Bronchitis is inflammation of the mucous membranes of the bronchi, the airways that carry airflow from the trachea into the lungs. Bronchitis can be classified into two categories, acute and chronic, each of which has unique etiologies, pathologies, and therapies. Acute bronchitis is characterized by the development of a cough, with or without the production of sputum, mucus that is expectorated (coughed up) from the respiratory tract. Acute bronchitis often occurs during the course of an acute viral illness such as the common cold or influenza. Viruses cause about 90% of cases of acute bronchitis while bacteria account for less than 10%. Chronic bronchitis, a type of chronic obstructive pulmonary disease, is characterized by the presence of a productive cough that lasts for 3 months or more per year for at least 2 years. Chronic bronchitis most often develops due to recurrent injury to the airways caused by inhaled irritants. Cigarette smoking is the most common cause, followed by air pollution and occupational exposure to irritants, and cold air.
Acute bronchitis: Acute bronchitis is most often caused by viruses that infect the epithelium of the bronchi, resulting in inflammation and increased secretion of mucus. Cough, a common symptom of acute bronchitis, develops in an attempt to expel the excess mucus from the lungs. Other common symptoms include sore throat, runny nose, nasal congestion (coryza), low-grade fever, malaise, and the production of sputum. Acute bronchitis often develops during the course of an upper respiratory infection (URI) such as the common cold or influenza. About 90% of cases of acute bronchitis are caused by viruses, including rhinoviruses, adenoviruses, and influenza. Bacteria, including Mycoplasma pneumoniae, Chlamydia pneumoniae, and Bordetella pertussis, account for about 10% of cases.
Treatment for acute bronchitis is primarily symptomatic. Non-steroidal anti-inflammatory drugs (NSAIDs) may be used to treat fever and sore throat. Decongestants can be useful in patients with nasal congestion, and expectorants may be used to loosen mucus and increase expulsion of sputum. Cough suppressants may be used if the cough interferes with sleep or is bothersome, although coughing may be useful in expelling sputum from the airways. Even with no treatment, most cases of acute bronchitis resolve quickly. As most cases of acute bronchitis are caused by viruses, antibiotics should not be used since they are only effective against bacteria. Using antibiotics in patients who do not have bacterial infections promotes the development of antibiotic-resistant bacteria, which may lead to greater morbidity and mortality. Antibiotics should only be prescribed if microscopic examination of Gram stained sputum shows large numbers of bacteria present. Chronic bronchitis: Chronic bronchitis, a type of chronic obstructive pulmonary disease, is defined by a productive cough that lasts for 3 months or more per year for at least 2 years. Other symptoms may include wheezing and shortness of breath, especially upon exertion. The cough is often worst soon after awakening, and the sputum produced may have a yellow or green color and may be streaked with blood. Chronic bronchitis is caused by recurring injury or irritation to the respiratory epithelium of the bronchi, resulting in chronic inflammation, edema (swelling), and increased production of mucus by goblet cells. Airflow into and out of the lungs is partly blocked because of the swelling and extra mucus in the bronchi or due to reversible bronchospasm. Most cases of chronic bronchitis are caused by smoking cigarettes or other forms of tobacco. Chronic inhalation of irritating fumes or dust from occupational exposure or air pollution may also be causative. About 5% of the population has chronic bronchitis, and it is two times more common in males than females. Chronic bronchitis is treated symptomatically. Inflammation and edema of the respiratory epithelium may be reduced with inhaled corticosteroids. Wheezing and shortness of breath can be treated by reducing bronchospasm (reversible narrowing of smaller bronchi due to constriction of the smooth muscle) with bronchodilators such as inhaled ß-Adrenergic agonists (e.g., albuterol) and inhaled anticholinergics (e.g., ipratropium bromide). Hypoxemia, too little oxygen in the blood, can be treated with supplemental oxygen. However, oxygen supplementation can result in decreased respiratory drive leading to increased blood levels of carbon dioxide and subsequent respiratory acidosis. The most effective method of preventing chronic bronchitis and other forms of COPD is to avoid smoking cigarettes and other forms of tobacco.
On pulmonary tests, a bronchitic (bronchitis) may present a decreased FEV1 and FEV1/FVC. However, unlike the other common obstructive disorders, asthma and emphysema, bronchitis rarely causes a high residual volume. This is because the air flow obstruction found in bronchitis is due to increased resistance, which does not generally cause the airways to collapse prematurely and trap air in the lungs.
Pneumonia is an inflammatory illness of the lung. Frequently, it is described as lung parenchyma/alveolar inflammation and abnormal alveolar filling with fluid (consolidation and exudation). The alveoli are microscopic air-filled sacs in the lungs responsible for absorbing oxygen. Pneumonia can result from a variety of causes, including infection with bacteria, viruses, fungi, or parasites, and chemical or physical injury to the lungs. Its cause may also be officially described as idiopathic—that is, unknown—when infectious causes have been excluded. Typical symptoms associated with pneumonia include cough, chest pain, fever, and difficulty in breathing. Diagnostic tools include x-rays and examination of the sputum. Treatment depends on the cause of pneumonia; bacterial pneumonia is treated with antibiotics. Pneumonia is a common illness which occurs in all age groups, and is a leading cause of death among the elderly and people who are chronically and terminally ill. Additionally, it is the leading cause of death in children under five years old worldwide. to prevent certain types of pneumonia are available. The prognosis depends on the type of pneumonia, the appropriate treatment, any complications, and the person's underlying health.
Signs And Symptoms: People with infectious pneumonia often have a cough producing greenish or yellow sputum, or phlegm and a high fever that may be accompanied by shaking chills. Shortness of breath is also common, as is pleuritic chest pain, a sharp or stabbing pain, either experienced during deep breaths or coughs or worsened by them. People with pneumonia may cough up blood, experience headaches, or develop sweaty and clammy skin. Other possible symptoms are loss of appetite, fatigue, blueness of the skin, nausea, vomiting, mood swings, and joint pains or muscle aches. Less common forms of pneumonia can cause other symptoms; for instance, pneumonia caused by Legionella may cause abdominal pain and diarrhea, while pneumonia caused by tuberculosis or Pneumocystis may cause only weight loss and night sweats. In elderly people manifestations of pneumonia may not be typical. They may develop a new or worsening confusion or may experience unsteadiness, leading to falls. Infants with pneumonia may have many of the symptoms above, but in many cases they are simply sleepy or have a decreased appetite. Pneumonia fills the lung's alveoli with fluid, keeping oxygen from reaching the bloodstream. The alveolus on the left is normal, while the alveolus on the right is full of fluid from pneumonia. Symptoms of pneumonia need immediate medical evaluation. Physical examination by a health care provider may reveal fever or sometimes low body temperature, an increased respiratory rate, low blood pressure, a high heart rate, or a low oxygen saturation, which is the amount of oxygen in the blood as indicated by either pulse oximetry or blood gas analysis. People who are struggling to breathe, who are confused, or who have cyanosis (blue-tinged skin) require immediate attention.Physical examination of the lungs may be normal, but often shows decreased expansion of the chest on the affected side, bronchial breathing on auscultation with a stethoscope (harsher sounds from the larger airways transmitted through the inflamed and consolidated lung), and rales (or crackles) heard over the affected area during inspiration. Percussion may be dulled over the affected lung, but increased rather than decreased vocal resonance (which distinguishes it from a pleural effusion). While these signs are relevant, they are insufficient to diagnose or rule out a pneumonia; moreover, in studies it has been shown that two doctors can arrive at different findings on the same patient.
