Anxiety

Question 1

NT targets for anxiety meds

Answer 1

5HT

GABA

(NE)

Question 2

which 3 drug classes target 5HT receptors

Answer 2

SSRIs

SNRIs

buspirone

Question 3

which drug class targets GABA receptors

Answer 3

benzos

Question 4

which drug targets glutamate

Answer 4

pregabalin

Question 5

which drug targets NE

Answer 5

bb

Question 6

when is anxiety pathologic

Answer 6

impaired ability to fxn

Question 7

1st line drug class for most anxiety disorders

Answer 7

SSRIs

SNRIs

Question 8

adjunctive therapy for anxiety

Answer 8

buspirone

weaker but fewer s.e

Question 9

what drug has declining use for anxiety, but is used in acute and situational anxiety

Answer 9

benzos

Question 10

what drug is not approved in US for anxiety but has similar efficacy to SSRIs/SNRIs

Answer 10

pregabalin

Question 11

3 classes of drugs for anxiety

Answer 11

antidepressants

benzos

buspirone

Question 12

benzos to know

Answer 12

alprazolam

clonazepam

lorazepam

diazepam

Question 13

most efficacious immediate relief of anxiety sx

Answer 13

benzos

but SSRIs are safer and used more

Question 14

benzos can counteract initial agitation that can occur w. __ when used for anxiety

Answer 14

SSRIs/SNRIs

Question 15

role of benzos in anxiety

Answer 15

bridge pt while waiting for onset of SSRI/SNRI

not for chronic use

Question 16

selection of benzo is based on

Answer 16

pharmacokinetics

Question 17

high potency benzos

Answer 17

alprazolam

clonazepam

Question 18

benzos w. most rapid oral onset

Answer 18

clorzepate

diazepam

Question 19

benzo w. most rapid IM absorption - most rapid and reliable

Answer 19

lorazepam

Question 20

which benzos are used in acute setting

Answer 20

high potency → alprazolam, clonazepam

Question 21

possible s.e of buspirone

Answer 21

EPS

Question 22

__ is best for acute anxiety

__ is best for chronic anxiety

Answer 22

acute: high potency benzos → alprazoam, clonazepam

chronic → buspirone

Question 23

buspirone must be administered __

and is not for __ use

Answer 23

routinely

prn

Question 24

buspirone does not carry risk of

Answer 24

sedation

additive CNS dpn

retrograde amnesia

tolerance/withdrawal

Question 25

how long does buspirone take to start working

Answer 25

2 weeks for anxiolytic 4-6 weeks for maximum effect

Question 26

why aren't barbituates used for anxiety

Answer 26

high abuse potential (class II) lethality in od ddi → via CYP450

Question 27

first line tx for generalized anxiety disorder (gad)

Answer 27

SSRI or SNRI CBT

Question 28

2nd line meds

Answer 28

TCADs benzos buspirone

Question 29

downside of TCADs

Answer 29

cardiotoxicity

Question 30

downside of benzos

Answer 30

abuse

Question 31

downsides of buspirone

Answer 31

longer time to onset weaker anxiolytic

Question 32

anxiety d.o with bb as first line tx

Answer 32

non generalized SAD (performance/social anxiety)

Question 33

2nd line tx for SAD

Answer 33

rapid acting benzos → alprazolam/clonazepam *but significant risk of sedation*

Question 34

bb preferred for SAD

Answer 34

propranolol

Question 35

tx for acute panic disorder acute: mild-mod: severe:

Answer 35

acute: benzos mild-mod: **SSRIs,** benzos, TCADs severe: SSRIs/SNRIs PLUS CBT

Question 36

for OCD tx, __ may be more effective than \_\_

Answer 36

CBT meds

Question 37

if you do use meds for OCD, what is first line

Answer 37

**SSRIs** +/- SNRI antipsychotic for refractory sx

Question 38

pharm for severe OCD

Answer 38

SSRI +/-SNRI PLUS CBT

Question 39

t/f: for PTSD, pharm and CBT are equally effective

Answer 39

T!

Question 40

what are positive sx of PTSD

Answer 40

arousal flashback nightmares

Question 41

most effective pharm for positive sx of PTSD

Answer 41

alpha blockers

Question 42

tx for PTSD: first line: severe:

Answer 42

first line: SSRIs severe: SSRIs PLUS CBT