Anxiety Disorders Flashcards
Which parts of the brain are important in anxiety disorders?
Amygdala
Hippocampus
What are listed as Anxiety Disorders in ICD10?
agoraphobia
social phobia
specific phobia
panic disorder
generalised anxiety disorder
mixed anxiety and depressive disorder
ocd
ptsd
How does Cognitive-Behavioural Therapy work?
change the way you think/behave
in relation to negative emotions and past experiences
What medication is used in Anxiety Disorders?
antidepressants (serotonergic)
Benzodiazepines
Buspirone TCAs MAOIs Pregabalin Beta blockers
Medication for Generalized Anxiety Disorder
first-line is SSRIs
or SNRI
if not tolerated, consider Pregabalin
Benzodiazepine anxiolytics (4)
diazepam
alprazolam
chlordiazepoxide hydrochloride
clobazam
Why is Benzodiazepine used for short durations?
severe, disabling, unacceptable distress
associated with insomnia
associated with short-term psychosomatic, organic or
pyschotic illness
What is Busipirone?
5-HT1A agonist
treat general anxiety disorders
Adverse effects of Busipirone, and contraindication
dizziness
nausea
headache
contraindication in epilepsy
What are short-acting hypnotics used for?
sleep onset insomnia
elderly patients
What are long-acting hypnotics used for?
considered for poor sleep maintenance with daytime effects
Transient Insomnia, and relevant drug
caused by extraneous factors
use rapidly eliminated hypnotic drug
only 1-2 doses if needed
Short-term Insomnia, and relevant drug
due to emotional problem or serious medical illness
hypnotic may be useful
Chronic Insomnia, and treatment
persistent sleep disturbance
treat underlying psychiatric condition
Which benzodiazepines have prolonged actions?
Nitrazepam
Flurazepam
Which benzodiazepines have shorter action?
Loprazolam
Lormetazepam
Temazepam
Z-Hypnotic function and examples
Zolpidem
Zopiclone
act at benzodiazepine receptor a1 subunit
Z-Hypnotic adverse effects
may cause dependence
daytime sedation
ataxia
not appropriate for elderly patients
Benzodiazepine mechanism of action
binding of GABAA receptors, increase affinity
increase Cl- channel opening, Cl- influx
hyperpolarises membrane, dampen neuron activity
When is IV benzodiazepine used?
acute seizures
Use of Midazolam
surgical sedative
hypnotic
Use of Temazepam and Lorazepam
hypnotic
anxiolytic
Use of Nitrazepam
anxiolytic
Use of Chlordiazepoxide, Diazepam
anxiolytic
muscle relaxant
anticonvulsant (Diazepam)
Adverse effects of Benzodiazepine
drowsiness
confusion
amnesia
may impair coordination, motor skills
Overdose effects of Benzodiazepine may be reversed by what?
flumazenil
What can be caused if Benzodiazepines are mixed with CNS depressants
severe respiratory depression