Complications: Sometimes pneumonia can lead to additional complications. Complications are more frequently associated with bacterial pneumonia than with viral pneumonia. The most important complications include: Respiratory and circulatory failure Because pneumonia affects the lungs, often people with pneumonia have difficulty breathing, and it may not be possible for them to breathe well enough to stay alive without support. Non-invasive breathing assistance may be helpful, such as with a bi-level positive airway pressure machine. In other cases, placement of an endotracheal tube (breathing tube) may be necessary, and a ventilator may be used to help the person breathe. Pneumonia can also cause respiratory failure by triggering acute respiratory distress syndrome (ARDS), which results from a combination of infection and inflammatory response. The lungs quickly fill with fluid and become very stiff. This stiffness, combined with severe difficulties extracting oxygen due to the alveolar fluid, create a need for mechanical ventilation. Pleural effusion. Chest x-ray showing a pleural effusion. The A arrow indicates "fluid layering" in the right chest. The B arrow indicates the width of the right lung. The volume of useful lung is reduced because of the collection of fluid around the lung. Sepsis and septic shock are potential complications of pneumonia. Sepsis occurs when microorganisms enter the bloodstream and the immune system responds by secreting cytokines. Sepsis most often occurs with bacterial pneumonia; Streptococcus pneumoniae is the most common cause. Individuals with sepsis or septic shock need hospitalization in an intensive care unit. They often require intravenous fluids and medications to help keep their blood pressure from dropping too low. Sepsis can cause liver, kidney, and heart damage, among other problems, and it often causes death. Pleural effusion, empyema, and abscess Occasionally, microorganisms infecting the lung will cause fluid (a pleural effusion) to build up in the space that surrounds the lung (the pleural cavity). If the microorganisms themselves are present in the pleural cavity, the fluid collection is called an empyema. When pleural fluid is present in a person with pneumonia, the fluid can often be collected with a needle (thoracentesis) and examined. Depending on the results of this examination, complete drainage of the fluid may be necessary, often requiring a chest tube. In severe cases of empyema, surgery may be needed. If the fluid is not drained, the infection may persist, because antibiotics do not penetrate well into the pleural cavity. Rarely, bacteria in the lung will form a pocket of infected fluid called an abscess. Lung abscesses can usually be seen with a chest x-ray or chest CT scan. Abscesses typically occur in aspiration pneumonia and often contain several types of bacteria. Antibiotics are usually adequate to treat a lung abscess, but sometimes the abscess must be drained by a surgeon or radiologist.
Most cases of pneumonia can be treated without hospitalization. Typically, oral antibiotics, rest, fluids, and home care are sufficient for complete resolution. However, people with pneumonia who are having trouble breathing, people with other medical problems, and the elderly may need more advanced treatment. If the symptoms get worse, the pneumonia does not improve with home treatment, or complications occur, the person will often have to be hospitalized. Bacterial pneumonia: Antibiotics are used to treat bacterial pneumonia. In contrast, antibiotics are not useful for viral pneumonia, although they sometimes are used to treat or prevent bacterial infections that can occur in lungs damaged by a viral pneumonia.[citation needed] The antibiotic choice depends on the nature of the pneumonia, the most common microorganisms causing pneumonia in the local geographic area, and the immune status and underlying health of the individual. Treatment for pneumonia should ideally be based on the causative microorganism and its known antibiotic sensitivity. However, a specific cause for pneumonia is identified in only 50% of people, even after extensive evaluation.[citation needed] Because treatment should generally not be delayed in any person with a serious pneumonia, empiric treatment is usually started well before laboratory reports are available. In the United Kingdom, amoxicillin and clarithromycin or erythromycin are the antibiotics selected for most patients with community-acquired pneumonia; patients allergic to penicillins are given erythromycin instead of amoxicillin. In North America, where the "atypical" forms of community-acquired pneumonia are becoming more common, macrolides (such as azithromycin and clarithromycin), the fluoroquinolones, and doxycycline have displaced amoxicillin as first-line outpatient treatment for community-acquired pneumonia. The duration of treatment has traditionally been seven to ten days, but there is increasing evidence that shorter courses (as short as three days) are sufficient. Antibiotics for hospital-acquired pneumonia include third- and fourth-generation cephalosporins, carbapenems, fluoroquinolones, aminoglycosides, and vancomycin. These antibiotics are usually given intravenously. Multiple antibiotics may be administered in combination in an attempt to treat all of the possible causative microorganisms. Antibiotic choices vary from hospital to hospital because of regional differences in the most likely microorganisms, and because of differences in the microorganisms' abilities to resist various antibiotic treatments. People who have difficulty breathing due to pneumonia may require extra oxygen. Extremely sick individuals may require intensive care, often including endotracheal intubation and artificial ventilation.
Viral pneumonia: Viral pneumonia caused by influenza A may be treated with rimantadine or amantadine, while viral pneumonia caused by influenza A or B may be treated with oseltamivir or zanamivir. These treatments are beneficial only if they are started within 48 hours of the onset of symptoms. Many strains of H5N1 influenza A, also known as avian influenza or "bird flu," have shown resistance to rimantadine and amantadine. There are no known effective treatments for viral pneumonias caused by the SARS coronavirus, adenovirus, hantavirus, or parainfluenza virus. Aspiration pneumonia: There is no evidence to support the use of antibiotics in chemical pneumonitis without bacterial infection. If infection is present in aspiration pneumonia, the choice of antibiotic will depend on several factors, including the suspected causative organism and whether pneumonia was acquired in the community or developed in a hospital setting. Common options include clindamycin, a combination of a beta-lactam antibiotic and metronidazole, or an aminoglycoside. Corticosteroids are commonly used in aspiration pneumonia, but there is no evidence to support their use either.
Atherosclerosis (also known as Arteriosclerotic Vascular Disease or ASVD) is the condition in which an artery wall thickens as the result of a build-up of fatty materials such as cholesterol. It is a syndrome affecting arterial blood vessels, a chronic inflammatory response in the walls of arteries, in large part due to the accumulation of macrophage white blood cells and promoted by low density (especially small particle) lipoproteins (plasma proteins that carry cholesterol and triglycerides) without adequate removal of fats and cholesterol from the macrophages by functional high density lipoproteins (HDL), (see apoA-1 Milano). It is commonly referred to as a hardening or furring of the arteries. It is caused by the formation of multiple plaques within the arteries.
