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Neuro > Week 8 > Flashcards

Week 8 Flashcards

1
Q

List some Anxiety diagnosis’

A
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2
Q

What is the most common mental health condition?

A

Anxiety

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3
Q

What % of people suffer with anxiety?

A

7.3 ~ 1:14

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4
Q

What is the ratio of men to women who suffer with anxiety?

A

1:2

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5
Q

Define Anxiety

A

Characterised by excessive fear and anxiety

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6
Q

What is the current theory of what causes anxiety?

A
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7
Q

How does Anxiety effect NT levels?

A
  • Serotonergic - Low
  • Noradrenergic - High
  • GABA system - Dysregulated
  • Cortico-steroid regulation (leads to hippocampal reduction)
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8
Q

What are some associated conditions of anxiety?

A
  • Depression / Low mood
  • Obsessive compulsive disorder (OCD)
  • PTSD
  • Stress
  • Addiction
  • Insomnia
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9
Q

What are some risk factors for Anxiety?

A
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10
Q

What are some symptoms of Anxiety?

A
  • Agitation
  • Trembling
  • Restless
  • Emotional distress
  • Avoidance
  • Low mood
  • Nothing
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11
Q

Describe the Generalised Anxiety Depression score

A
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12
Q

What other conditions is Chronic Anxiety related to?

A

HT
CV disease
Dementia

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13
Q

What are some non-pharmacological options for the treatment of Anxiety

A
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14
Q

What challenges are there to helping an individual with Anxiety?

A
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15
Q

What are some of the negative effects of caffeine?

A
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16
Q

What may patients be anxious about before surgery?

A
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17
Q

What are some post-operative outcomes for individual who experience high anxiety pre-operatively?

A

Less likely to understand informaion presented to them
Less likely to adhere to exercises designed to help with recovery

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18
Q

What are some effective approches to help patients who are anxious about a medical procedure?

A
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19
Q

Define Anxiolysis

A

Minimal sedation
A drug induced state during which the patient responds normally to verbal comands. Cognitive function and coordination may be impaired. Ventilatory and CV functions are unaffected

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20
Q

What drug is used to treat seizures lasting longer than 5 mins?

A

IV Lorazepam
(if IV not accessable, consider rectal diazepam)

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21
Q

What drug is used for Anticipatory Care Plan for End Of Life care?

A

IV Midazolam

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22
Q

What drug is used to treat Alcohol withdrawal?

A

Chlordiazepoxide

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23
Q

What are the 3 main classifications of Anxiety disorders?

A
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24
Q

What are the 6 main classes of drugs used to treat Anxiety?

A
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25
Q

What are some antidepressants that may be used to treat Anxiety?

A
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26
Q

What are some Benzodiazepines that may be used to treat Anxiety?

A
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27
Q

Are Benzodiazepines used for the management of Mild Actute, Severe Acute, Mild Chronic or Sever Chronic Anxiety?

A

Severe Acute

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28
Q

Describe the pharmacokinetics of Benzodiazepines

A
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29
Q

What are the 5 main clinical effects of Benzodiazepines?

A
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30
Q

Describe Benzodiazepines action on GABAa Receptors

A
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31
Q

What are some antiepileptics that may be used to treat Anxiety?

A
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32
Q

What is a 5-HT 1A receptor agonist that may be used to treat General Anxiety Disorder?

A
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33
Q

What are some Atypical antipsychotics that may be used to treat Anxiety?

A
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34
Q

What are some Beta-Adrenoceptor antagonists that may be used to treat Anxiety?

A
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35
Q

Describe the bodies tolerance to Benzodiazepines?

A
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36
Q

When has someone developed dependence on drugs used for treatment of anxiety?

A

3 of the 6 criteria in last 12 months

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37
Q

What are some symptoms of withdrawals from anxiety medication?

A
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38
Q

What are anti anxiety drugs at risk of being used for

A

Drug of misuse / abuse

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39
Q

What drug(s) would be prescribed to treat insomnia?

A

Short acting Benzo or Z-drug
(lowest effective dose for shortest time)

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40
Q

How could one establish a healthy Sleep hygiene?

