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Psych 660 > Exam 3 THIS ONE > Flashcards

Exam 3 THIS ONE Flashcards

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1
Q

What is initial insomnia?

A

difficulty falling asleep

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2
Q

What is the treatment for initial insomnia

A

Short acting benzodiazepines

Sometimes trazodone and doxepin are used off label for their sedating effects

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3
Q

What is middle insomnia?

A

Difficulty staying asleep

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4
Q

What is treatment for middle insomnia?

A

Longer acting benzos

DORAs

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5
Q

What is terminal insomnia?

A

Early morning waking.

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6
Q

What is the treatment for terminal insomnia?

A

If r/t depression - SSRI or SNRI

DORAs

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7
Q

What are beta fiber neurons?

A

Sensory nerve fibers responsible for transmitting signals related to touch and pressure sensation (mechanoreception) to the CNS -

non=noxious/feather

Relatively large and myelinated which allows for a faster transmission of signals.

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8
Q

How fast are beta fiber neurons?

A

Due to myelination - moderate speed

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9
Q

What are delta fiber neurons?

A

Transmit pain and temperature sensations (nociception and thermoreception) from the periphery to the CNS.

noxious mechanical and subnoxious thermal stimuli

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10
Q

How faster are delta fiber neurons?

A

Slower than beta fibers.

They are myelinated but are thinner and smaller than beta fibers.

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11
Q

What are C fiber neurons

A

unmyelinated

chemical and noxious heat

SLOW CHRONIC PAIN SIGNALS

NO MYELINATION - chronic pain

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12
Q

How fast are C fiber neurons

A

unmyelinated - SLOW

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13
Q

What is peripheral neuropathy

A

Dmg to peripheral nerves –> abnormal sensory signals sent to CNS

Central sensitization

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14
Q

Difference between neuropathic pain and nociceptive pain.

A

Nociceptive pain is caused by tissue injury or inflammation.

Neuro pain is caused by dmg to the nerves.

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15
Q

Neurotransmitters and receptors in peripheral neuropathy

A

glutamate and substance P

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16
Q

Non pharm approaches to peripheral neuropathy

A

TENS units, CBT, physical therapy

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17
Q

Pathophysiology of chronic pain

A

Peripheral sensitization - occurs in the peripheral nervous system, where nociceptors (pain receptors) become sensitized and more responsive to painful stimuli. Is often associated with inflammation or nerve dmg and leads to increased pain sensitivity in the affected area.

Central Sensitization: changes in the CNS. CNS becomes hypersensitive - amplifying pain signals and reducing pain threshold. As a result non-painful stimuli can be perceived as painful. The can remain after inflammation or initial injury has healed.

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18
Q

allyodynia

A

pain due to stimulus that does not normally provoke pain

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19
Q

What causes narcolepsy

A

not enough orexin

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20
Q

Medication for narcolepsy

A

Modafinil

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21
Q

What is the pathophysiology of anxiety?

A

Amygdala - Fear/Panic/Phobia

CSTC - Worry/Anxious/Obsession

Hippocampus - Memory/Internal fearmonger - re-experiencing

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22
Q

What is the antidote to benzo overdose?

A

Flumazil

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23
Q

What is the antidote to opiates?

A

Naloxone

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24
Q

How does caffeine promote wakefulness?

A

Caffeine is an antagonist at adenosine receptors

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25
Q

What is peripheral neuropathy

A

Peripheral tissue injury with central distribution

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26
Q

Tx for peripheral neuropathy

A

Cymbalta

Elavil

Gabapentin - always use when trying to take off alcohol

lyrica

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27
Q

Allodynia

A

Pain due to something that shouldn’t cause pain

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28
Q

Patho of chronic pain

A

Moves from peripheral process to Central sensitization

29
Q

Anxiety pathophysiology

A

SEE A BEAR → amygdala is stimulated → sympathetic nervous system stimulated → hypothalamus stimulated → stimulates anterior pituitary gland → cortisol is released → catacholimines are released (epinephrine) → energy/rediness to run for your life