The atheromatous plaque is divided into three distinct components:
1. The atheroma ("lump of wax", from Athera, wax in Greek,), which is the nodular accumulation of a soft, flaky, yellowish material at the center of large plaques, composed of macrophages nearest the lumen of the artery 2. Underlying areas of cholesterol crystals 3. Calcification at the outer base of older/more advanced lesions.
The following terms are similar, yet distinct, in both spelling and meaning, and can be easily confused: arteriosclerosis, arteriolosclerosis, and atherosclerosis. Arteriosclerosis is a general term describing any hardening (and loss of elasticity) of medium or large arteries (from the Greek Arterio, meaning artery, and sclerosis, meaning hardening); arteriolosclerosis is any hardening (and loss of elasticity) of arterioles (small arteries); atherosclerosis is a hardening of an artery specifically due to an atheromatous plaque. Therefore, atherosclerosis is a form of arteriosclerosis.
Atherosclerosis, though typically asymptomatic for decades, eventually produces two main problems: First, the atheromatous plaques, though long compensated for by artery enlargement (see IMT), eventually lead to plaque ruptures and clots inside the artery lumen over the ruptures. The clots heal and usually shrink but leave behind stenosis (narrowing) of the artery (both locally and in smaller downstream branches), or worse, complete closure, and, therefore, an insufficient blood supply to the tissues and organ it feeds. Second, if the compensating artery enlargement process is excessive, then a net aneurysm results.
These complications of advanced atherosclerosis are chronic, slowly progressive and cumulative. Most commonly, soft plaque suddenly ruptures (see vulnerable plaque), causing the formation of a thrombus that will rapidly slow or stop blood flow, leading to death of the tissues fed by the artery in approximately 5 minutes. This catastrophic event is called an infarction. One of the most common recognized scenarios is called coronary thrombosis of a coronary artery, causing myocardial infarction (a heart attack). Even worse is the same process in an artery to the brain, commonly called stroke. Another common scenario in very advanced disease is claudication from insufficient blood supply to the legs, typically due to a combination of both stenosis and aneurysmal segments narrowed with clots. Since atherosclerosis is a body-wide process, similar events occur also in the arteries to the brain, intestines, kidneys, legs, etc.
Yet, many infarctions involve only very small amounts of tissue and are termed clinically silent, because the person having the infarction does not notice the problem, does not seek medical help or when they do, physicians do not recognize what has happened.
Angina pectoris, commonly known as angina, is severe chest pain due to ischemia (a lack of blood and hence oxygen supply) of the heart muscle, generally due to obstruction or spasm of the coronary arteries (the heart's blood vessels). Coronary artery disease, the main cause of angina, is due to atherosclerosis of the cardiac arteries. The term derives from the Latin angina ("infection of the throat") from the Greek ?????? ankhone ("strangling"), and the Latin pectus ("chest"), and can therefore be translated as "a strangling feeling in the chest".
It is not common to equate severity of angina with risk of fatal cardiac events. There is a weak relationship between severity of pain and degree of oxygen deprivation in the heart muscle (i.e., there can be severe pain with little or no risk of a heart attack, and a heart attack can occur without pain).
Worsening ("crescendo") angina attacks, sudden-onset angina at rest, and angina lasting more than 15 minutes are symptoms of unstable angina (usually grouped with similar conditions as the acute coronary syndrome). As these may herald myocardial infarction (a heart attack), they require urgent medical attention and are generally treated as a presumed heart attack.
* Beta-Blockers- Carvediol, Propranolol * Short Acting Nitroglycerin for symptomatic relief * Calcium Channel Blockers- Nifedipin * Vasodialators- Nicorandil, Isosorbide mononitrite * Statin- Most Friquently Used * Low Dose Aspirin For Relief Of the Heart Attack in Angina Pectoris.
The government has warned people in the country are rapidly lethal legs Pasar Influenja A-H1N1 Swain flu the only effective drug used Temiflu not without medical advice and medication if it'd always get a full meal. Dose or stop in the middle half of the drug could be dangerous to health.
Health Research Department, Secretary and Director General of ICMR, said Dr. Katoch fatal Influenja e-H1N1, the only effective medication without medical advice not to use Temiflu and if it is to take medication always take a full meal. Dose or stop in the middle half of the drug could be harmful for health. He said that the patients taking this medicine to take care is absolutely necessary.
Dr. Katoch said that without the unnecessary use of medical advice Temiflu H1N1 of the virus resistant capacity is increased and consistent use to live like this on patients likely to reduce the effect of the drug increases. He said symptoms of the disease showed Swain flu patients should see a doctor soon and give advice should take this medicine. Asked whether the Government has taken concrete steps to prevent misuse of Temiflu are, said Dr. Katoch are not misusing any of Temiflu and needy patients are easily found, to ensure it the Government of the drug sales is directed to the same class of drug substances containing medicines (Schedule 10) are sold.
Pharmacists to sell drugs when such consultation, counseling and the doctor's name to whom it is being sold, the person must enter the name. Dr Katoch said that as people in India often take drugs without doctor's advice.
According to World Health Organization is expected to be available until the mid-October. In India in March next year is expected to indigenous vaccine. The time available for treatment of flu Swain Temiflu is the only medicine.
Influenza – A (H1N1) (earlier know as swine flu) is a new influenza virus causing illness in people.First detected in Mexico in April, 2009, it has spread to many countries in the World.Swine flu is basically a misnomer.This was originally referred to as “swine flu” because laboratory testing showed that many of the genes in this new virus were very similar to those found in pigs in North America.Further on, it has been found that this new virus has gene segments from the swine, avian and human flu virus genes.The scientists calls this a ‘quadruple reassortant” virus and hence this new (novel) virus is christened “influenza-A (H1N1) virus.”
InfluenzaA(H1N1) outbreak
It is causing an epidemic among humans in Mexico and it has spread to Argentina, Australia, Austria, Belgium, Brazil, Canada, Chile, China, Colombia, Costa Rica, Cuba, Denmark, Ecuador, El Salvador, Finland, France, Germany, Guatemala, India, Ireland, Israel, Italy, Japan, Republic of Korea, Malaysia, Netherlands, New Zealand, Norway, Panama, Peru, Poland, Portugal, Spain, Sweden, Switzerland, Thailand, Turkey, UK andUSA.
Are there human/infections with influenza – A (H1N1) in India?
One passenger who traveled to India from USA has tested positive for Influenza A [H1N1]. There is no further spread from him. Do not panic!
Is it safe to take pork items?
Pigs have nothing to do with this disease.Pork products are absolutely safe if properly cooked.There is no need to cull pigs.Do not panic if some pigs die in the community due to natural disease.
Is this flu virus contagious?
Influenza A (H1N1) virus is contagious and spreading from human to human.