A
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41
Q

Name and describe Z-drugs

A
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42
Q

What is the therapeutic role of Melatonin?

A
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43
Q

What are the 3 catagories of harm?

A
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44
Q

What are the 3 classes of drugs?

A
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45
Q

What are the 3 catagories of CNS stimulants?

A
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46
Q

Name an example of a Convulsant and Respiratory Stimulant and its function?

A
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47
Q

What catagory of drugs are Hallucinogens
AND
what is their function?

A

Psychotomimetic drugs

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48
Q

What are the pharmacological effects of Hallucinogens?

A
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49
Q

How quickly do we develop Tolerance to Hallucinogens
AND
What are the withdrawl symptoms?

A

Tolerance develops quickly

No physical withdrawals
Some psychological effects (flashbacks, psychosis)

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50
Q

What are some risks of taking Hallucinogens?

A
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51
Q

What are 2 examples of Dissociative anaesthetics
AND
What receptor do they antagonise?

A

Both are NMDA receptor antagonists

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52
Q

How quickly do we develop Tolerance to Dissociative anaesthetics
AND
What are the withdrawl symptoms?

A

Develop tolerance rapidly over regular repeated doses

Physical and psychological dependance, withdrawal syndromes with PCP

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53
Q

What are some risks of taking Dissociative anaesthetics?

A
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54
Q

What type of drug is Cannabis?

A

Psychotomimetics

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55
Q

What are 3 examples of Psychomotor Stimulants?

A
  • Amphetamine
  • Dextroamphetamine
  • Methylamphetamine
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56
Q

What are the main effects of Psychomotor Stimulants?

A
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57
Q

What are some of the behavioural effects of Amphetamine?

A
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58
Q

What is the MoA of Amphetamines?

A
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59
Q

What are the two 5-HT pathways in the brain?

A
60
Q

What are the 3 Dopamine pathways in the brain?

A
61
Q

What are the 2 Noradrenaline pathways in the brain?

A
62
Q

How quickly do we develop Tolerance to Amphetamines
AND
How dependant do we become?

A

Develop rapid tolerance to euphoric and anorexic effects, slowly for others

Moderate dependance due to euphoria

63
Q

What is, and how does one get Amphetamine psychosis?

A
64
Q

What are some side effects of taking Amphetamines?

A
65
Q

What are some examples of clinical uses of the Amphetamine drugs:
Lisdexamfetamine mesylate
Phentermine and Diethylpropion

A
66
Q

What type of drug are Khat and Nicotine examples of?

A

Psychomotor Stimulants

67
Q

What are the effects of Cocaine?

A

Potent inhibitor of catecholamine reuptake into nerve terminals

68
Q

How quickly do we develop Tolerance to Cocaine
AND
How dependant do we become?

A

Tolerance occurs rapidly

Mild physical dependance
Strong psychological dependace

69
Q

What are the acute risks of Cocaine?

A
70
Q

What are the chronic risks of Cocaine?

A
71
Q

What are the 2 main Methylxanthines?

A
72
Q

What are the main psychological effects of Methylxanthines?

A

Reduce fatigue
&
Improve mental performance w/o euphoria

73
Q

What is the MoA of Methylxanthines?

A
74
Q

How quickly do we develop Tolerance to Methylxanthines
AND
What are the withdrawl symptoms?

A

Develop small amounts of tolerance and habituation

75
Q

What are Eugeroics?

A
76
Q

What are the 3 main Eugeroics?

A
77
Q

What is PTSD
AND
What is it associated with?

A
78
Q

What is PTSD often related to historically speaking?

A

War (shellshock)

79
Q

What is the estimated lifetime prevalence of PTSD?

A

6.8%

80
Q

What are the most common causes of PTSD for men and for women?

A

Men - Combat
Women - Sexual molestation

81
Q

What % of people who experience trauma will develop PTSD?

A

25 - 30%

82
Q

What are some challenges with PTSD?

A
83
Q

What are some examples of signs of PTSD / CPTSD?

