Antianxiety and substance abuse meds Flashcards
how long should a patient be treated for anxiety after stabilization
at least 12 months
brand name for alprazolam
xanax
brand name for buspirone
buspar
brand name for clonazepam
klonopin
brand name for diazepam
valium
brand name for gabapentin
neurontin
brand name for hydoxyzine
vistaril
brand name for lorazepam
ativan
brand name for propranolol
inderal
dosage range for aplrazolam to treat panic disorder
start at 1.5mg divided into 3 doses
range 5-6mg daily
FDA approved uses for xanax
GAD
panic disorder
off label uses for alprazolam
other anxiety disorders
PMDD
acute mania adjunct
acute psychosis adjunct
pregnancy risk with alprazolam
avoid
discontinuing antianxiety meds
taper all of them to avoid rebound anxiety, withdrawal symptoms, or seizures
contraindications for alprazolam
angle-closure glaucoma
starting dosage of buspirone
15mg BID at breakfast and lunch
dosage range for buspirone
20-60mg qd
FDA approved uses for buspirone
anxiety disorders
short term treatment
off label uses for buspirone
mixed anxiety/depression
tx resistant depression adjunct
pregnancy risk with buspirone
risk v benefit
starting dose for clonazepam
0.25mg divided BID
maintenance dosage range for clonazepam
0.5-4mg qd divided or at hs
FDA approved uses for clonazepam
panic disorder (with or without agorophobia)
off label uses for clonazepam
insomnia
labs to monitor for clonazepam
CBC
LFT
if seizures or medical illnesses
pregnancy risk for clonazepam
avoid
contraindications for clonazepam
angle-closure glaucoma
severe liver disease
initial dosage of diazepam
2-10mg BID-QID
maintenance range for diazepam
4-40mg daily in divided doses
FDA approved uses for diazepam
anxiety disorders
acute agitation
off label uses for diazepam
insomnia
catatonia
diazepam dosage adjustment for elderly
initial is 2-2.5mg 1-2x/day
labs to monitor with diazepam
if hx of seizures or medical illnesses
CBC, LFT
pregnancy risk for diazepam
avoid
which antianxiety med has a rectal formulation
diazepam
contraindication for diazepam
angle-closure glaucoma
diazepam dosage adjustment for renal/hepatic impairment
2-2.5mg
dosage range for hydroxyzine
50-100mg QID
FDA approved uses for hydoxyzine
anxiety
off label uses for hydroxyzine
insomnia
geriatric considerations for hydroxyzine
avoid in dementia
pregnancy risk for hydroxyzine
avoid
what med cannot be given with hydroxyzine and why
citalopram d/t QT prolongation
dosage of lorazepam
2-3mg in 2-3 divided doses
max 10mg qd
FDA approved uses for lorazepam
anxiety, anxiety associated with depressive sx
off label uses for lorazepam
insomnia
alcohol withdrawal
panic disorder
acute mania adjunct
acute psychosis adjunct
catatonia
lorazepam dosage adjustment for elderly
1-2mg qd in 2-3 divided doses
labs to monitor with long term use of lorazepam
CBC
LFT
LDH
pregnancy risk for lorazepam
avoid
what is the preferred benzodiazepine for older adults and why
lorazepam because of its short half-life
which benzodiazepine is preferred for delirium
lorazepam
contraindications for lorazepam
angle-closure glaucoma
sleep apnea
lorazepam dosage adjustment for renal/hepatic impairment
1-2 mg qd in 2-3 divided doses
dosage range for propranolol
40-400mg in divided doses
off label uses for propranolol
akathisia, parkinsonian tremor, PTSD, GAD, violence/aggression
pregnancy risk for propranolol
risk v benefit
contraindications for propranolol
bradycardia
bronchial asthma
COPD
brand name for acamprosate
campral
brand name for chlordiazepoxide
librium
brand name for naltrexone
revia
vivitrol
dosage for acamprosate
666mg TID
MUST DOSE TID
no titration required
uses for acamprosate
maintenance of alcohol abstinence
pregnancy risk with acamprosate
avoid
dosage range for librium
15-40mg daily in 3-4 divided doses
FDA approved uses for librium
anxiety disorders
withdrawal from alcohol
pregnancy risk with librium
avoid
how to dc librium
taper by 10mg every 3 days
contraindication for librium
angle closure glaucoma
librium dosage adjustment for renal/hepatic impairment
10-20mg qd
dosage of naltrexone
50mg qd
FDA approved uses for naltrexone
alcohol dependence
prevention of opioid relapse
labs to monitor for naltrexone
LFT
UDS for presence of opioids
how long does a patient need to be opioid free before starting naltrexone
7-10 days
contraindications for naltrexone
opioid use
acute hepatitis
liver failure
rare risk of naltrexone
eosinophilic asthma