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31 Cards in this Set
- Front
- Back
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5HT partial agonist
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BuSpar (buspirone)
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a2 agonist
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Catapres (clonidine)
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Beta Blockers
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Inderal (propanolol)
Tenormin atenolol |
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Benzodiazepines (anxiety)
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Valium (diazepam)
Librium (chlordiazepoxide) Serax (oxazepam) Ativan (lorazepam) Xanax (alprazolam) Klonopin (clonazepam) |
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non-benzodiazepines (sleep)
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Ambien (zolpidem)
Sonata (zaleplon) Lunesta (eszopiclone) |
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Natural Sleep products
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Melatonin
Valerian |
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Antidepressants used for insomnia
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Elavil (amitriptylline*)
Desyrel (trazodone*) Serzone* (nefazodone) |
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Benzodiazepines (sleep)
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Dalmane (flurazepam)
Restoril (temazepam) Halcion (triazolam) Doral (quazepam) |
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Antihistamines
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Diphenhydramine
Doxylamine Hydroxyzine |
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Melatonin agonist
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Rozerem (varenicline tartrate)
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Ways panic disorders can be induced.
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sodium lactate infusion or CO2—mechanism may be stimulation of NE mechanisms in locus coeruleus; associated with increased blood flow in right parahippocampus.
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Brain changes as the result of repeated panic attacks.
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Temporal lobe abnormalities in white matter, plus ventricular enlargement correlate with number of attacks and age on onset.
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Effect of benzodiazepines on panic attacks.
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increase inhibitory effects of GABA (which lets Cl- in)
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Effect of Buspar (buspirone)on panic attacks.
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affects 5HTIA receptors, which have abnormal density in anxiety disorders.
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Factors involved in PTSD
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genetic, familial, situational
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Probable biological origin of PTSD
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involves startle response circuits that include NMDA-mediated mechanisms in amygdala and brain-stem pathways, and failure of extinction mechanisms, as well as behavioral sensitization mechanisms (enhanced response magnitudes which probably involve increases in dopamine)
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Likely cause for flashbacks and amnesia from PTSD
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cell loss in right hippocampus: damage likely by stress-induced glucocorticoids?
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Brain areas with increased metabolism associated with OCD
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left orbitaofrontal gyrus, cingulate and bilateral caudate
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What other two disorders share the same brain excitation as OCD?
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Tourette's, and also sometimes in ADHD
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What brain areas show a blood flow increase when OCD symptoms are provoked?
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right caudate, left anterior cingulate gyrus, and bilateral orbitofrontal
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What neurotransmitter effect does BuSpar have on anxiety?
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5HT1A partial agonist
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What neurotransmitter effect do alpha-2s have on anxiety?
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agonists on presynaptic autoreceptors or beta 1 blockers on post-synaptic receptors can inhibit noradrenergic overactivity in locus coeruleus
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What neurotransmitter effect do benzodiazepines have on anxiety?
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interact with GABA receptors, primarily GABA-A type
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What is the first rule in treating insomnia?
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First determine the cause, then treat underlying disorder if there is one
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What characterizes the ideal sleep-aid?
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rapid-onset, short half-life
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What neurotransmitters are implicated in OCD?
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5HT and DA
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What is the average time for an SSRI to be effective against OCD?
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4-8 weeks
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What is the preferred course of therapy for OCD?
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Initially treat with drugs if necessary, but best and longest-lasting treatment is CBT.
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What are treatments options for Panic Disorder and Panic attacks
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a. SSRI's, but at a lower dose than for depression
b. Other antidepressants c. Benzodiazepines—but these are problematic for long-term use d. CBT is as effective and longer-lasting than any drug treatment |
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What are treatment options for phobias?
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1. Specific phobias—treat with desensitization
2. Social phobias—treat with beta blockers for NE overactivity, or SSRI's; as usual, psychotherapy is best approach, especially along with drugs |
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What is the best psychotropic treatment for PTSD?
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SSRIs.
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