Lecture 9 (Exam 1) Flashcards
What is the thought cause of anxiety disorders? There are two types of anxiety disorders, what are they, what are the symptoms and what are the treatments?
- Increased amounts of cortisol release from the adrenal gland.
- Chronic, Mild Anxiety:
- Symptoms: Tense, irritable, related to the environment, trigger is normal.
- Treatment: Support, get them to relax, usually do not require medication.
- Chronic, Moderately Severe:
- Symptoms: Generalized anxiety disorder, no apparent stresser/trigger, problems concentrating,
- Treatment: Anxialytics, psychotherapy, relax and exercise.
For anxiety disorders, what category (Benz) of drugs is used for this? What does this category of drugs do? What are the positives of these drugs? What are the side effects? What are two examples of Sedative drugs and two examples of Hypnotic drugs and half lives in the Benzodiazepine group?
- Benzodiazepines
- Agonists on BDZ (Benzodiazepine) receptors which are allosteric modulators of GABA A receptors. (Increase in GABA causes increases Cl- influx and these both cause inhibitory effects).
- Positives: Little effect on respiration, Most popular CNS depressants, Therapeutic actions, Anxiolytic (treats anxiety, is a sedative), Treat seizures, helps with Alcohol withdrawals, aid with Insomnia (short-acting hypnotic), Muscle relaxation, Often used a couple hours before surgical (e.g. dental) procedures, long half life.
- Negatives: Long-term use can cause addiction and physical, dependence and withdrawal, Interacts synergistically with other depressants, causes Drowsiness, Motor impairment (don’t drive), Decrease cognition (can affect memory), Some people have paradoxical reaction especially in children, Elderly more sensitive to depressant effects, Don’t use on people with intellectual disability or in major depression (concern: suicide).
- Sedatives: Diazepam (longest half life) and Alprazolam (6-12 hour half life)
- Hypnotics: Lorazepam (2 hour half life) and Triazolam
What is a Benzodiazepine-like (NOT a benzodiazepine) drug that causes less drowsiness/hangover after talking, and lacks the addictive properties of benzodiazepines?
- Zolpidem (Ambien)
For anxiety disorders, what category (Barb) of drugs is used for this? What does this category of drugs do? What are the positives of these drugs? What are the side effects? What is an example of a Barbiturate that aids with short-term for anesthesia? What is an example of a Barbiturate that aids with Long-term for seizures?
- Barbiturates
- Enhance GABA (increases inhibitory action)
- Positives: Is used short-term for anesthesia induction and Long-term for seizures.
- Negatives: Major depression of respiration and tolerance, Severe addiction/dependence and withdrawal, Not frequently used (narrow margin of safety), Major interactions with liver.
- Short-term for anesthesia induction: Pentobarbital
- Long-term for seizures: Phenobarbital
What is a Barbiturate-like (NOT a barbiturate) drug that is fast acting, quickly reverses, is used as an anesthesia inducer and killed Michael Jackson?
- Propofol
What drug is used for anxiety disorders, specifically aids with Anxiety or tension associated with everyday stress, Often for use with having co-existing depression, Usually for short-term use, and not particularly addicting? What are the negatives of this drug?
- Buspirone
- Rare movement problems, and seizures, Irregular heart beat (rare), Interacts with MAO-inhibitors or antiseizure medicines and others.
What has a Dramatic/Fast onset, Self limiting, but can occur anywhere. Has an autonomic component. Causes increased respiration, is Unpredictable, May have other issues such as depressions and agoraphobia (Fear of places and situations that might cause panic)? What are the two types of drugs used to aid with this?
- Severe acute anxiety-panic attack
- SSRIs (Paxil) and Antidepressants (Venalfaxin)
A phobia is an irrational fear with no precipitated symptoms, what is the fear of places/spaces and the events that can occur at these places? What is the category of drugs used to treat these?
- Agoraphobia (Fear of places/spaces)
- SSRIs (Zoloft)
There are several children psychiatric disorders, one of which is ADHD/ADD, what are the two categories of these and what makes them different? There are two categories of drugs used to treat these (Stimulants and Non-stimulants), what drugs are in each of these categories, and what are their positives and negatives?
- Predominantly hyperactive-impulsive: Has difficulty with other children, act out, very impulsive and can’t focus.
- Predominantly inattentive: Are less likely to act out, may sit still, but don’t pay attention.
- Stimulant Drugs: Amphetamines, Methylphenidate. Positive: Are performance enhancers. Negatives: Can be abused (5-8%).
- Non-Stimulant Drugs: Modafinil (DA and NE transmitter blocker). Positives: Has fewer side effects, is Better tolerated and has Little abuse problem. Negatives: Minor headache, upset stomach, alters sleep (keeps you awake).
Autism, otherwise known as Autism Spectrum Disorder (ASD), has a mild version called what? What problems do these individuals struggle with? At what age is this diagnosed? What are the likely causes?
- Asperger’s disorder
- Have problems with social interaction, verbal or non-verbal communication and have repetitive behavior.
- Usually diagnosis at 2-3 years of age.
- Likely genetic and environmental.
There are many parts of the brain that are affected by Autism (Cerebral Cortex, Amygdala, Hippocampus, Basal Ganglia, Brain Stem, Cerebellum and Corpus Callosum), what are their effects?
- Cerebral Cortex: Mental function and perception.
- Amygdala: Emotional behavior/response.
- Hippocampus: Short-term memory.
- Basal Ganglia: Connection between the cerebrum and cerebellum.
- Brain Stem: Relay station to other parts of the brain.
- Cerebellum: Balance/Coordination
- Corpus Callosum: Allows for communication between the right and left hemispheres of the brain.
Some children are born with a susceptibility to autism, is there a single trigger to this? Is it caused by one gene or multiple genes? What are some factors environmental factors that may cause Autism? What medical conditions increase and individuals chance of developing Autism? What drugs have an ‘association’ with Autism? In what race and gender is it more commonly seen, least commonly seen? **(Prevalence in all individuals has increase from 1:150 to 1:68 in 10 years, unknown reason)
- No
- Multiple
- Problems during pregnancy or delivery as well as environmental factors such as viral infections, metabolic imbalances and exposure to chemicals (e.g., lead and
drugs) . - Autism tends to associate with certain medical conditions, including fragile X syndrome, congenital rubella syndrome and untreated phenylketonuria (PKU).
- Analgesics/Antipyretics (32%), Anti-nausea (12%).
- Most: White, Males. Least: Hispanic, Females.
What medications aid with Autism?
- Atypical Antipsychotics -OR- SSRIs may help
with psychotic, aggressive or repetitive behavior-
does not affect progression of the disease. - Behavioral Interventions: The intervention focuses on the core areas affected by autism. These include social skills, language and communication, imitation, play skills, daily living and motor skills.
In which gender are eating disorders most commonly seen? What are the two most common disorders and what are their symptoms? What is the mediator of compulsive disorders like these? What is treatment for these disorders?
- Women (1-2%)
- Anorexia Nervosa: • Relentless pursuit of thinness/distorted body image, • Extreme restriction of eating, • Osteoporosis, • Dry yellow skin, • Muscle wasting, • Damage to heart, • Infertility, • Other symptoms of malnutrition, • Typically female, • Use drugs such as laxatives & diuretics.
- Bulimia (nervosa): • Frequent bingeing and purging, • Usually normal weight, • Damage to esophagus, • Tooth damage, • Acid reflux & other GI problems (e.g., ulcers), • Dehydration from purging, • Emotional turmoil-shame.
- 5HT (Serotonin) levels.
- Antidepressants: Fluoxetine, and Supportive psychotherapy: image counseling.
