Anxiety

Question 1

what s the treatment for anxiety?

Answer 1

-acute: benzodiazepines
-chronic: SSRI or propranolol (alleviates physical symptoms only-tremors or palpitations)

Question 2

when should you be careful with using benzodiaipines?

Answer 2

-can induce hepatic coma, especially long acting benzodiaipines= treat with lowest dose for shortest period

Question 3

what are some examples of long-acting benzodiaipines?

Answer 3

-diazepam, alprazolam, chlordiazepoxide hydrochloride and clobazam

Question 4

what are some examples of short-acting benzodiazepines? who its preffered in?

Answer 4

lorazepam or oxazepam
-preferred in patients with hepatic impairment and elderly
-carry a greater risk of withdrawal symptoms (use for 2-4weeks)

Question 5

what type of effect are benzodiapines known to cause?

Answer 5

-paradoxical
-aggression, hostility, talkative, anxious, excited

Question 6

when can sedation be caused by benzodiazepines when used with?

Answer 6

-used with alcohol and CNS depressants or CYP enzyme inhibitor-avoided concomitant use

Question 7

can benzodiazepines cause drowsiness? driving?

Answer 7

yes should avoid with driving
-benzos have a legal driving limit if when feeling drowsy: clonazepam, oxazepam, lorazepam, diazepam,flunitrazepam, temazepam

Question 8

what can be used for benzos overdose or to treat paradoxical effects?

Answer 8

flumazenil

Question 9

what do you do for benzodiazepines withdrawal?

Answer 9

3 steps
1) convert all meds to once nightly dose of diazepam
2) reduce 1-2mg (1/10th on larger doses) every 2-4 weeks, WOULD wait till all symptoms have gone before changing again
3) reduce further (0.5mg near the end)