more chapter 18 Flashcards

1
Q

anxiety

A

an emotional response to anticipation of danger, the source of which is largely unknown or unrecognized.

a necessary force for survival. It is not the same as stress

subjective emotional response to that stressor

may be distinguished from fear in that anxiety is an emotional process, whereas fear is a cognitive one

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2
Q

Stressor

A

an external pressure that is brought to bear on the individual

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3
Q

Historical Aspects of Anxiety

A

Anxiety was once identified by its physiological symptoms, focusing largely on the cardiovascular system.

Freud was the first to associate anxiety with neurotic behaviors.

For many years, anxiety disorders were viewed as purely psychological or purely biological in nature

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4
Q

Cognitive theory of Panic and GAD

A

Faulty, distorted, or counterproductive thinking patterns result in anxiety that is maintained by mistaken or dysfunctional appraisal of a situation

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5
Q

Psychotropic medications

A

A psychoactive drug that changes brain function and alters perception, mood, consciousness or behavior. Antianxiety medications AKA- Anxiolytics

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6
Q

Reuptake

A

the process by which the presynaptic terminal of a neuron reabsorbs the neurotransmitter it has previously secreted in conveying an impulse to another neuron.

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7
Q

Other neurotransmitters are:

A

acetylcholine
dopamine
glutamate
histamine

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8
Q

Anti- depressants, antipsychotics and antihistamine that can produce anticholinergic effects

A
confusion
blurred vision
Constipation
dry mouth
dizziness
difficulty urination
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9
Q

SNRI Neurotransmitter effect

A

inhibit reuptake of serotonin, norepinephrine and mild dopamine

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10
Q

panic disorder

A

Characterized by recurrent panic attacks, the onset of which are unpredictable and manifested by intense apprehension, fear, or terror, often associated with feelings of impending doom and accompanied by intense physical discomfort

May or may not be accompanied by agoraphobia

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11
Q

symptoms of panic attack

A

Sweating, trembling, shaking

Shortness of breath, chest pain or discomfort

Nausea or abdominal distress

Dizziness, chills, or hot flashes

Numbness or tingling sensations

Derealization or depersonalization

Fear of losing control or “going crazy”

Fear of dying

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12
Q

Symptoms of GAD

A

Characterized by chronic, unrealistic, and excessive anxiety and worry

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13
Q

Psychodynamic theory of Panic and GAD

A

Ego unable to intervene between id and superego Overuse or ineffective use of ego defense mechanisms results in maladaptive responses S. Freud to anxiety

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14
Q

Biological aspects of Panic and GADs

A

Genetics

Neuroanatomical

Biochemical

Neurochemical

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15
Q

Agoraphobia

A

Fear of being in places or situations from which escape might be difficult or in which help might not be available in the event of panic-like symptoms or other incapacitating symptoms.

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16
Q

Social Anxiety Disorder (social phobia)

A

Excessive fear of situations in which the affected person might do something embarrassing or be evaluated negatively by others.

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17
Q

Specific phobia

A

Fear of specific objects or situations that could conceivably cause harm, but the person’s reaction to them is excessive, unreasonable, and inappropriate.

Exposure to the phobic object produces overwhelming symptoms of panic, including palpitations, sweating, dizziness, and difficulty breathing.

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18
Q

Norepinephrine

A

fight or flight, causes arousal and anxiety

19
Q

Serotonin

A

regulates sleep, arousal, mood, coordination and judgment. Decreased levels causes depression. Increase levels causes anxiety states

20
Q

GABA

A

Gamma-aminobutyric acid, inhibits neurotransmitters action in the brain

21
Q

Neurotransmitters that affect anxiety disorders:

A

Serotonin, GABA, Noepinephrine

**Note: Serotonin and GABA decreases and Norepinephrine increases in Anxiety Disorders

22
Q

Anticholinergic effect

A

An anticholinergic agent is a substance that blocks the neurotransmitter acetylcholine in the central and the peripheral nervous system