A

Bottom 3 needed for Complex PTSD

84
Q

Roughly describe Complex PTSD

A
85
Q

What is meant my avoidance in PTSD?

A

Avoidance of thoughts, feelings, people, places, and activities related to event that caused PTSD

86
Q

What are 5 issues of Hyperarousal in PTSD?

A
87
Q

What are some risk factors for PTSD?

A
  • Exposure to traumatic event
  • Certain professions (e.g. A&E, police, prison, fire services ect.)
  • Female sex
  • Younger age
  • Severity of incident (greater threat to life)
  • Multiple life stressors
  • History of mental health disorders
88
Q

How may the characteristics of the event effect the PTSD likelyhood?

A
89
Q

What are some other psychological factors that may impact PTSD?

A
  • Personal impact of the event
  • Extent of percieved control over future threats
  • How one is preped to deal with stressor
  • One’s beliefs and assumptions about trauma
90
Q

What are the 2 main treatment options for PTSD?

A

Psychological prevention and treatment
&
Pharmacological treatment

91
Q

Why was psychological debriefing ineffective in preventing PTSD

A

Increased risk of PTSD
- secondary traumatisation
- medicalising normal distress
- may prevent potentially protective responses of denial and distancing

92
Q

What are some interventions for individuals with PTSD?

A
93
Q

What niche form of treatment may be used for non-combat related PTSD

A

EMDR
(eye movement desensitisation and reprocessing)

94
Q

What are some pharmacological treatments for PTSD?

A
95
Q

Describe General Anaesthesia

A
96
Q

Give 4 examples of commonly used general anaesthetics drugs

A

IV induction agents which will induce loss of conciousness in one arm brain circulation time (20-30s)

97
Q

Name some commonly used General anaesthetic agents delivered via inhalation (gas / vapour)

A

May be used for children or to maintain anaesthesia

98
Q

What is Entonox, and what are its functions?

A

50:50 - NO:O2

Analgesic
Labour
Trauma

99
Q

Describe MAC (minimum alveolar conc)

A

Higher MAC -> Lower Potency

The more soluble a drug is in oil (lipophilic) the more potent its effects are

100
Q

What is the relation between lipid soluability and potency in inhalation analgaesic agents?

A

More lipophilic -> More Potent

More Blood soluble -> Slower onset

101
Q

What receptors do general anaesthetics mainly act on?

A

GABAa receptors

102
Q

Describe the MoA of General Anaesthetic upon GABAa receptors

A
103
Q

Where do general anaesthetics act in the brain?

A
104
Q

Describe Special K and some associated issues

A
105
Q

What is an issue with NO?

A

Misuse

106
Q

What is the relation between blood solubility of a drug and its rate of clearance?

A

Lower blood solubility -> Faster clearance

107
Q

What’s the difference between fat and lean tissues in euilibrium of inhalation anaesthetics?

A
108
Q

What is an issue with the use of Isoflurane (anaesthetic)

A

Causes cough and laryngospasm

109
Q

What is an issue with the use of Desflurane (anaesthetic)?

A

Patients wake up very quickly

110
Q

What are the Therapeutic Disadvantages of Inhalation anaethetics?

A

Desflurane
- Must be delivered using a special vaporiser

Nitrous Oxide
- Incomplete anaesthesia
- No muscle relaxation
- Must be used with other anaethetics for surgical anaesthesia

Sevoflurane
- Potential renal toxicity at low flows

111
Q

What are the Therapeutic Advantages of Inhalation anaethetics?

A

Nitrous Oxide
- Good analgesia
- Rapid onset/emergence
- Safe, nonirritating

Isoflurane
- Good muscle relaxation
- Rapid emergence
- Stability of cardiac output
- Does not raise intracranial pressure
- No sensitisation of heart to epinephrine

Sevoflurane
- Bronchial smooth muscle relaxation good for patients with asthma
- Rapid onset/emergence
- Nonirritating; useful in children

112
Q

What are the Therapeutic Disadvantages of Intravenous anaethetics?

A

Thiopental
- Poor analgesia
- Causes significant nausea
- Little muscle relaxation
- Laryngospasm

Propofol
- Poor analgesia

113
Q

What are the Therapeutic Advantages of Intravenous anaethetics?

