100% satisfaction guarantee Immediately available after payment Both online and in PDF No strings attached
logo-home
2024 NR546 MIDTERM EXAM WITH CORRECT ANSWERS $27.99   Add to cart

Exam (elaborations)

2024 NR546 MIDTERM EXAM WITH CORRECT ANSWERS

 12 views  0 purchase
  • Course
  • NR546
  • Institution
  • NR546

2024 NR546 MIDTERM EXAM WITH CORRECT ANSWERS

Preview 4 out of 52  pages

  • October 4, 2024
  • 52
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • NR546
  • NR546
avatar-seller
Elitaa
2024 NR546 MIDTERM EXAM WITH
CORRECT ANSWERS



autonomic and cardiovascular responses are mediated by: - CORRECT-
ANSWERSconnections between the amygdala and the locus coeruleus, home
of the noradrenergic cell bodies
-When autonomic responses are repetitive, inappropriately or chronically
triggered as part of an anxiety disorder, this can lead to increases in
atherosclerosis, cardiac ischemia, hypertension, myocardial infarction, and
even sudden death

The known neurobiological regulators of the amygdala: - CORRECT-
ANSWERSneurotransmitters GABA, serotonin, norepinephrine, and the
voltage-gated calcium channels
-known anxiolytics act upon these same neurotransmitters hypothetically in
order to mediate their therapeutic actions

neurotransmitters and regulators that modulate CSTC circuit - CORRECT-
ANSWERS-serotonin
-GABA
-dopamine
-norepinephrine
-glutamate
-voltage-gated ion channels

Excessive amygdala activity is theoretically reduced by: - CORRECT-
ANSWERSbenzodiazepines
-enhance phasic inhibition of GABA (γ-aminobutyric acid) by positive
allosteric modulation of postsynaptic GABA receptors
-blunt fear-associated outputs

modulate excessive output from worry loops - CORRECT-
ANSWERSbenzodiazepines
-enhancing the actions of inhibitory interneurons in CSTC circuits
-reduce symptoms of worry

also known as α2δ ligands since they bind to the α2δ subunit of presynaptic
N and P/Q VSCCs, block the release of excitatory neurotransmitters such as
glutamate that occurs when neurotransmission is excessive, as postulated in
the amygdala to cause fear (Figure 8-17A) and in CSTC circuits to cause
worry - CORRECT-ANSWERSGabapentin and pregabalin

,key neurotransmitter that innervates the amygdala as well as all the
elements of CSTC circuits - CORRECT-ANSWERSSerotonin
-regulate both the symptoms of fear and worry

Noradrenergic hyperactivity in anxiety - CORRECT-ANSWERSNorepinephrine
is another neurotransmitter with important regulatory input to the amygdala,
and to the prefrontal cortex and thalamus in CSTC circuits

__% of the population will develop an anxiety disorder - CORRECT-
ANSWERS30%

Treatment for anxiety disorder subtypes: Generalized Anxiety Disorder -
CORRECT-ANSWERSSSRIs, SNRIs, benzodiazepines, buspirone, and α2δ
ligands such as pregabalin and gabapentin

Other "off-label" treatments for anxiety can
include mirtazapine, trazodone, vilazodone, tricyclic antidepressants, or even
sedating antihistamines such as hydroxyzine.

Treatment for anxiety disorder subtypes: PTSD - CORRECT-
ANSWERSpsychopharmacological treatments
-not as effective as these same treatments are in anxiety disorders
-more effectively aimed at comorbidities: depression, insomnia, substance
abuse, and pain
Benzodiazepines are to be used with caution
-limited evidence from clinical trials for efficacy in PTSD
-many PTSD patients abuse alcohol and other substances
unique treatment for PTSD is the administration of α1 antagonists at night to
prevent nightmares

The amygdala hypothetically plays a central role in the _______________.
Cortico-striato-thalamo-cortical (CSTC) circuits are thought to play a key role
in mediating the symptom of __________. - CORRECT-ANSWERSfear response,
worry

________,_________,_________,________ are all key modulators of the
hypothetical fear and worry circuits - CORRECT-ANSWERSSerotonin,
norepinephrine, alpha-2 delta ligands and GABA

Amygdala-centered circuit - CORRECT-ANSWERSFear
-panic
-phobia

cortico-striato-thalamo-corical (CSTC) circuit - CORRECT-ANSWERSworry
-anxious misery

