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NUR 325 > E3 Depression, Anxiety, Addiction > Flashcards

E3 Depression, Anxiety, Addiction Flashcards

1
Q

Dopamine

A

-Attention
-Motivation
-Pleasure
-Reward
-Focus
-Energy/motivation
-Learning
-Antianxiety

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2
Q

Norepinephrine

A

-Alertness
-Energy

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3
Q

Serotonin (5HT)

A

-Obsessions
-Compulsions
-Happiness
-Sleep

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4
Q

GABA

A

Relaxation

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5
Q

Dopamine deficit

A

Parkinson-like symptoms
-Slow reaction time
-Anergia (abnormal lack of energy)
-Anhedonia “please center” dysfuntion

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6
Q

Serotonin deficit

A

OCD-like symptoms
-Obsessive thoughts
-compulsive behavior
-Impulsivity
-Suicide
-Aggression
-Susceptibility to “cue triggers”

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7
Q

GABA dysfunction is associated with

A

anxiety disorders especially panic disorders

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8
Q

High levels of Norepinephrine associated with

A

Anxiety, stress, hyperactivity

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9
Q

Low levels of Norepinephrine associated with

A

Lack of energy, focus, motivation

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10
Q

Depression is most common in

A

Unmarried Caucasian Women

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11
Q

Those with depression have a 64% greater risk of developing

A

coronary artery disease

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12
Q

Diagnosis of Depression requires

A

the presence of multiple symptoms that are intense enough to cause distress and to persistently impair psychosocial functioning

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13
Q

Depressive symptoms

A

-Loss of interest or pleasure
-Fatigue
-Restlessness, irritability
-Impaired concentration
-Low self-esteem
-Negative thinking
-Sleep disturbances
-Appetite disturbances

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14
Q

Depression treatment

A

-Medications (weeks to see results)
-Psychotherapy: talk therapy
-Cognitive behavioral therapy
-Pyschoeducation & support groups
-Brain stimulation therapy (last resort)

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15
Q

Panic disorder is characterized by two important psychological symptoms :

A

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

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16
Q

Overwhelming stress can induce circulating stress hormones which stimulate ______

A

glutamate

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17
Q

What is panic?

A

-Unexpected episodes
-Out of proportion to events going on around patient

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18
Q

What is Panic attacks?

A

Recurrent uncomfortable episodes with sudden onset with symptoms
-Heart palpitations
-Chest pain
-SOA/smothering
-Dizziness
-Nausea
-Fear of losing control
-Tingling in hands
-Flushing or chills
-VS change

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19
Q

Treatment of Panic disorders

A

-Cognitive behavioral therapy: reduce fearful thinking & cognitive/ physical stress response
-Anti-depressants: SSRI, SNRI, TCA, MAO inhibitors
-Benzodiazepines (for panic attack)

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20
Q

What is generalized anxiety disorder?

A

-Chronic condition
-Anxiety >6 months
-Excessive, uncontrolled, unrealistic worry
-Accompanied by muscle tension, autonomic hyperactivity, exaggerated startle, difficulty concentrating

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21
Q

Risk factors for generalized anxiety disorder?

A
  1. Excessive use of certain substances
  2. Childhood abuse or family trauma
  3. Genetics (fam hx)
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22
Q

Treatment of generalized anxiety disorder?

A

-Cognitive behavioral therapy
-Antidepressants: SNRIs & SSRIs
-Buspirone
-Benzodiazapines

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23
Q

What are the 3 core symptoms of PTSD?

A
  1. Hyper-arousal
  2. Avoidance of reminders
  3. Re-experiencing the events
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24
Q

What is PTSD?

A

Chronic activation of the stress response in relation to exposure to potentially life-threatening event

25
Q

PTSD is characterized by

A

vivid flashbacks, nightmares, emotional blunting, irritability, exaggerated startle

memory, sleep, and depression probs very common

26
Q

What are the top 4 causes of PTSD in men and women?

A

Men: Rape, combat exposure, childhood neglect, childhood physical abuse

Women: Rape, sexual molestation, physical attack, being threatened with a weapon

27
Q

PTSD treament

A

-Psychotherapy: trauma focused, exposure therapy, Cognitive behavioral therapy
-EMDR: eye movement desensitization and reprocessing
-SSRIs (Paroxetine & sertraline)
-SNRIs (venlafaxine)

28
Q

Social anxiety disorder

A

-Intense fear of being criticized by others
-Persistent fear of humiliation
-Withdrawn

29
Q

What is the causes of social anxiety disorder?

