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Flashcards in anxiety Deck (32):
1

treatment of GAD

SSRI - sertraline in particular, CBT

2

treatment of panic attack

reassure, SSRI, benzo acutely if needed but rarely used

3

agoraphobia treatment

SSRI, CBT, bahavioural theapy

4

social phobia treatment

CBT, BB + benzo for performance, SSRI

5

Specific phobias treatment

behavioural therapy

6

OCD treatmnet

CBT, SSRI, tricyclic

7

PTSD ICD10

exposure to stressor
pressistant remembering
avoidance synptoms
inability to recall/increased psychological sensitivity
within 6 months

8

signs in PTSD

low cortisol, hippocampal size corrolates severity, deactivation of brocas area

9

management of PTSD

CBT, eye movement desensitisation reprocessing

10

how do benzos work

increase GABA mediated inhibition (binds to GABA receptor, makes GABA have a greater effect) theerfore increase the frequency of chloride ions through the channels - this causes -ve charge inside so less likely that an action potential will be generated

11

rapid withdrawl of benzo symptoms

confusion, toxic psychosis, convulsions

12

how long giev Benzo for

not long as eventually causes decreased response to GABA only give for 2-4 weeks, gradually decreased dose every 2-3 weeks by 2mg. withdraw in steps of 1/8 of the dose every fortnight

13

signs in schiz

enlarged lateral ventricles, decreased frontal grey matter, decreased frontal lobe volume, decreased activation of prefrontal area

14

strongest risk factor for schiz

fam history

15

GAD diagnosis

need 4. at least 1 must be from autonomic arousal:
- autonomic arousal - palpitations, sweating, trembling
- chest and abdo - diff breathing, feeling of choking, chest pain
- brain + mind - dizzy, feeling objects are unreal...
- general symptoms - hot flushes, cld chills, numbness
- tension - muscle tension, restless...
- non specific symptoms - exaggerated response to minor surprises, difficulty concentrating, irratable ...

16

what happens if you withdraw benzo too quickly

insomnia, irritable, tremor, loss of appetite, tinnitus, perceptual disturbances, seizures, persperation

17

schniders 1st rank symptoms

1. auditory hallucinations (3rd person runnning commentry)
2. passivity phenomena - body sensations controlled by external influence
3. delusional perception - normal onject percieved then there is a delusional insight into what the object means
4. thought disorders - insertion/withdrawl/broadcasting

18

phases of schiz

prodromal, active, residual

19

poss cause of schiz

increased dopamine (antipsychotics block D2 receptors, but clozapine is a weak D2 agonist so probs more involved)

20

treatment of schiz

1st line - atypical antipsychotics - risperidone, olanzapine
typical - chlorpromazine, haloperidol
clozapine
CBT OFFERED TO EVERYONE

21

SE of risperidone

hyperprolactinemia - due to inhibitory effect dopamine has on prolactin release

22

risk of elderly using antipsychotcs

stroke and VTE

23

how do antipsychotics work

block D2 receptors (antagonist)

24

SE of olanzapine

wt gain

25

risk of clozapine

agranulocytosis - decreased WBC (primary neutrophils) so blood test shows decraesed leukocytes. Need blood monitoriing!
also can cuase wt gain and sailorrhoae, decraesed seizure threshold

26

EPSE

dystonia, akathisai, tardive dyskineasia, parkinsonism

27

dystonia

torticollis (wry neck), muscle stiffness, eye devistions
treated with anticholinergic - benztrophine

28

akathisia

restlesness. treat with benzo

29

parkinsonism

decreased domapine level. shuffling gait, rigidity, tremor, drooling
treat with antihistamie or anticholinergic

30

tardive dyskinesia

involuntary movements of orofacial muscles

31

neuroepileptic malignant syndrome

hyperthermia, decreased cnsciousness, rigidity, severe EPSE, muscle breakdown products cause severe renal damage (increased CK, incraese WBC, abnormal LFT). stop teh drug

32

5-HT metabolic syndrome

hyperprolactinemia, wt gain, heart rhythm abnormlaities, sedation