Depression, Anxiety, and Withdrawal Exam 2 Flashcards
what do neurotransmitters do
travel across the synapse and either block or facilitates relay of stimulus
- allow communication or stop communication
dopamine
attention, motivation, pleasure, reward
norepinephrine
alertness, energy
serotonin
obsession, compulsions
GABA
relaxation
What is GABA dysfunction associated with
anxiety disorders, especially panic disorders
Are people with depression more or less likely to have coronary artery disease
more likely
anticipatory anxiety
fearful expectation of panic anxiety onset
avoidance anxiety
personal strategies used to increase feeling of control and decrease the risk of panic anxiety
what is generalized anxiety disorder
chronic condition; anxiety for more than 6 months
excessive, uncontrolled, unrealistic worry
accompanied by muscle tension, autonomic. hyperactivity exaggerated startle difficulty concentrating
social anxiety disorder
intense fear of being criticized by others; persistent fear of humiliation
amygdala plays a role in fear response
obsessive compulsive disorder
repetitive unwanted thoughts/obsessions
repeated activities/rituals
Drugs to treat generalized anxiety disorder
antidepressants - SNRI and SSRI
buspirone
Benzos
PTSD drug treatment
SSRI and SNRI
Social anxiety drug treatment
therapy, SSRI, Benzos, propranolol (beta-blocker)
SSRI (selective serotonin reuptake inhibitor)
fluoxetine
MOA: inhibitors of serotonin at nerve endings, more serotonin is available at the nerve endings
-when we block reuptake allowing more serotonin to be at nerve endings to exert effects
-more serotonin in synapse the more serotonin available to exert
SE: serotonin syndrome (using two serotonin uptake drugs), withdrawal syndrome) (DO NOT STOP ABRUPTLY), suicidal risk, neonatal effect
SNRI (serotonin and norepinephrine reuptake inhibitors)
venlafaxine
MOA: blocks neuronal activity of serotonin and norepinephrine
- leaves more serotonin and norepinephrine in synapse to work
SE: sexual dysfunction, anorexia, insomnia, somnolence, withdrawal syndrome
tricyclic antidepressants
amitriptyline
MOA: block reuptake of 2 monoamine transmitters, norepinephrine & serotonin making it more available in the synapse
hot as a hare, dry as a bone, blind as a bat, red red as a beat, mad as hatter
SIGNIFICANT drug-drug interaction with MAOI
Monoamine Oxidase Inhibitors (MAOI)
phenelzine
refractory depression
MOA: inhibits MAO (monoamine oxidase)- enzyme found in the liver, intestinal wall, and terminals of neurons
- MAO converts norepi, 5-HT, and dopamine to inactive product
= DECREASED MAO INCREASES AVAILABILITY OF NEUROTRANSMITTERS AT THE NERVE ENDINGS
SE: food/drug interactions (aged cheese, smoked meats, yeast, red wine)(=HTN), drug-drug interactions, rapid increases in BP, stroke, coma
fluoxetine
SSRI
MOA: stops serotonin at nerve endings; more serotonin available to exert effects
venlafazine
SNRI
MOA: blocks neuronal activity of serotonin and norepinephrine
amitriptyline
tricyclic antidepressant
MOA: block reuptake of norepinephrine & serotonin making more available in the synapse
phenelzine
MAOI
MOA: inhibits MAO-enzyme, converts norepi, 5-HT, dopamine to inactive product
do not eat smoked meats and cheeses and wine with phenelzine
ketamine
can help with suicide and depression
SE: perceptual disturbances, dissociation
trazadone
blockade of 5-HT reuptake
used to help treat anxiety and insomnia
Benzodiazepines
pams and lams
MOA: enhance inhibitory effects of GABA (relaxation) in the CNS
FOR: generalized anxiety disorder and panic disorders
SE: CNS depression, withdrawal effects, memory loss, respiratory depression
Do not take with grapefruit
NO WITH PREGNANT
schedule 4 drug
alprazolam
anxiety and panic
benzo
MOA: enhance inhibitory effects of GABA in the CNS
no pregnant
SE: CNS depression, withdrawal effect, memory loss, respiratory depression
diazepam
benzo anxiety and panic enhances inhibitory effects of GABA in the CNS no while pregnant schedule 4
lorazepam
anxiety and panic
benzo
enhance inhibitory effects of GABA in the CNS
se; cns depression, withdrawal effects, memory loss, respiratory depression
no while pregnant
schedule 4
what is the antidote to benzos
flumazenil
dopamine is associated with…?
dopamine is associated with reward and good feeling
what cortex is addiction associated with
prefrontal cortex
methadone
reduces symptoms of withdrawal
synthetic opioid analgesic, mu-agonist
SE: lightheaded, hives, chest pain, tachycardia, hallucinations, confusion
methadone can be abused and people can become dependent on it
what does buprenorphine + naloxone = ?
Suboxone
-helps patients recover more quickly from addiction
when do symptoms start for opioid withdrawal
72 hours
what is peak for benzo withdrawal
2 weeks
what is peak for alcohol withdrawal
24-48 hours