What are the signs and symptoms of influenza-A (H1N1) in people?
The symptoms of swine flu in people are similar to the symptoms of regular seasonal flu and include fever, cough, sore throat, body aches, headache, chills and fatigue.Some people have reported diarrhea and vomiting associated with influenza-A (H1N1)
How does influenza-A (H1N1) spread?
Flu viruses are spread mainly from person to person through droplets created while coughing or sneezing by a person infected with the influenza-A (H1N1).
How can someone with the flu infect someone else?
Infected person may be able to infect others beginning one day before symptoms develop and up to seven or more days after becoming sick.
How to keep away from getting the flu?
First and most important:Follow simple steps as cough etiquettes (covering mouth & nose with handkerchief or tissue paper while coughing), stay at least an arm’s length from persons coughing or sneezing, avoid gathering and wash your hands frequently.Try to stay in good general health.Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids and eat nutritious food.
Are there medicines to treat this flu?
Yes.Necessary medicines in sufficient quantity are available.The Government has in the designated hospitals stored medicines if required.It is strongly advisable not to take medicines of your own, as it will lower your immunity.
What can I do to protect myself from getting sick?
(a)Cover your nose and mouth with a tissue when you cough or sneeze.Throw the tissue in the trash after you use it.
(b)Wash your hands often with soap and water, especially after you cough or sneeze.Alcohol-based hand cleaners are also effective.
(c)Avoid touching your eyes, nose or mouth.Germs spread this way.
(d)Try to avoid close contact with people having respiratory illness.
(e)If one gets sick with influenza, one must stay at home, away from work or school and limit contact with others to keep from infecting them.However, if one is having any respiratory distress, one should report to a nearby hospital.
What steps Government of India taking to prevent outbreak of this flu inIndia?
(1)The strategy is basically to detect early cases among the passengers coming from the affected countries either by air, road or ship.
(2)The Government has launched a massive mass media campaign to inform and educate people on dos and do nots.
(3)Sharing information with public through media.
APPEAL
People who have traveled from the affected countries in the past ten days and show symptoms of influenza A (H1N1) like fever, cough, sore throat and difficulty in breathing should immediately contact the telephone number given below or the nearby Government Hospital.
Vomiting (known medically as emesis and informally as throwing up and a number of other terms) is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose. Undesired vomiting may result from many causes, ranging from gastritis or poisoning to brain tumors, or elevated intracranial pressure. The feeling that one is about to vomit is called nausea. It usually precedes, but does not always lead to vomiting. Antiemetics are sometimes necessary to suppress nausea and vomiting, and, in severe cases where dehydration develops, intravenous fluid may need to be administered to replace fluid volume. Vomiting is different from regurgitation, although the two terms are often used interchangeably. Regurgitation is the return of undigested food back up the esophagus to the mouth, without the force and displeasure associated with vomiting. The causes of vomiting and regurgitation are generally different. Receptors on the floor of the fourth ventricle of the brain represent a chemoreceptor trigger zone, known as the area postrema, stimulation of which can lead to vomiting. The area postrema is a circumventricular organ and as such lies outside the blood-brain barrier; it can therefore be stimulated by blood-borne drugs that can stimulate vomiting or inhibit it.
There are various sources of input to the vomiting center: * The chemoreceptor trigger zone at the base of the fourth ventricle has numerous dopamine D2 receptors, serotonin 5-HT3 receptors, opioid receptors, acetylcholine receptors, and receptors for substance P. Stimulation of different receptors are involved in different pathways leading to emesis, in the final common pathway substance P appears to be involved.[1] * The vestibular system which sends information to the brain via cranial nerve VIII (vestibulocochlear nerve). It plays a major role in motion sickness and is rich in muscarinic receptors and histamine H1 receptors. * Cranial nerve X (vagus nerve), which is activated when the pharynx is irritated, leading to a gag reflex. * Vagal and enteric nervous system inputs that transmit information regarding the state of the gastrointestinal system. Irritation of the GI mucosa by chemotherapy, radiation, distention, or acute infectious gastroenteritis activates the 5-HT3 receptors of these inputs. * The CNS mediates vomiting arising from psychiatric disorders and stress from higher brain centers.
Act: The vomiting act encompasses three types of outputs initiated by the chemoreceptor trigger zone: Motor, parasympathetic nervous system (PNS), and sympathetic nervous system (SNS). They are as follows: * Increased salivation to protect the enamel of teeth from stomach acids (excessive vomiting leads to dental erosion). This is part of the PNS output. * A deep breath is taken to avoid aspiration of vomit. * Retroperistalsis, starting from the middle of the small intestine, sweeping up the contents of the digestive tract into the stomach, through the relaxed pyloric sphincter. * A lowering of intrathoracic pressure (by inspiration against a closed glottis), coupled with an increase in abdominal pressure as the abdominal muscles contract, propels stomach contents into the esophagus as the lower esophageal sphincter relaxes. The stomach itself does not contract in the process of vomiting except for at the angular notch, nor is there any retroperistalsis in the esophagus. * Vomiting is ordinarily preceded by retching. * Vomiting also initiates an SNS response causing both sweating and increased heart rate. The neurotransmitters that regulate vomiting are poorly understood, but inhibitors of dopamine, histamine, and serotonin are all used to suppress vomiting, suggesting that these play a role in the initiation or maintenance of a vomiting cycle. Vasopressin and neurokinin may also participate.
Phases: The vomiting act has two phases. In the retching phase, the abdominal muscles undergo a few rounds of coordinated contractions together with the diaphragm and the muscles used in respiratory inspiration. For this reason, an individual may confuse this phase with an episode of violent hiccups. In this retching phase nothing has yet been expelled. In the next phase, also termed the expulsive phase, intense pressure is formed in the stomach brought about by enormous shifts in both the diaphragm and the abdomen. These shifts are, in essence, vigorous contractions of these muscles that last for extended periods of time - much longer than a normal period of muscular contraction. The pressure is then suddenly released when the upper esophageal sphincter relaxes resulting in the expulsion of gastric contents. For people not in the habit of exercising the abdominal muscles, they may be painful for the next few days. The relief of pressure and the release of endorphins into the bloodstream after the expulsion causes the vomiter to feel better. Content: Gastric secretions and likewise vomit are highly acidic. Recent food intake will be reflected in the gastric vomit. Irrespective of the content, vomit tends to be malodorous. The content of the vomitus (vomit) may be of medical interest. Fresh blood in the vomit is termed hematemesis ("blood vomiting"). Altered blood bears resemblance to coffee grounds (as the iron in the blood is oxidized) and, when this matter is identified, the term "coffee ground vomiting" is used. Bile can enter the vomit during subsequent heaves due to duodenal contraction if the vomiting is severe. Fecal vomiting is often a consequence of intestinal obstruction or a gastrocolic fistula and is treated as a warning sign of this potentially serious problem ("signum mali ominis"); such vomiting is sometimes called "miserere." If the vomiting reflex continues for an extended period with no appreciable vomitus, the condition is known as non-productive emesis or dry heaves, which can be painful and debilitating.
