B3. Anxiety disorders Part III

Question 1

How would you manage GAD?

Answer 1

Pharmacological management

Relieve the symptoms

Non-pharmacological

Prevent relapse

Improve QoL

Question 2

Give examples of non-pharmacological treatment for GAD ?

Answer 2

Self help

Medication and relaxation techniques- mindfullness

Exercise

Lifestyle changed

Question 3

What is the objectives of CBT ?

Answer 3

Stop the cycle of negative thinking that influences emotion and behaviour .

Look at situations that the patient sees as negative but help them see it in a more positive light

FEELING
THOUGHTS
BEHAVIOUR

Question 4

GIVE examples of pharmacological management

Answer 4

SSRI: sertraline

SNRI: duloxetine

Antiepileptic agent: Pregabalin

Benzodiazepines

Question 5

What are benzodiazepines used for ?

Answer 5

Muscle relaxation

Insomnia

Pre-medication

Epilepsy

Alcohol withdrawal

Anxiety

Question 6

What are the classifications of benzodiazepines ?

Answer 6

Short acting
Short-intermediate
Long acting

Question 7

What receptors do benzodiazepines bind to ?

Answer 7

GABA- inhibitory neurotransmitter in the CNS

Question 8

What is the mechanism of action of benzodiazepine ?

Answer 8

BDZ binds to the GABA receptor between the alpha and gamma)

Conformational change occurs which allows the binding of GABA

Conformational change in GABA receptor chloride channel

Greater flow of chloride (cl-) ions into the neurones

hyperpolarisation= inhibition