Week 8 Flashcards
(146 cards)
1
Q
List some Anxiety diagnosis’
A
2
Q
What is the most common mental health condition?
A
Anxiety
3
Q
What % of people suffer with anxiety?
A
7.3 ~ 1:14
4
Q
What is the ratio of men to women who suffer with anxiety?
A
1:2
5
Q
Define Anxiety
A
Characterised by excessive fear and anxiety
6
Q
What is the current theory of what causes anxiety?
A
7
Q
How does Anxiety effect NT levels?
A
- Serotonergic - Low
- Noradrenergic - High
- GABA system - Dysregulated
- Cortico-steroid regulation (leads to hippocampal reduction)
8
Q
What are some associated conditions of anxiety?
A
- Depression / Low mood
- Obsessive compulsive disorder (OCD)
- PTSD
- Stress
- Addiction
- Insomnia
9
Q
What are some risk factors for Anxiety?
A
10
Q
What are some symptoms of Anxiety?
A
- Agitation
- Trembling
- Restless
- Emotional distress
- Avoidance
- Low mood
- Nothing
11
Q
Describe the Generalised Anxiety Depression score
A
12
Q
What other conditions is Chronic Anxiety related to?
A
HT
CV disease
Dementia
13
Q
What are some non-pharmacological options for the treatment of Anxiety
A
14
Q
What challenges are there to helping an individual with Anxiety?
A
15
Q
What are some of the negative effects of caffeine?
A
16
Q
What may patients be anxious about before surgery?
A
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
18
Q
What are some effective approches to help patients who are anxious about a medical procedure?
A
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
20
Q
What drug is used to treat seizures lasting longer than 5 mins?
A
IV Lorazepam
(if IV not accessable, consider rectal diazepam)
21
Q
What drug is used for Anticipatory Care Plan for End Of Life care?
A
IV Midazolam
22
Q
What drug is used to treat Alcohol withdrawal?
A
Chlordiazepoxide
23
Q
What are the 3 main classifications of Anxiety disorders?
A
24
Q
What are the 6 main classes of drugs used to treat Anxiety?
A
25
What are some **antidepressants** that may be used to treat Anxiety?
26
What are some **Benzodiazepines** that may be used to treat Anxiety?
27
Are Benzodiazepines used for the management of **Mild Actute, Severe Acute, Mild Chronic or Sever Chronic** Anxiety?
**Severe Acute**
28
Describe the **pharmacokinetics** of Benzodiazepines
29
What are the **5 main clinical effects** of Benzodiazepines?
30
Describe Benzodiazepines action on **GABAa Receptors**
31
What are some **antiepileptics** that may be used to treat Anxiety?
32
What is a **5-HT 1A receptor agonist** that may be used to treat General Anxiety Disorder?
33
What are some **Atypical antipsychotics** that may be used to treat Anxiety?
34
What are some **Beta-Adrenoceptor antagonists** that may be used to treat Anxiety?
35
Describe the bodies **tolerance** to Benzodiazepines?
36
When has someone developed dependence on drugs used for treatment of anxiety?
**3 of the 6** criteria in last 12 months
37
What are some symptoms of **withdrawals** from anxiety medication?
38
What are anti anxiety drugs at risk of being used for
Drug of **misuse / abuse**
39
What drug(s) would be prescribed to treat **insomnia**?
Short acting **Benzo** or **Z-drug**
(lowest effective dose for shortest time)
40
How could one establish a healthy **Sleep hygiene**?
41
Name and describe **Z-drugs**
42
What is the therapeutic role of **Melatonin**?
43
What are the **3 catagories of harm**?
44
What are the **3 classes of drugs**?
45
What are the 3 catagories of **CNS stimulants**?
46
Name an example of a **Convulsant and Respiratory Stimulant** and its function?
47
What catagory of drugs are Hallucinogens
**AND**
what is their function?
**Psychotomimetic** drugs
48
What are the **pharmacological effects** of Hallucinogens?
49
How quickly do we develop Tolerance to **Hallucinogens**
**AND**
What are the withdrawl symptoms?
Tolerance develops **quickly**
**No physical** withdrawals
**Some psychological** effects (flashbacks, psychosis)
50
What are some **risks** of taking Hallucinogens?
51
What are 2 examples of **Dissociative anaesthetics**
**AND**
What **receptor** do they antagonise?
Both are **NMDA receptor antagonists**
52
How quickly do we develop Tolerance to **Dissociative anaesthetics**
**AND**
What are the withdrawl symptoms?