Complications: 1.Aspiration of vomit: Vomiting can be dangerous if the gastric content gets into the respiratory tract. Under normal circumstances the gag reflex and coughing will prevent this from occurring, however these protective reflexes are compromised in persons under the influences of certain substances such as alcohol or anesthesia. The individual may choke and asphyxiate or suffer an aspiration pneumonia. 2.Dehydration and electrolyte imbalance: Prolonged and excessive vomiting will deplete the body of water (dehydration) and may alter the electrolyte status. Gastric vomiting leads to the loss of acid (protons) and chlorine directly. Combined with the resulting alkaline tide, this leads to hypochloremic metabolic alkalosis (low chloride levels together with high HCO3 and CO2 and increased blood pH) and often hypokalemia (potassium depletion). The hypokalemia is an indirect result of the kidney compensating for the loss of acid. With the loss of intake of food the individual may eventually become cachectic. A less frequent occurrence results from a vomiting of intestinal contents, including bile acids and HCO3- which can lead to metabolic acidosis. 3.Mallory-Weiss tear: Repeated or profuse vomiting may cause erosions to the esophagus or small tears in the esophageal mucosa (Mallory-Weiss tear). This may become apparent if fresh red blood is mixed with vomit after several episodes. 4.Recuurent Vomiting: Recurrent vomiting, such as observed in bulimia nervosa, may lead to destruction of the tooth enamel due to the acidity of the vomit. Digestive enzymes can also have a negative effect on oral health, by degrading the tissue of the gums.
Causes: Vomiting may be due to a large number of causes, and protracted vomiting has a long differential diagnosis. 1.Digestive tract: * Gastritis (inflammation of the gastric wall, usually by viruses) * Gastroenteritis * Pyloric stenosis (in babies, this typically causes a very forceful "projectile vomiting" and is an indication for urgent surgery) * Bowel obstruction * Overeating * Acute abdomen and/or peritonitis * Ileus * Cholecystitis, pancreatitis, appendicitis, hepatitis * Food poisoning * In children, it can be caused by an allergic reaction to cow's milk proteins (Milk allergy or lactose intolerance) 2.Sensory system: * Movement: motion sickness (which is caused by overstimulation of the labyrinthine canals of the ear) * Ménière's disease 3.Causes in the brain: * Concussion * Cerebral hemorrhage * Migraine * Brain tumors, which can cause the chemoreceptors to malfunction * Benign intracranial hypertension and hydrocephalus 4.Metabolic disturbances (these may irritate both the stomach and the parts of the brain that coordinate vomiting) * Hypercalcemia (high calcium levels) * Uremia (urea accumulation, usually due to renal failure) * Adrenal insufficiency * Hypoglycemia * Hyperglycemia 5.Pregnancy * Hyperemesis, Morning sickness 6.Drug reaction (vomiting may occur as an acute somatic response to) * alcohol (being sick while being drunk or being sick the next morning, suffering from the after-effects, i.e., the hangover). * opioids * selective serotonin reuptake inhibitors * many chemotherapy drugs * some entheogens (such as peyote or ayahuasca)
Illness: * Norwalk virus
Miscellaneous: * Self-induced o Eating disorders (anorexia nervosa or bulimia nervosa) o To eliminate an ingested poison (some poisons should not be vomited as they may be more toxic when inhaled or aspirated; it is better to ask for help before inducing vomiting) o Some people who are engaged in binge drinking will induce vomiting in order to make room in their stomachs for further alcohol consumption. * After surgery (postoperative nausea and vomiting) * Disagreeable sights, smells or thoughts (such as decayed matter, others' vomit, thinking of vomiting), etc. * Extreme pain, such as intense headache or myocardial infarction (heart attack) * Violent emotions * Cyclic vomiting syndrome (a poorly-understood condition with attacks of vomiting) * High doses of ionizing radiation will sometimes trigger a vomit reflex in the victim * Violent fits of coughing, hiccups, or asthma * Nervousness * Performing physical activity (such as swimming) shortly after a meal. * Being struck hard in the stomach. * Overexertion (doing too much strenuous exercise can lead to vomiting shortly afterwards). * Rumination syndrome, an underdiagnosed and poorly understood disorder that causes sufferers to regurgitate food shortly after ingestion.
Unusual types: Fecal vomiting is a kind of emesis in which half-digested matter is expelled from the intestines into the stomach, by spasmodic contractions of the gastric muscles, and then subsequently forcefully expelled from the stomach up into the esophagus and out through the mouth and sometimes nasal passages. Though it is not actual fecal matter that is expelled, it smells similar. Alternative medical terms for fecal vomiting are copremesis and stercoraceous vomiting.[2] This form of aspiration usually leads to a severe aspiration pneumonia, secondary to the massive number of bacteria present in the fecal matter.[citation needed] This form of pneumonia is often severe enough to be fatal.
An antiemetic is a drug that is effective against vomiting and nausea. Anti-emetics are typically used to treat motion sickness and the side effects of opioid analgesics, general anaesthetics and chemotherapy directed against cancer.
