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Flashcards in Anxiety disorders Deck (37):
1

Disturbances in serotonin , norepinephrine, and gamma-aminobutyric acid (GABA) have been implicated in the pathophysiology of ...

anxiety disorders

2

Fear, particularly important in panic and phobic disorders

Amygdala

3

Associated with memory related to fear responses

Hippocampus

4

Arousal

Locus ceruleus

5

Respiratory activation, heart rate

Brain stem

6

Activation of stress response

Hypothalamus

7

Cognitive interpretations

Frontal cortex

8

Integration of sensory stimuli

Thalamus

9

Tremor

Basal ganglia

10

Recurrent attacks, unpredictable, intense fear, feeling of impending doom; intense physical discomfort

Panic disorder

11

Chronic , unrealistic , excessive anxiety and worry; symptoms existed 6 months or longer .

Generalized anxiety disorder

12

Fear of being in places or situations from which escape might be difficult ; help might not be available

Agoraphobia without history of panic disorder

13

Fear of situations in which a person might do something embarrassing or be evaluated negatively by others

Social phobia

14

Unreasonable fear when in the presence of, or when anticipating an encounter with , a specific object or situation

Specific phobia

15

Unwanted repetitive behavior pattern or mental acts ( praying, counting) that are intended to reduce anxiety , not to provide pleasure . They may be performed to an obsession or in stereotyped fashion

Compulsions

16

Recurrent obsessions or compulsions that are severe enough to be time consuming or to cause marked distress or significant impairment

Obsessive-Compulsive Disorder

17

The development of characteristic symptoms following exposure to an extreme traumatic stressor involving a personal threat to physical integrity or to the physical integrity of others

Posttraumatic Stress Disorder

18

1. Panic anxiety - Panic disoreder ; Generalized anxiety diorder
2. Powerlessness -
3. Fear - Phobic diosrder
4. Social isolation - Phobic disorder
5. Ineffective coping - OCD
6. Ineffective role performance - OCD
7. Posttrauma syndrome - PTSD
8.Complicated grieving - PTCD

nursing diagnoses commonly associated with anxiety disorders

19

Characterized by physical symptoms suggesting medical disease , but without demonstrable organic pathology or known pathophysiological mechanism to account for them .

Somatoform disorders : pain disorder; hypochondriasis; conversion disorder; body dysmorphic disorder

20

Disruption in the usually integrated functions of consciousness , memory, identity or perception

Dissociative disorders - dissociative amnesia; dissociative identity disorder; depersonalization disorder

21

Supportive therapy
• Group therapy
• Cognitive-behavioral strategies
• Stress reduction
• Relaxation training
• Psychopharmacology

four psychological interventions the nurse might use in the treatment of
the patient with a maladaptive psychophysiological response to stress.

22

particularly effective
treatment for panic disorder

Cognitive-behavioral therapy (CBT) - a patient can gain mastery over panic episodes by identifying and replacing negative beliefs that cause anxiety with positive,
empowering self-talk.

23

GABA acts by

nhibiting neurotransmitter release at the synapses, thus
preventing neurons from “overfiring.” This decrease in neuronal activity keeps anxiety messages from reaching the brain and produces a calming effect. The opposite effect will occur if the
action of GABA is inhibited; anxiety can increase to cause a panic response.

24

Alprazolam ( Xanax )

benzodiazepine - antianxiety agent

25

Chlordiazepoxide (Librium )

benzodiazepine - antianxiety agent

26

Diazepam ( Valium )

benzodiazepine - antianxiety agent

27

Clonazepam ( Klonopin )

benzodiazepine - antianxiety agent

28

Buspirone ( BuSpar )

azaspirodecanediones - antianxiety agent

29

Depress subcortical levels of the CNS, particularly the limbic system and reticular formation ; may potentiate powerful inhibitory action of GABA.

benzodiazepines action

30

not known; does not depress the CNS; desired effect through interactions with serotonin , dopamine, and other neurotransmitter receptors

Buspirone action

31

Used in the treatment of anxiety disorders , anxiety symptoms, acute alcohol withdrawal, skeletal muscle spasms, convulsive disorders, status epilepticus, preoperative sedation

antianxiety agents - indications

32

1. Drowsiness, confusion, lethargy
2. Tolerance; physical and psychological dependence
3. Potentiate the effects of other CNS depressants
4. Aggravation of depression
5. Orthostatic hypotension
6. Paradoxical excitement (opposite effect)
7. Nausea and vomiting
8. Dry mouth
9. Blood dyscrasias ( unusual bleeding)

benzodiazepines - side effects

33

same as for benzodiazepines except
1. No tolerance
2. Delayed onset - 10 days - 2 weeks

Buspirone - side effects

34

For patients on long-term therapy - Don't quit taking the drug abruptly - can be life threatening - depression, insomnia, increased anxiety, abdominal and muscle cramps , tremors, vomiting, sweating, convulsions, and delirium

benzodiazepines - Tolerance - interventions

35

1. Antianxiety - antiolytic agents : benzodiazepines + Buspirone
2. Antidepressants

Psychopharmacological therapy - anxiety disorders

36

Used to desensitize individuals to phobic stimuli ; individual is "flooded" with continuous presentation (through mental imagery) of the phobic stimulus until it no longer elicits anxiety

Implosive therapy - flooding

37

technique for assisting individuals to overcome their fear of a phobic stimulus; there is hierarchy of anxiety producing events through which the individual progresses during therapy

Systematic desensitization