**Develop tolerance rapidly** over regular repeated doses
**Physical and psychological dependance**, withdrawal syndromes with PCP
53
What are some **risks** of taking Dissociative anaesthetics?
54
What type of drug is **Cannabis**?
**Psychotomimetics**
55
What are 3 examples of **Psychomotor Stimulants**?
- Amphetamine
- Dextroamphetamine
- Methylamphetamine
56
What are the main effects of **Psychomotor Stimulants**?
57
What are some of the behavioural effects of **Amphetamine**?
58
What is the **MoA of Amphetamines**?
59
What are the **two 5-HT pathways** in the brain?
60
What are the **3 Dopamine pathways** in the brain?
61
What are the **2 Noradrenaline pathways** in the brain?
62
How quickly do we develop Tolerance to **Amphetamines**
**AND**
How dependant do we become?
Develop **rapid** tolerance to euphoric and anorexic effects, **slowly** for others
**Moderate dependance** due to euphoria
63
What is, and how does one get **Amphetamine psychosis**?
64
What are some **side effects** of taking Amphetamines?
65
What are some examples of **clinical uses** of the Amphetamine drugs:
Lisdexamfetamine mesylate
Phentermine and Diethylpropion
66
What type of drug are Khat and Nicotine examples of?
**Psychomotor Stimulants**
67
What are the **effects** of Cocaine?
**Potent inhibitor of catecholamine reuptake into nerve terminals**
68
How quickly do we develop Tolerance to **Cocaine**
**AND**
How dependant do we become?
Tolerance occurs **rapidly**
**Mild physical** dependance
**Strong psychological** dependace
69
What are the **acute risks** of Cocaine?
70
What are the **chronic risks** of Cocaine?
71
What are the **2 main Methylxanthines**?
72
What are the main **psychological effects** of Methylxanthines?
Reduce fatigue
&
Improve mental performance w/o euphoria
73
What is the **MoA of Methylxanthines**?
74
How quickly do we develop Tolerance to **Methylxanthines**
**AND**
What are the withdrawl symptoms?
Develop **small amounts** of tolerance and habituation
75
What are **Eugeroics**?
76
What are the **3 main Eugeroics**?
77
What is **PTSD**
**AND**
What is it associated with?
78
What is PTSD often related to **historically speaking**?
**War** (shellshock)
79
What is the **estimated lifetime prevalence** of PTSD?
**6.8%**
80
What are the **most common causes** of PTSD for men and for women?
Men - **Combat**
Women - **Sexual molestation**
81
What % of people who experience trauma will develop PTSD?
**25 - 30%**
82
What are some **challenges with PTSD**?
83
What are some examples of **signs of PTSD / CPTSD**?
Bottom 3 needed for Complex PTSD
84
Roughly describe **Complex PTSD**
85
What is meant my **avoidance** in PTSD?
Avoidance of thoughts, feelings, people, places, and activities related to event that caused PTSD
86
What are **5 issues of Hyperarousal** in PTSD?
87
What are some **risk factors** for PTSD?
- 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
How may the **characteristics of the event** effect the PTSD likelyhood?
89
What are some other **psychological factors** that may impact PTSD?
- 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
What are the **2 main treatment options** for PTSD?
**Psychological prevention and treatment**
&
**Pharmacological treatment**
91
Why was **psychological debriefing** ineffective in preventing PTSD
**Increased risk of PTSD**
- secondary traumatisation
- medicalising normal distress
- may prevent potentially protective responses of denial and distancing
92
What are some **interventions** for individuals with PTSD?
93
What **niche form of treatment** may be used for non-combat related PTSD
**EMDR**
(eye movement desensitisation and reprocessing)
94
What are some **pharmacological treatments** for PTSD?
95
Describe **General Anaesthesia**
96
Give 4 examples of commonly used **general anaesthetics drugs**
**IV induction agents** which will induce loss of conciousness in **one arm brain circulation time** (20-30s)
97
Name some commonly used General anaesthetic agents **delivered via inhalation** (gas / vapour)
May be used for children or to maintain anaesthesia
98
What is **Entonox**, and what are its functions?
50:50 - NO:O2
Analgesic
Labour
Trauma
99
Describe **MAC** (minimum alveolar conc)
**Higher MAC -> Lower Potency**
The **more soluble** a drug is in oil (lipophilic) the **more potent** its effects are
100
What is the relation between **lipid soluability** and **potency** in inhalation analgaesic agents?
**More lipophilic -> More Potent**
More Blood soluble -> Slower onset
101
What **receptors** do general anaesthetics mainly act on?