Types of Antiemetics:
Antiemetics include:
* 5-HT3 receptor antagonists - these block serotonin receptors in the central nervous system and gastrointestinal tract. As such, they can be used to treat post-operative and cytotoxic drug nausea & vomiting. o Dolasetron (Anzemet) Dolasetron can be administered in tablet form or in an injection. Tablets are administered one hour before chemotherapy or surgery. Injection is administered 30 minutes before certain chemotherapy or surgery. o Granisetron (Kytril, Sancuso) Granisetron can be administered in tablet (Kytril), oral solution (Kytril), or in a single transdermal patch to the upper arm (SANCUSO). Tablet and Oral solution (Kytril) should be administered twice daily up to one hour before chemotherapy with 12 hours between doses. Granisetron in patch form (SANCUSO) should be applied to the upper arm a minimum of 24 to 48 hours before the chemotherapy regimen begins. One patch can be worn for up to 7 days depending on the chemotherapy regimen. o Ondansetron (Zofran) Ondansetron is administered in an oral tablet form 30 minutes before chemotherapy. Further doses may be taken 1-2 days after chemotherapy completion. o Tropisetron (Navoban) Tropisetron can be administered in oral capsules or in injection form. It is given as a single for 6 days after the first day of chemotherapy. o Palonosetron (Aloxi) Palonosetron can be administered in an injection form 30 minutes before chemotherapy regimen begins or immediately before surgery. It can also be administered in oral capsule form one hour prior to the start of chemotherapy. o Mirtazapine (Remeron) * Dopamine antagonists act in the brain and are used to treat nausea and vomiting associated with neoplastic disease, radiation sickness, opioids, cytotoxic drugs and general anaesthetics. o Domperidone o Droperidol, haloperidol, chlorpromazine, promethazine, prochlorperazine. Some of these drugs are limited in their usefullness by their extra-pyramidal and sedative side-effects. o Metoclopramide (Reglan) also acts on the GI tract as a pro-kinetic, and is thus useful in gastrointestinal disease; however, it is poor in cytotoxic or post-op vomiting. o Alizapride * Antihistamines (H1 histamine receptor antagonists), effective in many conditions, including motion sickness and severe morning sickness in pregnancy. o Cyclizine o Diphenhydramine (Benadryl) o Dimenhydrinate (Gravol, Dramamine) o Meclizine (Bonine, Antivert) o Promethazine (Pentazine, Phenergan, Promacot) o Hydroxyzine * Cannabinoids are used in patients with cachexia, cytotoxic nausea, and vomiting, or who are unresponsive to other agents. o Cannabis (Marijuana). Most patients prefer smoked or vaporized cannabis over pharmaceutical versions because they do not contain all 66 cannabinoids that are in cannabis, many of which have medicinal applications. Medical marijuana is also much less expensive than related pharmaceuticals. CBD is a main cannabinoid not in Marinol or Cesamet. o Dronabinol (Marinol). Ninety percent of sales are for cancer and AIDS patients. The other 10% of its sales thought to be for pain, Multiple Sclerosis and also for Alzheimer's disease. o Nabilone (Cesamet). Put back on the market in late 2006. In the US, it is a Schedule II substance unlike Marinol which is Schedule III and cannabis which is Schedule I. o Sativex is an oral spray containing THC and CBD. It is currently legal in Canada and a few countries in Europe but not in the U.S. * Benzodiazepines o Midazolam given at the onset of anesthesia has been shown in recent trials to be as effective as ondansetron, a 5-HT3 antagonist in the prevention of post-operative nausea and vomiting. Further studies need to be undertaken. o Lorazepam said to be very good as an adjunct treatment for nausea along with first line medications such as Compazine or Zofran. * Anticholinergics o Hyoscine (also known as scopolamine) * Steroids o Dexamethasone given in low dose at the onset of a general anaesthetic for surgery is an effective anti-emetic. The specific mechanism of action is not fully understood. * NK1 receptor antagonist o Aprepitant (Emend) Commercially available NK1 Receptor antagonist o Casopitant Investigational NK1 receptor antagonist * Other o Trimethobenzamide; thought to work on the CTZ o Ginger o Emetrol also claimed to be an effective antiemetic. o Propofol given intravenously. It has been used in an acute care setting in hospital as a rescue therapy for emesis. o Peppermint claimed to help nausea or stomach pain when added into a tea or peppermint candies. o Muscimol purported as such [1] o Ajwain purported to be antiemetic. It is a popular spice in India, Ethiopia and Eritrea. o Zolpidem has also been reported to be a newer antiemetic that is being used more and more for patients that have been unresponsive to other first-line typical antiemetic. Its mechanism of action when used as an antiemetic (Zolpidem's first-most prescribed on-label use is for the treatment of insomnia; some cancer patients receiving chemotherapy medication, as well as Zolpidem (which at the time was only being used by the patents to help their cancer-related insomnia; and noticed the potentially powerful antiemetic properties of the medicine, which was reported to their doctors). Clinicians have not found a direct link between specific types of nausea and Zolpidem other than various patient reports that appear to show a possible, and potentially powerful and new secondary-use of the medication (off-label at this point). More formal trials will need to be concluded before any detailed results can be analyzed. In the meantime, physicians do seem to be using Zolpidem on a growing basis; usually as a second- or third-line drug after a patient has tried the more prominent antiemetics such as Zofran. Lastly, judging from the fairly small number of actual published reports from physicians using this medication (Probably due to the fact that either a patient's insurance refused to off-label coverage and/or that physicians are less-likely overall to present or publicly generate major "breakthrough" news when they only have treated/access to a small and typically quite limited number of patients. At this time it seems that the main trials and individual, case-by-case usage of this medication for nausea, have been centered in both the United Kingdom and the United States. Also to note, it is not understood, or well-enough studied at this point to say that Zolpidem is a virtually "unknown" antiemetic, but when patients have severe nausea reactions to any number of root causes; ongoing daily treatment with Zolpidem seems to be a worthy medication to explore with the patient.
* Non-pharmaceutical therapies with some evidence of efficacy include acupuncture and hypnosis. All drugs have potential side effects. It is important to try to reduce the baseline risk of nausea and vomiting, particularly with respect to surgery.
Controlling nausea and vomiting (anti-emetic therapy) This information is about ways to help prevent or reduce nausea (feelings of sickness) and vomiting (being sick), which can sometimes be caused by cancer or its treatment. It covers the medicines that are commonly used, which are known as anti-sickness drugs (or anti-emetics), as well as containing other ideas to help you cope. If you are having chemotherapy or radiotherapy treatment, this information should ideally be read with our general information about these treatments.
Causes: The mechanisms by which a person feels sick or vomits are complicated. Within the body, nausea and vomiting are controlled by an area of the brain known as the vomiting centre. This area may be stimulated to cause nausea or vomiting by nerves within the gut (stomach) or by other parts of the brain. Psychological and emotional factors can also influence whether a person feels sick.
Some of the reasons why someone with cancer may experience nausea and vomiting are listed below. Treatments: * Chemotherapy Some types of chemotherapy can affect the part of the brain known as the vomiting centre and cause nausea and vomiting. * Radiotherapy If radiotherapy is given to the brain, stomach, bowel, or close to the liver, it may lead to nausea and vomiting. * Hormonal therapies Hormonal therapies may occasionally cause nausea. * Morphine-based medicines These are used as painkillers. Some of these drugs can affect the vomiting centre.
Physical reasons: * Changes in the body chemistry High levels of calcium in the blood, or raised pressure within the brain, can affect the vomiting centre. * Damage to the liver If the liver is not working properly, waste products can build up in the blood, leading to nausea and vomiting. * Blockage of the bowel This can be caused by some types of cancer, especially cancers that affect the pelvis or abdomen.
Emotional reasons: * Anxiety Feeling anxious about the cancer or your treatment may cause nausea and vomiting. * Anticipatory nausea Feelings of nausea, and sometimes vomiting, can occasionally be triggered by circumstances that remind you of previous episodes of nausea and vomiting. This can sometimes occur with chemotherapy.
How anti-emetic medicines work: The type of anti-sickness treatment you receive will depend on the cause. Sometimes there is more than one cause of nausea and vomiting and more than one type of treatment may be needed. The drugs also work in different ways and are often used together to best effect.
Many different types of drugs are used to control nausea and vomiting. Some of these work on the brain by preventing the stimulation of the vomiting centre. Others work on the gut by speeding up the rate at which the stomach empties and so help to move food through the intestines more quickly. The most effective way of controlling nausea and vomiting is by treating the cause, if possible.
