Anxiety and Stress
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- Created by: sagalets
- Created on: 15-05-17 13:44
What area of the brain is activated by stress and positively feedbacks the HPA axis?
Amygdala
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What area of the brain is under negative feedback by Cortisol and inhibits the HPA axis?
Hippocampus
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What is HPA axis and what is released as a result of its activation?
Hypothalamic-Pituatory-Adrenal axis, releases Cortisol
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What hormone is released by hypothalamus in the HPA axis?
Corticotropin-Releasing Hormone
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WHat is released by Anterior Pituatory in the HPA axis?
Adrenocorticotropic Hormone
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Where is cortisol released from and under influence of which hormone?
Adrenal gland, by Adrenocorticotrpic hormone
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What is the mechanisms behind sweating, tachycardia, palpitations etc. in a stress reponse?
Activation of the autonomic system by Anterior pituatory in response to Corticotropin-releasing hormone
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WHat does amygdala do within the brain?
Processes sensory information va basolateral nuclei cells; control emotional and behavioral stress response
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Is there a link between stress and dementia?
Yes, persistent elevation of cortisol in the blood in thought to contribute to the development of Alzheimer's
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Wat is Cushing's syndrome and what are the symptoms of it?
Too much cortisol in the blood (excessive glucocorticoid activity) which could be due to ACRH hormone tumour. Symptoms: lump on the back, abdominal fat, moon face, bruising, bleeding, thin arms and legs and skin.
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What is the deficiency in corticosteroid production called?
Addison's disease
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What are the types of anxiety disorders?
GAD, SAD, Post-traumatic disorder, Panic disorder, OCD, Phobias (e.g. social). Could be anxiety secondary to hyperthyroidism
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What are the ligands to GABA receptors?
BZD (+Z drugs), alcohol, barbiturates, propofol, steroids
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What are the inhibitory neurons in the brain and how are they activated?
GABA neurons have GABA G-protein receptors that are inhibtory as they cause hyperpolarization due to activation of Chloride channels and promoting anion influx into the cell.
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What are the effects of GABA receptor activation?
anxiolytic, anticonvulsant, euphoric, amnestic, sedative, muscle relaxant, hypnotic
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What are the types of anxiolytic drugs?
BZD, SSRIs, SNRIs, 5-HT1a receptor agonists (buspirone), beta-blockers
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How and when are BZD prescribed?
Firts-line treatment for severe and disbling anxiety that interferes with daily activities
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Why are BZD not recommended for long-termuse?
High risk of tolerance and dependence; upleasant withdrawal symptoms
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What is a suitable long-term anxiety treatment?
SSRIs
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Whta is the safe long-term treatment for GAD?
Buspirone, an agonist to 5-HT1a (autoreceptors) inhibiting serotonin neurotransmission, augments antidepressants. Safe, no tolerance or withdrawal effects. 4 weeks onset
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How can OCD be treated?
SSRIs, onset time may take up to 10 weeks
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How can panic attacks be treated?
SSRIs, BZD can be prescribed to resistant panic attacks
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How can post-traumatic stress be treated?
Antidepressants and Buspirone
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What are the long-acting BZD?
diazepam and flunazepam
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What are the short-acting BZD?
triazolam, midazolam
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What is an intermediate-acting metabolite of diazepam called?
Temazepam
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What is classified as insomnia?
Inabilty to fall asleep more than 3 times a week for at least 1 month
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How can insomnia be treated?
Short-acting BZD, for short-term; Z-drugs; sedating short-acting antihistmines (diphenhydramine, promethazine)
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What are Z-drugs and how do they work?
Similar action to BZD but a different chemical structure. Zopiclone, Zolpidem, Zaleplon. Sedative hypnotics
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What is the best option to treat insomnia + daytime anxiety?
Diazepam due to longer action
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What are the non-medication therapies for insomnia?
Cognitive behavioral therapy, improvement of sleep hygiene, treating the underlying cause, sleep clinics
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What neurotransmitters in brain are enhanced by amphetamines and what condition can they be prescribed for?
ADHD - methylphenidate, dexamphetamine. Enhance dopamine transmission in the brain
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What is used second line for ADHD treatment?
Atomoxetine, non-stimulant antidepressant, inhibits noradrenaline reuptake
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What is narcolepsy? What treatments are available?
An unsustainable need to sleep or nap during the day. Stimulants and antidepressants to improve REM sleep
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Other cards in this set
Card 2
Front
What area of the brain is under negative feedback by Cortisol and inhibits the HPA axis?
Back
Hippocampus
Card 3
Front
What is HPA axis and what is released as a result of its activation?
Back

Card 4
Front
What hormone is released by hypothalamus in the HPA axis?
Back

Card 5
Front
WHat is released by Anterior Pituatory in the HPA axis?
Back

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