**GABAa** receptors
102
Describe the **MoA of General Anaesthetic upon GABAa receptors**
103
Where do general anaesthetics act in the brain?
104
Describe **Special K** and some associated issues
105
What is an **issue with NO**?
**Misuse**
106
What is the relation between **blood solubility of a drug** and its **rate of clearance**?
Lower blood solubility -> Faster clearance
107
What's the difference between fat and lean tissues in euilibrium of inhalation anaesthetics?
108
What is an issue with the use of **Isoflurane** (anaesthetic)
Causes cough and laryngospasm
109
What is an issue with the use of **Desflurane** (anaesthetic)?
Patients wake up very quickly
110
What are the **Therapeutic Disadvantages** of **Inhalation** anaethetics?
**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
What are the **Therapeutic Advantages** of **Inhalation** anaethetics?
**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
What are the **Therapeutic Disadvantages** of **Intravenous** anaethetics?
**Thiopental**
- Poor analgesia
- Causes significant nausea
- Little muscle relaxation
- Laryngospasm
**Propofol**
- Poor analgesia
113
What are the **Therapeutic Advantages** of **Intravenous** anaethetics?
**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
What is **Psychosis**?
Any disorder so severe that the victim loses contact with reality
115
What are some examples of **disorders w/ psychosis**?
- Schizophrenia
- Schizoaffective disorders
- Persistent delusional disorders
- Bipolar disorder w/ psychotic symptoms
- Secondary to drug use, focal epilepsy, dementia, organ brain disease
116
What **%** of people have schizophrenia?
1%
117
What are some **+ve symptoms of Schizophrenia**?
**+ve symptoms tend to be transient and during acute episodes**
118
What are some **-ve symptoms of Schizophrenia**?
**-ve symptoms tend to be chronic**
119
What are some examples of **Cognitive deficits / decline** in Schizophrenia?
120
What are some **risk factors for Schizophrenia**?
**Bilogical**
- Genes
- Physiological
- Anatomical
**Environmental**
- Difficult labour
- Hypoxia at birth
- Cannabis
**Early indicators**
- Few childhood friends
- Withdrawn
121
Describe the **Diathesis model** for Schizophrenia?
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
What **anatomical changes** occur in an individual w/ Schizophrenia?
Atrophy of Caudate nuc.
Increased lateral ventricles
123
What **psychosocial factors** are relevant in Schizophrenia?
124
What are the **outcomes** of individuals w/ Schizophrenia?
125
What are some **psychological interventions** used for Schizophrenics?
- Family Intervention
- Cognitive Behaviour Therapy
- Social-skills Training
126
What are some **catagories** of early intervention and assessment targets for adults w/ Schizophrenia?
127
What is the treatment for a Schizophrenic's **first episode**?
**Oral antipsychotic medication**
In conjunction with psychological intervention (family intervention and individual CBT)
128
What should be done in the case of **continuing treatment and care** for Schizophrenic's?
129
What are the **%** of the 3 Schizophrenia prognoses?
Independant - **30%**
Relatively dependant - **50%**
Highly dependant - **20%**
130
What are **Antipsychotics** also know as?
- Neuroleptics
- Antischizophrenic drugs
- Major tranquillisers
131
What is the **main action** of Antipsychotics?
**Antagonising** the actions of **dopamine** in the brain
132
What are antipsychotics mainly used for?
133
Describe the **Dopamine Theory** of Schizophrenia
134
What is the correlation between **efficacy of Antipsychotic and its affinity for D2 receptors**?
**Dirrectly correlated**
High affinity = High efficacy
135
Describe the **Glutamate Theory** for Schizophrenia
136
Name some **First Gen Antipsychotics** (FGAs)
- Chlorpromazine
- Haloperidol
- Flupentixol
- Zuclopenthixol
137
Name some **Second Gen Antipsychotics** (SGAs)
138
What is the difference between **Classic** (First gen) and **Atypical** (Second gen) Antipsychotics?
139
What are the **relative receptor affinities** of antipsychotic drugs?
Green - Classic
Pink - Atypical
140
What are some of the **behaivioural effects** of Antipsychotics?
141
What are **common side effects** of Antipychotics?
142
What are the two main **Extrapyramidal Motor Disturbances** in the use of Antipsychotics?
143
Describe **Tardive Dyskinesia**
144
What are some **unspecific** unwanted side effects of Antipsychotics?
145
What should be taken into account when using **Antipsychotics w/ elderly** patients?
146
What should be done when treating **First Episode Schizophrenia**?