A

-Inherited traits
-Brain structure: amygdala plays role in the fear response
-Environment: learned behavior

30
Q

Treatment of Social anxiety

A

-Cognitive behavioral therapy
-SSRI (paroxetine & sertraline)
-Benzos
-Propranolol: 1-2 hour before activity (B-blocker to slow down anxiety before activity)

31
Q

Obsessive compulsive disorder

A

-Repetitive unwanted thoughts/ obsessions
-Repeated activities/ rituals
-Time consuming, may be distressing to individual, friends, family members

32
Q

OCD treatment

A

VERY difficult to treat
-SSRI: Fluxetine, fluvoxamine. sertraline, paroxetine, citalopram, escitalopram
-Clomipramine: TCA (second line)
-Deep brain stimulation
-EMDR
-Transcranial magnetic stimulation

33
Q

Addiction is a _____

A

disease

34
Q

Rewarding effects of drugs come from large and rapid upsurges of ______

A

dopamine
-Mimics regular pleasure response but greatly exceeds it

35
Q

Addiction is associated with deficits in the _______

A

prefrontal cortex

36
Q

What factors increase risk of substance use disorder?

A
  1. Aggressive behavior in childhood
  2. Lack of parental supervision
  3. Poor social skills
  4. Drug experimentation
  5. Availability of drugs at schools
37
Q

What factors decrease risk of substance used disorder?

A
  1. Good self control
  2. Parental monitoring & support
  3. Positive relationships
  4. Good grades
  5. School ani-drug policies
38
Q

Treatment of substance use disorder

A

-No single treatment is appropriate for everyone
-Therapy is crucial
-Cognitive behavioral therapy
-Contingency management: positive reinforcement
-Motivation enhancement therapy
-Family therapy
-12-step facilitation programs
-Treatment must address the whole person

39
Q

Treatment programs test patients for presence of other diseases associated with substance use disorder: (4)

A
  1. HIV/AIDS
  2. Hepatitis B & C
  3. Tuberculosis
  4. Endocarditis (bacteria in blood stream gets lodged in heart valves)
40
Q

Methadone MOA

A

Synthetic opioid analgesics, mu-agonist

41
Q

Methadone side effects

A

-Light headed
-Hives
-Chest pain
-Tachycardia
-Hallucinations
-Confusion

42
Q

Abuse potential of methadone?

A

Pts can be addicted to methadone and it can be abused, but the potential is much lower
-Traditionally pts get their methadone once a day from a ‘methadone clinic’

43
Q

MOA of Buprenorphine & Naloxone

A

Buprenorphine: partial opioid agonist (helps block receptors to prevent craving)

Naloxone: Opioid antagonist, block opioid receptors

44
Q

Buprenorphine & Naloxone Side effects

A

-Headache
-Opioid withdrawal symptoms, anxiety, insomnia, sweating, depression, constipation, nausea

45
Q

Abuse potential of Buprenorphine & Naloxone

A

Still has the potential for abuse, but less than methadone and buprenorphine alone

46
Q

Buprenorphine & Naloxone is available

A

sublingual and buccal
(works very quickly)

47
Q

Opioid withdrawal begins ______ following last dose. Peaks at _______ and Last _____

A

12-24 hrs
72 hrs
5-10 days

48
Q

S/S of opioid withdrawal

A

-Flu-like symptoms
-N/V/D
-Stomach cramping
-Goosebumps
-Depression
-Drug cravings
-Anxiety
-Sweating
-Muscle aches
-Fever

49
Q

Treatment of opioid withdrawal?

A

Supportive (Tylenol or antidiarrheals)

Buprenorphine & Naloxone

50
Q

Benzos & Alcohol both act on _______, therefore the withdrawal symptoms are treated the same

A

GABA receptors

51
Q

Both alcohol and benzo withdrawal have dangerous symptoms that can _____

A

lead to death

52
Q

S/S of Alcohol and Benzo withdrawal

A

-Sleep disturbances
-Dry retching
-Irritability
-Nausea
-Increased tension
-Wt loss
-Anxiety
-Palpitations
-Panic attacks
-Headache
-Sweating
-Muscle aches
-Difficulty concentrating
-Perceptual changes

53
Q

What are the dangerous symptoms of Benzo & Alcohol withdrawal?

A

-Seizures
-Hallucinations
-Delirium tremens
-Wernicke’s Encephalopathy

54
Q

What is Wernickes encephalopathy?

A
  1. Encephalopathy: profound disorientation, indifference, inattention
  2. Oculmotor dysfunction (nystagmus, lateral rectus palsy, conjugate gaze palsy)
  3. Gait ataxia
55
Q

What is delirium tremens?

A

-Hallucinations
-Disorientation
-Tachycardia
-Hypertension
-Fever
-Agitation
-Diaphoresis

56
Q

Benzodiazepine onset, peak, duration

A

Onset: 6-12 hrs

Peak: Around 2 weeks

Duration: Months to a year

57
Q

Alcohol withdrawal timeline

A

Stage 1: 8 hrs, Anxiety, Insomnia, Nausea, Abdominal pain
Stage 2: 1-3 days: High BP & Temp
Stage 3: 1 wk, Hallucinations, fever, seizure, agitation

58
Q

Alcohol and Benzo withdrawal treatment

A

Benzodiazepine taper
-helps prevent seizures & DT severity

59
Q

Those with alcohol withdrawal also requires _____

A

Vitamin supplementation especially Vit B1 (thiamine)

NUR 325 (21 decks)

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