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Therapeutics 2 > Anxiety > Flashcards

Anxiety Flashcards

1
Q

Which gender is more likely to develop anxiety?

A

Females

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2
Q

Average age of onset for GAD

A

24-31

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3
Q

Comorbidities associated with anxiety

A

Depression

Alcohol or Substance abuse

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4
Q

What may cause anxiety?

A

Moderate genetic risk
Life stressors
Coping means
Etc.

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5
Q

Symptoms of GAD

A 
Excessive anxiety/worry involving multiple events or activities occurring more days than not for at least 6 months, and associated with at least 3 of the following:
restlessness
easily fatigued
poor concentration
irritability
muscle tension
insomnia
unsatisfying sleep
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6
Q

Psychiatric medical conditions that may cause, contribute, or exacerbate anxiety symptoms

A 
Mood disorders
hypochondriasis
personality disorders
alcohol/substance abuse/withdrawal
other anxiety disorders
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7
Q

Neurologic medical conditions that may cause, contribute, or exacerbate anxiety symptoms

A 
CVA
seizure disorders
dementia
stroke
migraine
encephalitis
vestibular dysfunction
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8
Q

CV medical conditions that may cause, contribute, or exacerbate anxiety symptoms

A 
angina
arrhythmias
CHF
mitral valve prolapse
MI
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9
Q

Endocrine and metabolic medical conditions that may cause, contribute, or exacerbate anxiety symptoms

A 
Hypo/hyperthyroidism
hypoglycemia
Cushing's disease
Addison's disease
pheochromocytoma
hyperadenocorticism
hyponatremia
hyperkalemia
B12 deficiency
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10
Q

Respiratory medical conditions that may cause, contribute, or exacerbate anxiety symptoms

A 
asthma
COPD
pulmonary embolism
pneumonia
hyperventilation
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11
Q

Other medical conditions that may cause, contribute, or exacerbate anxiety symptoms

A

carcinoid syndrome
anemias
SLE

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12
Q

Medications that may cause, contriute, or exacerbate anxiety symptoms

A 
anticonvulsants
antidepressants
antihypertensives
antimicrobials
antiparkinson's
bronchodilators
corticosteroids
decongestants
herbals
NSAIDs
stimulants
thyroid hormones
Toxicity
Abrupt withdrawal of CNS depressants
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13
Q

Nonpharmacologic therapies for GAD

A

Psychoeducation
Exercise
Stress management
Psychotherapy

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14
Q

Role of antidepressants in GAD management

A

1st line treatment for chronic GAD

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15
Q

Which antidepressants are 1st line for anxiety?

A

BDZs are first line overall

SNRI or SSRI

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16
Q

What is used if BDZs, SNRIs, or SSRIs fail?

A 
Change to a different SSRI or SNRI
imipramine
buspirone
pregabalin
Last: atypical antipsychotic or BDZ for somatic symptoms
17
Q

Symptoms of anxiety reduced by antidepressants

A

Psychic symptoms like worry and apprehension
Autonomic or somatic symptoms like tremor, rapid heart rate, and sweating

Takes ~8 weeks for onset

18
Q

SSRIs used to treat GAD

A 
citalopram
escitalopram
fluoxetine
fluvoxamine
paroxitine
sertraline
19
Q

SNRIs used to treat GAD

A

venlafaxine

duloxetine

20
Q

TCAs used to treat GAD

A

imipramine

21
Q

When are BDZs used in GAD treatment?

A

Recommended for acute treatment when short-term relief is needed
as adjunct during initiation of antidepressant therapy
to improve sleep

22
Q

GAD symptoms reduced by BDZs

A

Somatic symptoms (less on psychic symptoms)

23
Q

Disadvantages of BDZs

A

Lack of effectiveness in treating depression
Risk of dependency and abuse
Potential interdose

24
Q

BDZ Mechinism

A

Enhances transmission of GABA through GABAa receptor complex

25
Q

Which BDZs are preferred in hepatid dysfunction and elderly patients?

A

Lorazepam and Oxazepam

26
Q

BDZ adverse effects

A 
CNS depression (drowsiness, sedation, psychomotor impairment, ataxia)
Cognitive effects (poor recall and anterograde amnesia)
27
Q

Buspirone Mechanism

A

5-HT partial agonist

thought to reduce presynaptic 5-HT firing

28
Q

How does buspirone differ from BDZs?

A

no abuse potential
no withdrawal
does not potentiate alcohol and sedative hypnotic effects

29
Q

Buspirone onset of action

A

2 weeks

30
Q

Buspirone adverse effects

A

dizziness
nausea
headaches

Therapeutics 2 (11 decks)

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