30
Q

Benzo overdose antidote

A

Flumazenil

31
Q

Benzos can treat insomnia in …

A

PTSD

32
Q

Alprazolam info

A

high potency due to high allosteric modulation

short half life, low volume distribution

33
Q

Amitriptyline SE

A

anticholinergic SE
H1, M1, Alpha1

voltage-gated sodium channel blockade - cardio toxicity

34
Q

Amitriptyline treats what

A

2nd line for fibromyalgia and neuropathy

low dose - insomnia

35
Q

Buspirone MOA, How to use

A

5HT1A partial agonist
– Binds to pre - helps with depression
– Binds to post - it inhibits serotonin - helps with anxiety

– Adjunct for anxiety with SNRI or SSRI
– 3-4 weeks before you can feel it
– Not a PRN, 3-4 x/day

36
Q

Buspirone helps what SE of SNRI/SSRI

A

decreases sexual SE

37
Q

Cyclobenzaprine MOA, indications

A

5HT2A antagonist

Used for: Skeletal pain, muscle spasms

38
Q

Cyclobenzaprine ADR

A

glaucoma and heart attack

39
Q

Diazepam half life etc and used for

A

High half life, high volume distribution → NOT VERY DEPENDANT

Used for: ETOH detox

40
Q

Duloxetine SE and when not to use

A

SE: BP

Hard on liver

41
Q

Lorazepam key points

A

gentle on the liver

moderate benzo

42
Q

Melatonin - when is it used and where is it released from

A

initial insomnia

Pineal gland when it’s dark

43
Q

Milnacipran - drug class and what does it treat

A

SNRI

1st line treatment for fibromyalgia

44
Q

Modafinil- drug class and what does it treat

A

TCA

narcolepsy

45
Q

Modafinil MOA

A

increases histamine to increase wakefullness

inhibits dopamine reuptake

46
Q

Naloxone - what labs

A

check LFT first

47
Q

Paroxetine treats what and how

A

joint pain/arthritis

suppresses T cells
M1 receptors - sleep

48
Q

Pregabalin and gabapentin MOA

A

binds to OPEN voltage-sensitive calcium channels – preventing the release of glutamate

49
Q

pregabalin and gabapentin used for

A

neuropathy and fibromyalgia

50
Q

SS of benzo OD

A

lethargy, ataxia, confusion, coma, respiratory depression

51
Q

Benzos ok in liver failure and ETOH withdrawal

A

Out The Liver

Oxazepam
Temazepam
Lorazepam

52
Q

Alprazolam

A

short half life

53
Q

Belsomra MOA

A

Antagonism of orexin receptors (Orex 1 and 2)

54
Q

Benzos for ETOH detox

A
  • Diazepam, lorazepam

Benzos work BECAUSE they both work on GABA

55
Q

Z drugs and food

A

Take 3 hrs away from food

56
Q

Amygdala

A

fear

57
Q

Hippocampus

A

Memory/flashback
– PTSD

worry
– anxious misery

58
Q

Parabrachial nucleus

A

Breathing symptoms with panic attack

59
Q

Periaqueductal gray

A

fight/flight

60
Q

Pineal gland

A

Secretes melatonin in response to darkness

61
Q

Prefrontal cortex

A

Anxiety
Pain

62
Q

Thalamus

A

Temperature control
Lymbic system
Pain

63
Q

Hypothalamus

A

Regulates sleep cycle

it’s on when histamine is going

64
Q

Neurotransmitters responsible for sleep

A

GABA, histamine

65
Q

What areas of the brain are involved with PTSD

A

Amygdala, hippocampus, and PFC

66
Q

Short-acting benzos

A

LOT
Lorazepam, oxazepam, temazepam

67
Q

Treatment for PTSD

A

Paroxetine and Sertraline

68
Q

DORAs MOA

A

Dual Orexin Receptor Antagonist

– Block orexin signals in the brain
– Need 8 hrs for sleep after
– Good options for middle and terminal

Psych 660 (6 decks)

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