L13 - anxiolytics and hypnotics Flashcards
what is anxiety?
can be a normal fear response
beneficial in some cases to keep us safe
when is anxiety an issue
when the source and intensity of the anxiety become abnormal
- anxiety becomes chronic, constant and irrational - triggered by situations / events that it shouldnt be
- when it leads to avoidance behaviours, social disturbances, insomnia etc
what are the
psychological
physiological (physical)
symptoms of anxiety
psychological
- worry
- stress
- nervousness
physiological
- increased HR and breathing
- dizziness and headaches
- flushing
- sweating
- feelings of sicknes
- insomnia
list some possible causes of anxiety
- past childhood experiences
- everyday life (work, financial problems, exams)
- diet (coffee and sugar)
- drugs and medication (alcohol, antimalarials)
- physical and mental health (co-morbidities)
- genetic
what drugs have been associated with causing anxiety?
alcohol
antimalarials
drugs of abuse
define GAD - generalised anxiety of disorder
constant (sometimes low level) anxiety with an unclear source
list soome types of anxiety disorders
specific phobias
separation anxiety
OCD
Social phobias
PTSD
panic disorder
describe panic disorder
a disorder when individuals suffer from panic attacks with no apparent triggers
what symptoms of anxiety are treated by anxiolytics
some treat psychological (nervousness etc)
some treat pysiological symptoms (agitation, palpitations, sweating, GI disturbances, high HR)
what symptoms of anxiety do hypnotics treat?
insomnia
list the types of drugs used to treat anxiety (and briefly how they work)
what type of drugs have no anxiolytic effect at low dose/potency
Z drugs
high dose/potency used as hypnotic
BRIEFLY how do barbiturates, benzodiazepines and Z drugs act, to treat anxiety / insomnia
GABA(A) receptor modulators
what is the most common subunit conformation of the GABA(A) receptor
(2x a) + (2x B) + (y)
are GABA(A) receptors mainly found pre or post synaptically?
post
name the transporter that re-uptakes GABA from cleft
GAT
where is the GABA binding site on GABA(A)
between a and B subunits
also site of other agonists and antagonists
where on the GABA(A) receptor do the BZDs bind?
between a and y subunits
where on the GABA(A) receptor do the barbiturates bind
allosterc site
what are barbiturates and what is their mechanism of action.
positive allosteric modulators
- bind to allosteric site of GABA(A) found in the inner pore
- this binding holds the channel open for longer, so more Cl- can flow through channel
- increasing inhibition