Anticholinergics inhibit parasympathetic nerve impulses by selectively blocking the binding of the Neurotransmitter acetylcholine to its receptor in nerve cells

23
Q

Agonist-drugs

A

increase neurotransmitter activity by direct stimulation of the specific receptor

24
Q

Antagonist-drugs

A

cause receptor blockade resulting in a reduction of the transmission and decreased neurotransmitter activity

25
Q

None addictive anxiolytics

A

Azaspirodec-anedione
Antidepressants: SSRI or SNRI
Anti-hypertensives - Betablockers & Alpha agonists
Anti-histamine

26
Q

addictive anxiolytics

A

Benzodiazepines

Carbamate derivative/tranquilizer

27
Q

Buspirone (Buspar)

A

Azaspirodec-anedione

Partial agonist of 5-HT receptor, 2 agonist/antagonist

Neurotransmitter effect unknown: serotonin, norepinephrine and dopamine

Delayed Onset (10-14days)

Used for long term TX GAD

Does not cause physical dependence/tolerance

28
Q

Side effects of Buspirone (Buspar)

A

GI Upset: Nausea, diarrhea, constipation, dry mouth

DWD- dizziness, weakness, & drowsiness.
Headache, blurred vision

SPIN- sleep problems: insomnia, nightmares, feeling tired

29
Q

Benzodiazepine

A

most common type med used for the acute anxiety state

diazepam (Valium)
chlordiazepoxide (Librium)
clonazepam (Klonopin)
lorazepam (Ativan)
alprazolam (Xanax )
30
Q

Neurotransmitter effect of benzodiazepine

A

increases receptor affinity for GABA

31
Q

Side effects of benzodiazepines

A

CNS depression, difficulty breathing**

Dependence- physiological psychological (addiction)

DWD- dizziness, weakness, & drowsiness

BLSC: blurred vision, lack of coordination, slurred speech

Confusion

32
Q

Antidepressants: SSRIs

A
luoxetine (Prozac)
sertraline (Zoloft)
paroxetine (Paxil)
citalopram (Celexa)
fluvoxamine (Luvox)
escitalopram (Lexapro)
33
Q

SSRI Neurotransmitter effect

A

block reuptake of serotonin into presynaptic nerve terminal

34
Q

Onset of antidepressants

A

varies 2-4-6 wks

35
Q

Side effects of antidepressants

A

DWD- dizziness, weakness,
& drowsiness.

SPIN- Sleep problems insomnia, nightmare

GI Upset- nausea, dry mouth, constipation

NAR- Nervousness, agitation, or restlessness

SD - sexual dysfunction

36
Q

Anti-hypertensives

A

hydroxyzine (Vistaril)

diphenhydramine (Benadryl)???? (this isn’t right is it??)

37
Q

Neurotransmitters effect on anti-hypertensives

A

Dopaminergic Agonist

38
Q

Onset of anti-hypertensives

A

1-2 hours peak

39
Q

Side effects of anti-hypertensives

A

GU/GU upset: Nausea and vomiting, difficult urination
DMSE -dry mouth, skin, or eyes

Confusion, drowsiness, dizziness.

Restlessness or moodiness (in children)

Blurred vision

40
Q

Carbamate derivative/tranquilizer

A

meprobamate (Miltown, Equanil)

41
Q

Neurotransmitter effects of Carbamate derivative/tranquilizer

A

binds to GABA receptors

42
Q

Onset of carbamate derivative/tranquilizer

A

2hours, metabolite half-life up to 2+ days

43
Q

Side effects of carbamate derivative/tranquilizer

A

DWD+H- dizziness. weakness, drowsiness,+ headache, GI Upset, nausea, vomiting, Diarrhea

NAR- nervous, anxious & restless

Serious must report immediately:
confusion, shortness of breath numbness/tingling/swelling arms & legs

Dependence potential combined
with ETOH