A

Thiopental
- Rapid onset of action
- Potent anaesthesia

Ketamine
- Good analgesia

Fentanyl
- Good analgesia

Propofol
- Not likely to cause nausea
- Rapid onset
- Lowers intracranial pressure

114
Q

What is Psychosis?

A

Any disorder so severe that the victim loses contact with reality

115
Q

What are some examples of disorders w/ psychosis?

A
  • Schizophrenia
  • Schizoaffective disorders
  • Persistent delusional disorders
  • Bipolar disorder w/ psychotic symptoms
  • Secondary to drug use, focal epilepsy, dementia, organ brain disease
116
Q

What % of people have schizophrenia?

A

1%

117
Q

What are some +ve symptoms of Schizophrenia?

A

+ve symptoms tend to be transient and during acute episodes

118
Q

What are some -ve symptoms of Schizophrenia?

A

-ve symptoms tend to be chronic

119
Q

What are some examples of Cognitive deficits / decline in Schizophrenia?

A
120
Q

What are some risk factors for Schizophrenia?

A

Bilogical
- Genes
- Physiological
- Anatomical

Environmental
- Difficult labour
- Hypoxia at birth
- Cannabis

Early indicators
- Few childhood friends
- Withdrawn

121
Q

Describe the Diathesis model for Schizophrenia?

A

Genetics generates a predisposition / vulnerability to developing schizo

Stressors / environmental risk factors push an individual over the threshold which leads them to develop schizo

122
Q

What anatomical changes occur in an individual w/ Schizophrenia?

A

Atrophy of Caudate nuc.
Increased lateral ventricles

123
Q

What psychosocial factors are relevant in Schizophrenia?

A
124
Q

What are the outcomes of individuals w/ Schizophrenia?

A
125
Q

What are some psychological interventions used for Schizophrenics?

A
  • Family Intervention
  • Cognitive Behaviour Therapy
  • Social-skills Training
126
Q

What are some catagories of early intervention and assessment targets for adults w/ Schizophrenia?

A
127
Q

What is the treatment for a Schizophrenic’s first episode?

A

Oral antipsychotic medication

In conjunction with psychological intervention (family intervention and individual CBT)

128
Q

What should be done in the case of continuing treatment and care for Schizophrenic’s?

A
129
Q

What are the % of the 3 Schizophrenia prognoses?

A

Independant - 30%
Relatively dependant - 50%
Highly dependant - 20%

130
Q

What are Antipsychotics also know as?

A
  • Neuroleptics
  • Antischizophrenic drugs
  • Major tranquillisers
131
Q

What is the main action of Antipsychotics?

A

Antagonising the actions of dopamine in the brain

132
Q

What are antipsychotics mainly used for?

A
133
Q

Describe the Dopamine Theory of Schizophrenia

A
134
Q

What is the correlation between efficacy of Antipsychotic and its affinity for D2 receptors?

A

Dirrectly correlated
High affinity = High efficacy

135
Q

Describe the Glutamate Theory for Schizophrenia

A
136
Q

Name some First Gen Antipsychotics (FGAs)

A
  • Chlorpromazine
  • Haloperidol
  • Flupentixol
  • Zuclopenthixol
137
Q

Name some Second Gen Antipsychotics (SGAs)

A
138
Q

What is the difference between Classic (First gen) and Atypical (Second gen) Antipsychotics?

A
139
Q

What are the relative receptor affinities of antipsychotic drugs?

A

Green - Classic
Pink - Atypical

140
Q

What are some of the behaivioural effects of Antipsychotics?

A
141
Q

What are common side effects of Antipychotics?

A
142
Q

What are the two main Extrapyramidal Motor Disturbances in the use of Antipsychotics?

A
143
Q

Describe Tardive Dyskinesia

A
144
Q

What are some unspecific unwanted side effects of Antipsychotics?

A
145
Q

What should be taken into account when using Antipsychotics w/ elderly patients?

A
146
Q

What should be done when treating First Episode Schizophrenia?

A

Neuro (14 decks)

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