Anxiety Flashcards
What is the treatment for acute anxiety
Benzodiazepines such as diazepam
Short term use at the lowest effective dose
What is the treatment for chronic anxiety
SSRIs- sertraline, citalopram, escitalopram, fluoxetine
Propranolol 10mg - alleviates physical symptoms only (like high blood pressure
What dangerous side effect can benzodiazepines occur
Can induce hepatic coma, especially long acting benzodiazepine
-treat with them lowest dose for the shortest period
Name long acting benzodiazepine
Diazepam
Alprazolam
Chordiazepoxide hydrochloride
Clobazam
Name short acting benzodiazepine
Lorazepam and oxazepam
In which patients is short acting benzodiazepine preferred
In patients who have hepatic impairment and the elderly
What risk does short acting benzodiazepine carry
It carries a greater risk of withdrawal symptoms ( only use for 2-4 weeks)
What are the side effects of benzodiazepines
Can cause paradoxical effects
- aggression, hostility, talkative, anxious, excited
Sedation increased with use of alcohol, CNS depressants or CYP enzyme inhibitors- avoided concomitant use
Will increase the level so increase rate of sedation
Avoid driving if feeling drowsy
-benzodiazepine have a legal driving limit: Clonazepam, oxazepam, lorazepam, diazepam, flunitrazepam and temazepam (COLD FT)
What drug is given when you have an overdose of benzodiazepines
Flumazenil
What are the side effects of withdrawal with benzodiazepines
Dependence: anxiety, sweating, weight loss, tremors, loss of appetite
What do you do when experiencing withdrawals of benzodiazepines
1) convert all medication to a once nightly dose of diazepams
2) reduce by 1-2mg (1/10th on larger doses) every 2-4 weeks
Only further withdraw if the patient has with come any withdrawal symptoms
3) further reduce (0.5mg near the end)