Ways Of Administration: Anti-emetic drugs can be given in different ways.
* By mouth Some tablets can be swallowed with plenty of water, while others can be placed under the tongue (sublingually) to dissolve.
* Into a vein by drip Some anti-emetics can be diluted in a fluid and given through a small tube (cannula) inserted into the vein (intravenously).
* Into the muscle The drugs are given by injection into a muscle (intramuscular injection).
*Into the fatty tissue under the skin (subcutaneously) The drugs are either injected using a syringe or given slowly over several hours, using a pump attached to a small needle that is placed just under the skin.
* Suppositories These are put into the back passage (rectum), where they dissolve and are absorbed into the bloodstream through the lining of the gut.
* Skin patches Some anti-emetic drugs can be absorbed through the skin (transdermally) from a small patch that is changed every three days.
Some cancer treatments, including certain chemotherapy drugs, are known to cause nausea and vomiting. If you are taking these drugs, anti-emetic therapy will be given before the treatment has started. It may also be continued for a few days after the treatment has finished.
When someone feels sick or nauseated due to the cancer itself, it can take a while to control this distressing symptom. You will be given anti-emetics and, if possible, the cause of the sickness will be treated.
Whatever the cause of the sickness, the anti-emetics should be taken regularly so that the sickness does not have a chance to come back. If you have any nausea or vomiting which is new, becomes worse, or lasts more than a few days, let your doctor or nurse know.
A large number of-phobia lists circulate on the Internet, with words collected from indiscriminate sources, often copying each other. Also, a number of psychiatric websites exist that at the first glance cover a huge number of phobias, but in fact use a standard text to fit any phobia and reuse it for all unusual phobias by merely changing the name. Sometimes it leads to bizarre results, such as suggestions to cure "prostitute phobia".Such practice is known as content spamming and is used to attract search engines.
Psychological conditions: In many cases specialists prefer to avoid the suffix -phobia and use more descriptive terms, see, e.g., personality disorders, anxiety disorders, avoidant personality disorder, love-shyness.
* Ablutophobia – fear of bathing, washing, or cleaning. * Acrophobia, Altophobia – fear of heights. * Agoraphobia, Agoraphobia Without History of Panic Disorder – fear of places or events where escape is impossible or when help is unavailable. * Agraphobia – fear of sexual abuse. * Aichmophobia – fear of sharp or pointed objects (as a needle, knife or a pointing finger). * Algophobia – fear of pain. * Agyrophobia – fear of crossing roads. * Androphobia – fear of men. * Anthropophobia – fear of people or being in a company, a form of social phobia. * Anthophobia – fear of flowers. * Aquaphobia, Hydrophobia – fear of water. * Astraphobia, Astrapophobia, Brontophobia, Keraunophobia – fear of thunder, lightning and storms; especially common in young children. * Autophobia – fear of being alone. * Aviophobia, Aviatophobia – fear of flying. * Bacillophobia, Bacteriophobia, Microbiophobia – fear of microbes and bacteria. * Blood-injection-injury type phobia – a DSM-IV subtype of specific phobias * Catoptrophobia - fear of mirrors or of one's own reflection. * Cibophobia, Sitophobia – aversion to food, synonymous to Anorexia nervosa. * Claustrophobia – fear of confined spaces. * Coulrophobia – fear of clowns (not restricted to evil clowns). * Decidophobia – fear of making decisions. * Dental phobia, Dentophobia, Odontophobia – fear of dentists and dental procedures * Dysmorphophobia, or body dysmorphic disorder – a phobic obsession with a real or imaginary body defect. * Emetophobia – fear of vomiting. * Ergasiophobia, Ergophobia – fear of work or functioning, or a surgeon's fear of operating. * Ergophobia – fear of work or functioning. * Erotophobia – fear of sexual love or sexual questions. * Erythrophobia – pathological blushing. * Gephyrophobia – fear of bridges. * Genophobia, Coitophobia – fear of sexual intercourse. * Gerascophobia – fear of growing old or ageing. * Gerontophobia – fear of growing old, or a hatred or fear of the elderly. * Glossophobia – fear of speaking in public or of trying to speak. * Gymnophobia – fear of nudity. * Gynophobia – fear of women. * Haptephobia – fear of being touched. * Heliophobia – fear of sunlight. * Hemophobia, Haemophobia – fear of blood. * Hexakosioihexekontahexaphobia – fear of the number 666. * Hoplophobia – fear of weapons, specifically firearms (Generally a political term but the clinical phobia is also documented). * Ligyrophobia – fear of loud noises. * Lipophobia – fear/avoidance of fats in food. * Mysophobia – fear of germs, contamination or dirt. * Necrophobia – fear of death, the dead. * Neophobia, Cainophobia, Cainotophobia, Cenophobia, Centophobia, Kainolophobia, Kainophobia – fear of newness, novelty. * Nomophobia – fear of being out of mobile phone contact. * Nosophobia – fear of contracting a disease. * Nyctophobia, Achluophobia, Lygophobia, Scotophobia – fear of darkness. * Osmophobia, Olfactophobia – fear of smells. * Paraskavedekatriaphobia, Paraskevidekatriaphobia, Friggatriskaidekaphobia – fear of Friday the 13th. * Panphobia – fear of everything or constantly afraid without knowing what is causing it. * Pedophobia - fear/dislike of children * Phasmophobia - fear of ghosts, spectres or phantasms. * Phagophobia – fear of swallowing. * Phobophobia – fear of having a phobia. * Phonophobia – fear of loud sounds. * Photophobia - fear of bright lights. * Pyrophobia – fear of fire. * Radiophobia – fear of radioactivity or X-rays. * Sociophobia – fear of people or social situations * Scopophobia – fear of being looked at or stared at. * Somniphobia – fear of sleep. * Spectrophobia – fear of mirrors and one's own reflections. * Taphophobia – fear of the grave, or fear of being placed in a grave while still alive. * Technophobia – fear of technology (see also Luddite). * Tetraphobia – fear of the number 4. * Tokophobia – fear of childbirth. * Tomophobia – fear or anxiety of surgeries/surgical operations. * Traumatophobia – a synonym for injury phobia, a fear of having an injury * Triskaidekaphobia, Terdekaphobia – fear of the number 13. * Trypanophobia, Belonephobia, Enetophobia – fear of needles or injections. * Workplace phobia – fear of the work place. * Xenophobia – fear of strangers, foreigners, or aliens.
