Panic Disorders

 Recurrent and at times unexpected; at least one of the attacks followed by 1 month or more of:A)persistent concern about having additional attacks B)Worry about the implications of the attack or its consequences C) significant change in behavior related to the attacks D)

Panic Disorder (2)

consists of for or more of the following:

A) palpitations, pounding heart, or accelerated heart rate B)sweating C) trembling or shakeing D) sensations of shortnes of breath or smothering E) feeling of choking F)

Panic Disorders (3)

Nausea or abdominal distress; feeling dizzy, unsteady, lightheaded or faint; derealization or depersonalizion; fear of losing control or going crazy; fear of dying; farathesias; chills or hot flashes;

Anxiety disroders

(specific phobia)

marked and persistent fear of clearly discernible circumscribed objects or situtaions. exposure to the stimulus provokes an immediate anxiety response: leads to avoidance.

Subtypes: animal; natural environmental; blood-injection injury; situational; other

Anxiety (social phobia)

OCD

recurrent obsessions or compulsions that are severe enough to be time consumng (more than 1 hour a day) or cause marked distres or significant impairment.

Posttraumatic Stress

Acute Stress Disorder

same critera as PTSD except symptoms have been ongoing for at least one day and no more than 30 days.

GAD

excessive anxiety and worry occurring more days than not, for a period of at least six months, about a number of events or activites

Action Potential of Neuron

-resting cell (polarized)

interacellular (inside the cell) 70 mv

extracellular (outside the cell) 70mv

.........

GAB Aergic Neurons

Neurotransmitter: gamma-aminobutyric acid (GABA)

-receptor site A: gatekeeper of the chloride channel: inhibits anxiety; hyperpolarization; increase action potential threshold

 Receptor site B: newer anticonvulsant medication, clinical trials

Benodiazepine: Mechanism of Action

benzo. are agonists of the GABA - beno. -chloride receptor complex, faciliting the binding of the GABA

in turn the increaso fo GABA raises the action potential threshold of the post synaptic neuron (hyper-polarized)

anxioly......

Indications for the use of Benzoiazepines

- short-term treatment of psychological distress/anxiety and sysphoria related to anxiety.

- sleep disorders

- panic disorder

- acute alcohol withdrawl

Affects of Benzo

- seizures Benzo. increases threshold

- acute mania

- drug induces phycosis

- pre-op

- addictive potential withdrawl, possible seizures, rebound anxiety

- tapering phase veryimportant

- indicated for short term treatment

- short term memory loss

- sedation

-extreme caution with the elderly (must use minimum doses)

Benzo and 1/2 life:

long acting

valium

Xanax

alproazolam

Valium

diazepam