Anxiety

Question 1

Drugs to treat

Answer 1

Benzodiazepines
Short acting are lorazepam and oxazepam
BB- propranolol and oxprenolol
Busipronone- cant really get addicted but it takes two weeks to work

Question 2

SHORT ACTING VS LONG ACTING

Answer 2

short acting higher risk of dependance and withdrawal

Long acting less risk of dependence

Question 3

How do Benzodiazepines work

Answer 3

Schedule 4 part 1
work by binding to GABA
should be used short term

Question 4

Benzodiazepine side effects

Answer 4

Driving skilled tasks affected
Dependence
overdose Drowsiness/ akathisia
Paradoxical increase in hostility aggression

Question 5

How to withdraw benzodiazepines

Answer 5

Switch to equivalent dose of diazepam ON
reduce by 1-2mg every 2-4 weeks
reduce until stopped

Question 6

Side effects of benzodiazepines

Answer 6

sedation and CNS depression

Increased plasma conc- enzyme inhibitors

Question 7

MHRA warnings for benzos

Answer 7

Increased risk of death, coma and resp depression when used with opioids. Should not be Rx’d together unless absolutely necessary.

when prescribed with Methadone can cause effects 2 weeks later. Monitor and counsel patients

Question 8

ADHD

Answer 8

Over 5 y/o:
Methylphenidate
Lisdexamfetamine= alternative

Adult:
Methylphenidate/Lisdexamfetamine

Question 9

Methylphenidate class CD and side effects and monitoring and contraindications

Answer 9

Class 2 CD
works by increasing dopamine
Rx MR by brand

Side effects: 
Weight loss reduced appetite and insomnia 
Cardio events 
Hypertension and HR 
Tics and tourettes 
Growth restrictions

Monitor: BP, HR, weight height and appetite before initiation and every 6 months and at dose changes.

Contraindications:
Heart block, cardiac arrest, CVD events, anorexia, suicidal thoughts, depression, hyperthyroid

Question 10

Lisdexamfetamine/dexamfetamine Side effects/monitoring and CI

Answer 10

Works by increasing GABA

Side effects:

anorexia, insomnia, weight loss and loss of appetite
tics and tourettes
Hypertension and HR
growth restrictions

Monitor HR BP HEIGHT WEIGHT AND APPETITE BEFORE DOSE CHANGES AND EVERY 6 MONTHS

CI: depression, anorexia, Cardiovascular events, hypertension, drug abuse, psychosis and suicide, hyperthyroidism

Question 11

Atomoxetine:

Answer 11

QT prolongation

Suicidal ideation

Hepatotoxicity