Animal phobias:
* Ailurophobia – fear/dislike of cats * Animal phobia - fear of certain animals, a category of specific phobias * Apiphobia – fear/dislike of bees (also known as Melissophobia) * Arachnophobia – fear/dislike of spiders * Bufonophobia - fear/dislike of toads * Cetaphobia - fear/dislike of whales * Chiroptophobia – fear/dislike of bats * Cynophobia – fear/dislike of dogs * Entomophobia – fear/dislike of insects * Equinophobia – fear/dislike of horses (also known as Hippophobia) * Herpetophobia - fear/dislike of reptiles * Ichthyophobia – fear/dislike of fish * Leporiphobia - fear/dislike of rabbits * Musophobia – fear/dislike of mice and/or rat * Ophidiophobia – fear/dislike of snakes * Ornithophobia – fear/dislike of birds * Scoleciphobia – fear of worms * Selachophobia - fear/dislike of sharks * Taurophobia - fear/dislike of bulls * Zoophobia – a generic term for animal phobias
Non-psychological conditions:
The following medical conditions have nothing to do with irrational fears. However, each usually has a psychological disorder of the same name which is an irrational fear. The behavior of an individual with the medical condition can be similar to the behavior of an individual with the psychological disorder of the same name (e.g., for both usages of Photophobia the person avoids light). The difference in usage is that for the medical term there is an underlying physiological condition that results in the behavior. For example, with medical Photophobia the hypersensitivity to light is sufficient such that at some light levels the person experiences pain which they avoid by seeking darkness. Removing the physiological cause of the hypersensitivity to light results in the person no longer avoiding light. With psychological Photophobia the person fears the light even though there is no current physiological pain caused by light.
* Hydrophobia – fear of water (a symptom of rabies). * Photophobia – hypersensitivity to light causing aversion to light (a symptom of Meningitis and a common condition of migrane headaches). * Phonophobia – hypersensitivity to sound causing aversion to sounds. Common during an alcohol hangover or migrane and in those with sensory disorders. * Osmophobia – hypersensitivity to smells causing aversion to odors. Common during pregnancy.
Biology, chemistry:
Biologists use a number of -phobia/-phobic terms to describe predispositions by plants and animals against certain conditions. For antonyms, see here.
* Acidophobia/Acidophobic – preference for non-acidic conditions. * Heliophobia/Heliophobic – aversion to sunlight. * Hydrophobia/Hydrophobic – a property of being repelled by water. * Lipophobicity – a property of fat rejection * Ombrophobia – avoidance of rain * Photophobia/Photophobic – a negative phototaxis or phototropism response. * Superhydrophobe – the property given to materials that are extremely difficult to get wet. * Thermophobia/Thermophobic – aversion to heat. * Xerophobia/Xerophobic – aversion to dryness.
Prejudices and discrimination: The suffix -phobia is used to coin terms that denote a particular anti-ethnic or anti-demographic sentiment, such as Europhobia, Francophobia, Hispanophobia, and Indophobia. Often a synonym with the prefix "anti-" already exists (e.g., Polonophobia vs. anti-Polonism). Anti-religious sentiments are expressed in terms such as Christianophobia and Islamophobia.
Other prejudices include: * Biphobia – dislike of bisexuals * Chemophobia – prejudice against artificial substances in favour of 'natural' substances. * Ephebiphobia – fear/dislike of youth. * Gerontophobia, Gerascophobia – fear of growing old or a hatred of the elderly. * Heterophobia – fear/dislike of heterosexuals. * Homophobia – aversion to homosexuality or fear of homosexuals. (This word has become a common political term, and many people interpret it as a slur.) * Hoplophobia – aversion to firearms or firearms owners. This word has also gained a certain political notoriety as a dysphemism for "gun control advocate" * Judeophobia – fear/dislike of Jews * Lesbophobia – fear/dislike of lesbian women * Pedophobia, Pediophobia – fear/dislike of children * Psychophobia – fear/dislike of mentally ill * Transphobia – fear or dislike of transgender or transsexual people. * Xenophobia – fear or dislike of foreigners
Miscellaneous: * Arachnophobia – "fear/dislike of spiders," a film * Chromophobia – "hatred/fear of colors," a film * Choreophobia – hatred of dance, a book by Anthony Shay about Iranian dance and its prohibition after the Iranian Revolution * Entomophobia – a genus of orchids. The word means "fear of insects" * Philophobia, an album by Arab Strap * Robophobia – a novel by Richard Evans
Existential anxiety: Example: Angst, Existential crisis, and nihilism
Philosopher Søren Kierkegaard, in The Concept of Dread, described anxiety or dread associated with the "dizziness of freedom" and suggested the possibility for positive resolution of anxiety through the self-conscious exercise of responsibility and choosing. Theologian Paul Tillich characterized existential anxiety as "the state in which a being is aware of its possible nonbeing" and he listed three categories for the nonbeing and resulting anxiety: ontic (fate and death), moral (guilt and condemnation), and spiritual (emptiness and meaninglessness). According to Tillich, the last of these three types of existential anxiety is predominant in modern times while the others were predominant in earlier periods. Tillich argues that this anxiety can be accepted as part of the human condition or it can be resisted but with negative consequences. In its pathological form, spiritual anxiety may tend to "drive the person toward the creation of certitude in systems of meaning which are supported by tradition and authority" even though such "undoubted certitude is not built on the rock of reality". According to Viktor Frankl, author of Man's Search for Meaning, when faced with extreme mortal dangers the most basic of all human wishes is to find a meaning of life to combat the "trauma of nonbeing" as death is near.
Test anxiety: Test anxiety is the uneasiness, apprehension, or nervousness felt by students who have a fear of failing an exam. Students suffering from test anxiety may experience any of the following: the association of grades with personal worth, fear of embarrassment by a teacher, fear of alienation from parents or friends, time pressures, or feeling a loss of control. Emotional, cognitive, behavioral, and physical components can all be present in test anxiety. Sweating, dizziness, headaches, racing heartbeats, nausea, fidgeting, and drumming on a desk are all common. An optimal level of arousal is necessary to best complete a task such as an exam; however, when the anxiety or level of arousal exceeds that optimum, it results in a decline in performance. Because test anxiety hinges on fear of negative evaluation, debate exists as to whether test anxiety is itself a unique anxiety disorder or whether it is a specific type of social phobia. In 2006, approximately 49%(need reference) of high school students were reportedly experiencing this condition. While the term "test anxiety" refers specifically to students, many adults share the same experience with regard to their career or profession. The fear of failing a task and being negatively evaluated for it can have a similarly negative effect on the adult.
Stranger and social anxiety: Anxiety when meeting or interacting with unknown people is a common stage of development in young people. For others, it may persist into adulthood and become social anxiety or social phobia. "Stranger anxiety" in small children is not a phobia. Rather it is a developmentally appropriate fear by toddlers and preschool children of those who are not parents or family members. In adults, an excessive fear of other people is not a developmentally common stage; it is called social anxiety. Trait anxiety: Anxiety can be either a short term "state" or a long term "trait." Trait anxiety reflects a stable tendency to respond with state anxiety in the anticipation of threatening situations.It is closely related to the personality trait of neuroticism.
Anxiety in Positive psychology: Anxiety in terms of challenge level and skill level. In positive psychology, anxiety is described as a response to a difficult challenge for which the subject has low coping skills.
