazepam

Question 25

What are the withdrawal symptoms of benzodiazepines?

Answer 25

- Insomnia, anxiety, vivid dreams | - Can be mistaken for reccurence of the disease

Question 26

How should withdarwal occur with benzodiazepines?

Answer 26

- Gradual withdrawal - First switch to longer acting benzo's - Takes years

Question 27

What is the antidote for benzo's?

Answer 27

- Romazicon - has a shorter half life than benzo's

Question 28

Buspirone is an anxiolytic. TRUE ORFLASE?

Answer 28

TRUE

Question 29

How does Buspirone work?

Answer 29

- It is a partial 5HTa1 agonist - It inhibits 5HT release - which has delayed anxiolytic effects

Question 30

Buspirone undergoes first pass metabolism. true or flase?

Answer 30

- true

Question 31

what are the ADRs of Buspirone?

Answer 31

- Nausea, dizziness, restlessness

Question 32

Why does Buspirone have better ADRs benzodiazepines?

Answer 32

- Does not cause drwosiness - No sedation - No withdrawal effects

Question 33

What is insomnia?

Answer 33

- Insomnia is the perception of having indequate amount of sleep that leads to distress or impaired function

Question 34

Anxiety and insomnia come together. TRUE OR FLASE?

Answer 34

TRUE

Question 35

You are considered to be insomniac if it takes you ore thn 30 to 45 minutes to sleep. TRUE OR FLASE?

Answer 35

TRUE

Question 36

What are the different types of insomnias?

Answer 36

- transient - caused due to excitement - Short term - caused due to stress at home or work - Chronic - ongoing sleeplessness causeddue to anxiety or medications

Question 37

What are the causes of insomnia?

Answer 37

- Napping during the day - caffeine and CNS depressants - Medical conditions - changes in sleeping pattern

Question 38

what are the treatments for insomniac?

Answer 38

- Cogntive behavoiral therapy - Drug therapy - ALternative treatments

Question 39

What is the aim of cognitive behavoiral therapy?

Answer 39

- The aim is to enhace the stimuli between sleep and bed, bedtime and bedroom surroundings

Question 40

CBT is not effective when insomnia is correlated with other psychological disorders. TRUE OR FALSE?

Answer 40

TRUE

Question 41

What is the mechnism of action of Z drug (drug therapy for insomnia?

Answer 41

- Binds to GABAz causing an incresae CL- influx

Question 42

Z drugs are chemically unrelated to benzo's true or flase?

Answer 42

TRUE

Question 43

Benzo's can be used for the treatment of insomnia. true or flase/

Answer 43

true

Question 44

Provide an example of a Z drug?

Answer 44

zoldipem

Question 45

Z drugs have a rapid onset of action. TRUE OR FLASE?

Answer 45

TRUE

Question 46

What are the ADRs of Z drugs?

Answer 46

- they cause drowsiness, headaches, dizziness

Question 47

Where is melatonin produced and what does it promote?

Answer 47

- In the peneal gland in the brain | - it promotes sleep

Question 48

Antihistamines (H1 antagonists) are normally used to treat allergies but they have common sedation side effects. true or false?

Answer 48

true

Question 49

Give an example of a antihistamine drug?

Answer 49

- Diphenhydrramine

Question 50

Some antidepressants have sedative effects. TRUE OR FLASE?

Answer 50

TRUE

Question 51

Antidepressants improve the quality of sleep unlike benzo's that decrease it. TRUE OR FALSE?

Answer 51

TRUE

Question 52

What is an exmple of antidepressant for the treatmentof insomnia?

Answer 52

- Serotonine antagonists and reuptake inhibitors

Question 53

Give an example of a tricyclic antidepressant?

Answer 53

- Doxepin

Question 54

What is hypnotherapy aimed to do?

Answer 54

- Uses the mind to breakdown bad habbits or coping with stress