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pharmacology > Anxiety > Flashcards

Flashcards in Anxiety Deck (23):
0

What is anxiety?

Hypervigilance, physiological preparedness and negative subjective states and may share some critical neural circuits with fear.

State of preparation for danger in the absence of immediate threat.

1

Role of the amygdala

Key to sensing fear, may also be key for producing empathy to others peoples fear.

2

What is CRF?

Corticotrophin releasing factor
Acts on GRF1 and 2 GPCR
Released in central nucleus of the amygdala to produce fear
Releases glucocorticoids from the adrenal cortex (supressed inflamation heightens arousal)
-CRF receptor antagonists may have treatment potential for anxiety.

3

What does bed nucleus stria terminalis do?

Responds to general stimuli
Part of anxiety circuit
Larger in females
Releases CRF

4

Types of anxiety disorders

Ptsd
Panic disorder
Generalised anxiety disorder
Simple ohobias
Social phobia
Ocd

5

Role of beta adrenergic receptor activation in emotion enhanced memories.

Activation leads to memory with associated fear. Block with propanolol in a&e

6

What is PTSD?

Hypervigilance, sleep distubance, nightmares cue induced reexperience, cues can be over generalised.

7

Treatment for PTSD?

CBT
SNRI antidepressants VENLAFAXINE and DULOXETINE
Propanolol, maintain memory without fear?
Mdma with cbt, postivie feeling recalling negative events

8

What is generLised anxiety disorder?

Unrealistic excessive worry for more than 6 months accompained by specific anxiety related symptoms, motor tension, hypervigilance, sympathetic hyperactivity

9

Treatment for generalised anxiety disorder?

Antidepressants ssris snris and benzodiazepine
Benzos produce anterograde amnesia :(

10

What is panic disorder?

Discrete attacks of intense anxiety accompanied by tachycardia, tachpynea and dizziness.

11

Treatment for panic disorder

Antidepressants snris and benzos with cbt
Alprazolam
Clonazepam

12

Benzos

Benzos bind to alpha and increase gaba's affinity for beta, its hard to overdose on them but dont take with alcohol as this increases endogenous gaba

13

Beta gabaa subunit

Gaba binds to beta, gamma is also required

14

B-carboline

Binds alpha gabaa
Its an inverse agonist (pam) produces opposite effects to benzos,

15

Zolipidem

Bind alpha, but structurally distinct to benzos.

16

Delta gabaa subunit

Alcohol interacts with it????

17

Gaba a convulsant site

Binds picrotoxin and pentylentetrazol

18

Barbituates bind to....

Near chloride channel
Increase frequency and duration of channel opening,
can act independently of gaba

19

Neurosteroid site on gabaa

Binds endogenous preganolone (sedative) released during pregnancy

20

Symptoms of obsessive compulsive disorder

Obsessive, intrusive throughts and ritualised behaviours
Reduce anxiety but impair normal functions
Anxiety drives compulsion but sufferes show impaired impulse control

21

Neurocircuitry of ocd

- similar to tourettes syndrome (abnormal striatal thalamic prefrontal cortex function)
- related to impaired impulse control and anxiety

22

Treatment for ocd

Cbt
Snris and clomipramine
Higher doses than for depression
Nicotine patches? Increases pfc activity