Anxiety, Pain, and Pharmacology Review

Practice flashcards covering medical disorders and pharmacological treatments including anxiety, pain, thyroid issues, lipids, diabetes, gastrointestinal drugs, and sedatives.

What are the hallmark symptoms of generalized anxiety disorder?

Fear, apprehension, dread, uneasiness, and uncontrollable worrying lasting $6\,\text{months}$ or longer.

What is a panic disorder characterized by?

A sudden sense of fear.

What is OCD characterized by?

Persistent obsessions and compulsions.

What is social anxiety disorder?

Intense and irrational fear of being scrutinized by others.

What is PTSD characterized by?

Reliving a traumatic event and avoidance of reminders of that event.

What non-drug treatments are used for anxiety disorders?

Supportive therapy, CBT, and biofeedback.

Which drug classes are commonly used for anxiety?

Benzodiazepines, buspirone, SSRIs, and SNRIs.

Which drug class is especially useful for panic disorder?

Benzodiazepines.

Which drug classes are commonly used for OCD?

SSRIs and SNRIs.

What is nociceptive pain?

Pain from tissue injury that travels from peripheral tissues \rightarrow spinal cord \rightarrow brain.

What are the two forms of nociceptive pain?

Somatic pain and visceral pain.

What is inflammatory pain?

Pain associated with tissue swelling and hypersensitivity.

What is neuropathic pain?

Pain caused by damage or lesions of the nervous system.

Does neuropathic pain respond well to opioids?

No, it responds poorly to opioids.

What are examples of adjuvant analgesics for neuropathic pain?

TCAs, antiseizure drugs, and local anesthetics.

What comprises Step 1 of the pain ladder?

NSAIDs and acetaminophen.

What comprises Step 2 of the pain ladder?

The addition of weaker opioids such as hydrocodone or oxycodone.

What comprises Step 3 of the pain ladder?

Strong opioids such as morphine or fentanyl.

Which opioid is commonly used for severe cancer pain?

Morphine.

What are classic migraine symptoms?

Throbbing headache, nausea/vomiting, and sensitivity to light and sound.

What are the first-line drugs used to abort a migraine attack?

Triptans (5-HT1B/1D agonists).

What specific receptors do triptans activate?

Serotonin 5-HT1B/1D receptors.

What are the second-line drugs for migraines not responding to triptans?

Ergot alkaloids.

What are common migraine preventive drugs?

Beta blockers, TCAs, calcium channel blockers, Botox, and angiotensin II blockers.

What drug is the first-line treatment for hypothyroidism?

Levothyroxine (T4).

Which drug is a synthetic form of T3?

Liothyronine.

What are common symptoms of hypothyroidism?

Cold dry skin, fatigue, bradycardia, pale puffy face, and brittle hair.

What is the most common autoimmune cause of hypothyroidism?

Hashimoto disease.

What are the two major forms of hyperthyroidism?

Graves disease and toxic nodular goiter.

What eye finding is associated with Graves disease?

Exophthalmos (bulging eyes).

What is the first-line drug for hyperthyroidism?

Methimazole.

Which drug is preferred for treating thyroid storm?

PTU.

What radioactive treatment is used to destroy thyroid tissue?

Iodine-131.

Why are beta blockers used in hyperthyroidism?

To control tachycardia and sympathetic symptoms.

What is the primary cause of coronary heart disease?

Atherosclerosis.

Which lipid is most associated with increased cardiovascular risk?

LDL.

Which lipid-lowering drugs are most effective for lowering LDL?

Statins.

What enzyme do statins inhibit?

HMG-CoA reductase.

What are the major effects of statins on a lipid profile?

$\downarrow$ LDL, $\uparrow$ HDL, and $\downarrow$ TG.

How long does it take for statins to show their full effect?

About $4\,\text{weeks}$.

What is a major serious adverse effect of statins?

Myopathy/rhabdomyolysis.

Why are statins usually taken in the evening?

Cholesterol synthesis is highest at night.

Which lipid-lowering drug increases HDL the most?

Niacin.

Which lipid-lowering drug class is best for lowering triglycerides?

Fibrates.

Which drug blocks cholesterol absorption?

Ezetimibe.

What specific lipid markers does ezetimibe lower?

Total cholesterol, LDL, and ApoB.

Which lipid-lowering drugs are mainly used as adjuncts to statins?

Bile-acid sequestrants.

What is the cause of Type 1 diabetes?

Autoimmune destruction of pancreatic beta cells.

What is the cause of Type 2 diabetes?

Insulin resistance and impaired insulin secretion.

What are the classic symptoms of diabetes?

Hyperglycemia, polyuria, polydipsia, ketonuria, and weight loss.

Which long-acting insulin was emphasized for the exam?

Insulin glargine.

What blood glucose level defines hypoglycemia?

$70\,\text{mg/dL}$.

What are the four oral hypoglycemic classes emphasized?

Biguanides, sulfonylureas, thiazolidinediones, and meglitinides.

What is the most common cause of peptic ulcer disease?

H. pylori.

What are the three major mucosal defense factors?

Mucus, bicarbonate, and prostaglandins.

How do NSAIDs contribute to the formation of ulcers?

They inhibit prostaglandin synthesis.

What is the standard treatment for H. pylori?

$2$ to $3$ antibiotics plus a PPI or H2 blocker.

Which drug class suppresses gastric acid secretion most effectively?

PPIs.

What is sucralfate used for?

Acute ulcers and maintenance therapy.

What drug is specifically used to prevent NSAID-induced ulcers?

Misoprostol.

Which laxative class acts like dietary fiber?

Bulk-forming laxatives (psyllium).

Which laxative softens stool by increasing water content?

Docusate (surfactant).

Which laxative class is commonly used for opioid-induced constipation?

Stimulant laxatives (Dulcolax/bisacodyl).

What is the action of osmotic laxatives (Milk of Magnesia)?

They draw water into the intestine.

What are examples of benzodiazepines?

Diazepam, lorazepam, and alprazolam.

What are the main therapeutic uses of benzodiazepines?

Anxiety, insomnia, seizures, panic disorder, and alcohol withdrawal.

What is the major adverse effect of benzodiazepines?

CNS depression.

What is anterograde amnesia in the context of drug use?

The inability to form new memories after drug administration.

What are the paradoxical effects of benzodiazepines?

Anger, agitation, and irritability.

What is the antidote for a benzodiazepine overdose?

Flumazenil.

What is the major danger associated with barbiturates?

Respiratory depression.

What is the primary receptor targeted by morphine?

Mu opioid receptor.

What is the classic opioid overdose triad?

Coma, respiratory depression, and pinpoint pupils.

What is the antidote for an opioid overdose?

Naloxone (Narcan).

What is the most common adverse effect of opioids?

Constipation.

Which CNS depressants interact dangerously with opioids?

Alcohol, benzodiazepines, and barbiturates.