Anxiety Disorders

Question 1

Which parts of the brain are important in anxiety disorders?

Answer 1

Amygdala

Hippocampus

Question 2

What are listed as Anxiety Disorders in ICD10?

Answer 2

agoraphobia
social phobia
specific phobia

panic disorder
generalised anxiety disorder
mixed anxiety and depressive disorder

ocd
ptsd

Question 3

How does Cognitive-Behavioural Therapy work?

Answer 3

change the way you think/behave

in relation to negative emotions and past experiences

Question 4

What medication is used in Anxiety Disorders?

Answer 4

antidepressants (serotonergic)
Benzodiazepines

Buspirone
TCAs
MAOIs
Pregabalin
Beta blockers

Question 5

Medication for Generalized Anxiety Disorder

Answer 5

first-line is SSRIs
or SNRI
if not tolerated, consider Pregabalin

Question 6

Benzodiazepine anxiolytics (4)

Answer 6

diazepam
alprazolam
chlordiazepoxide hydrochloride
clobazam

Question 7

Why is Benzodiazepine used for short durations?

Answer 7

severe, disabling, unacceptable distress
associated with insomnia
associated with short-term psychosomatic, organic or
pyschotic illness

Question 8

What is Busipirone?

Answer 8

5-HT1A agonist

treat general anxiety disorders

Question 9

Adverse effects of Busipirone, and contraindication

Answer 9

dizziness
nausea
headache

contraindication in epilepsy

Question 10

What are short-acting hypnotics used for?

Answer 10

sleep onset insomnia

elderly patients

Question 11

What are long-acting hypnotics used for?

Answer 11

considered for poor sleep maintenance with daytime effects

Question 12

Transient Insomnia, and relevant drug

Answer 12

caused by extraneous factors
use rapidly eliminated hypnotic drug
only 1-2 doses if needed

Question 13

Short-term Insomnia, and relevant drug

Answer 13

due to emotional problem or serious medical illness

hypnotic may be useful

Question 14

Chronic Insomnia, and treatment

Answer 14

persistent sleep disturbance

treat underlying psychiatric condition

Question 15

Which benzodiazepines have prolonged actions?

Answer 15

Nitrazepam

Flurazepam

Question 16

Which benzodiazepines have shorter action?

Answer 16

Loprazolam
Lormetazepam
Temazepam

Question 17

Z-Hypnotic function and examples

Answer 17

Zolpidem
Zopiclone

act at benzodiazepine receptor a1 subunit

Question 18

Z-Hypnotic adverse effects

Answer 18

may cause dependence
daytime sedation
ataxia

not appropriate for elderly patients

Question 19

Benzodiazepine mechanism of action

Answer 19

binding of GABAA receptors, increase affinity
increase Cl- channel opening, Cl- influx
hyperpolarises membrane, dampen neuron activity

Question 20

When is IV benzodiazepine used?

Answer 20

acute seizures

Question 21

Use of Midazolam

Answer 21

surgical sedative

hypnotic

Question 22

Use of Temazepam and Lorazepam

Answer 22

hypnotic

anxiolytic

Question 23

Use of Nitrazepam

Answer 23

anxiolytic

Question 24

Use of Chlordiazepoxide, Diazepam

Answer 24

anxiolytic
muscle relaxant
anticonvulsant (Diazepam)

Question 25

Adverse effects of Benzodiazepine

Answer 25

drowsiness
confusion
amnesia
may impair coordination, motor skills

Question 26

Overdose effects of Benzodiazepine may be reversed by what?

Answer 26

flumazenil

Question 27

What can be caused if Benzodiazepines are mixed with CNS depressants

Answer 27

severe respiratory depression