,-apprehensive expectation
-obsession

Gabapentin - CORRECT-ANSWERSAnxiolytic
glutamate voltage-gated calcium channel blocker, Anticonvulsant; alpha 2
delta ligand at voltage-sensitive calcium channels
-Indication: Partial seizures with or without secondary generalization,
postherpetic neuralgia, restless leg syndrome, neuropathic pain/chronic pain,
anxiety, bipolar disorder.
-Dosing: 900-1800 mg/day in 3 divided doses

Risks: CNS side effects:
Sedation
Ataxia
fatigue
nystagmus
tremor

Pearls:
-Most use if off-label
-Off-label use for first-line treatment of neuropathic pain may be justified

Pregabalin - CORRECT-ANSWERSAnxiolytic
glutamate voltage-gated calcium channel blocker, Anticonvulsant; alpha 2
delta ligand at voltage-sensitive calcium channels
-Indication: Diabetic peripheral neuropathy, postherpetic neuralgia,
fibromyalgia, neuropathic pain associated with spinal cord injury, partial
onset seizures, peripheral neuropathic pain, GAD, panic disorder, social
anxiety disorder.
-Dosing: IR: 150-600 mg/day in 2-3 doses, CR: 330 mg once per day

Risks: CNS side effects:
Sedation

Pearls:
-First treatment approved for fibromyalgia
-Off-label use for GAD, panic disorder, and social anxiety disorder may be
justified in the USA

Buspirone - CORRECT-ANSWERSAnxiolytic
serotonin receptor partial agonist
-Indication: Anxiety, depression, treatment-resistant depression
-Dosing: usual 20-30 mg/day. Initial 15 mg twice a day; increase in 5 mg/day
increments every 2-3 days until desired efficacy reached (max 60 mg/day)

Risks:

, Dizziness
Headache
Nervousness
Sedation

Pearls:
-Do not use if patient taking an MAOI
-generally reserved as an augmenting agent to treat anxiety

Hydroxyzine - CORRECT-ANSWERSAnxiolytic
histamine receptor antagonist
-Indication: Anxiety and tension associated with psychoneurosis, pruritus,
sedation, hysteria, withdrawal symptoms, delirium tremens, nausea and
vomiting, insomnia.
-Dosing:
• Anxiety: 50-100 mg 4 times a day
• Sedative: 50-100 mg oral, 25-100 mg intramuscular injection
• Pruritus: 75 mg/day divided into 3-4 doses

Risks: Blocking histamine 1 receptors can cause sedation

Pearls:
-preferred anxiolytic for patients with dermatitis or skin symptoms such as
pruritis

Alprazolam - CORRECT-ANSWERSAnxiolytic
BENZODIAZEPINE
GABA positive allosteric modulator
-Indication: Generalized anxiety disorder, other anxiety disorders, panic
disorder, premenstrual dysphoric disorder, irritable bowel syndrome,
insomnia, acute mania, acute psychosis, catatonia.
-Dosing:
• Anxiety: alprazolam IR: 1-4 mg/day (start at 0.75-1.5, 3 divided doses)
• Panic: alprazolam IR: 5-6 mg/day (start at 1.5, 3 divided doses)
• Panic: alprazolam XR: 3-6 mg/day (start at 0.5-1 QD AM)

Risks:
-Sedation, fatigue, depression
-Dizziness, ataxia, slurred speech, weakness
-Forgetfulness, confusion
-Hyperexcitability, nervousness

Pearls:
-not recommended during pregnancy, especially during first trimester
-Recommended either D/C drug or bottle feed

The benefits of buying summaries with Stuvia:

Guaranteed quality through customer reviews

Guaranteed quality through customer reviews

Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.

Quick and easy check-out

Quick and easy check-out

You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.

Focus on what matters

Focus on what matters

Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!

Frequently asked questions

What do I get when I buy this document?

You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.

Satisfaction guarantee: how does it work?

Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.

Who am I buying these notes from?

Stuvia is a marketplace, so you are not buying this document from us, but from seller Elitaa. Stuvia facilitates payment to the seller.

Will I be stuck with a subscription?

No, you only buy these notes for $27.99. You're not tied to anything after your purchase.

Can Stuvia be trusted?

4.6 stars on Google & Trustpilot (+1000 reviews)

72042 documents were sold in the last 30 days

Founded in 2010, the go-to place to buy study notes for 14 years now

Start selling
$27.99
  • (0)
  Add to cart