Anti-Anxiety 35 Flashcards
• Anxiety is an uncomfortable state that has both_____ and ______components.
psychologic and physical
The physical component manifests as ? (8)
tachycardia, palpitations, trembling, dry mouth, sweating, weakness, fatigue, and shortness of breath.
How many people in the US develop an anxiety D/O at some point in their lives
25%
The five most common anxiety disorders are ?
generalized anxiety disorder (GAS),
panic disorder,
obsessive-compulsive disorder (OCD),
social anxiety disorder,
and post-traumatic stress disorder (PTSD).
Although each type is distinct, they all have one element in common: an unhealthy level of anxiety.
What 2 classes of drugs treat anxiety
benzodiazepines and selective serotonin reuptake inhibitors (SSRIs).
benzodiazepines are used primarly for
Generlized anxiety Disorder (GAD)
Generalized anxiety disorder (GAD) is
a chronic condition characterized by uncontrollable worrying.
The hallmark (symptoms) of GAD is
unrealistic or excessive anxiety about several events or activities that lasts 6 months or longer. Other psychologic manifestations include vigilance, tension, apprehension, poor concentration, and difficulty falling or staying asleep. Somatic manifestations include trembling, muscle tension, restlessness, and signs of autonomic hyperactivity, such as palpitations, tachycardia, sweating, and cold clammy hands.
GAD can be managed with ????
Both nondrug therapy and with drugs
Nondrug approaches for treatment of GAD include
supportive therapy, cognitive behavioral therapy, biofeedback, and relaxation training.
Current first-line choices for drug therapy of GAD are?
benzodiazepines, buspirone, and four antidepressants: (venlafaxine, paroxetine, escitalopram, and duloxetine. )
The _______are the preferred drugs for immediate stabilization, especially when anxiety is severe. However, for long-term management, ______and the _______ are preferred.
benzodiazepines (short-term), buspirone , antidepressants (longterm)
For Benzos, Their benefits derive from ?
enhancement of responses to gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter.
Benzos: The onset of effects is immediate, and the margin of safety is high. Principal side effects are ?
sedation and psychomotor slowing. Patients should be warned about these effects and informed that they will subside in 7 to 10 days.
The agents (drugs) prescribed most often are ??
alprazolam and lorazepam.
Benzodiazepines can cause ?
physical dependence, which can make withdrawal extremely hard for some patients.
What is the difficulty in withdrawing and or detoxing from Benzos?
The difficulty is that withdrawal produces intense anxiety, which people with panic disorder may find intolerable. To minimize withdrawal symptoms, benzodiazepines should be withdrawn very slowly—over a period of several months.
Buspirone is an ?
anxiolytic drug that differs significantly from the benzodiazepines.
Buspirone is not a central nervous system (CNS) depressant. TRUE or False?
TRUE
For the treatment of anxiety, buspirone is as effective as the _______?
benzodiazepines
Advantage of Buspirone over Benzos
(1) it does not cause sedation; (2) it has no abuse potential; and (3) it does not intensify the effects of CNS depressants.
Disadvantage of Buspirone over Benzos
ITS SLOW. Buspirone’s major disadvantage is that its anxiolytic effects develop slowly; initial responses take a week to appear, and several more weeks must pass before responses peak. Buspirone is labeled only for short-term treatment of anxiety.
The MOA for buspirone is ____?
The mechanism by which buspirone relieves anxiety has not been established. The drug binds with high affinity to receptors for serotonin and with lower affinity to receptors for dopamine. Buspirone does not bind to receptors for GABA or benzodiazepines.
How is buspirone tolerated and what are the potential side effects
is generally well tolerated. The most common reactions are dizziness, nausea, headache, nervousness, lightheadedness, and excitement.