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ai exam 2 > Anxiety > Flashcards

Anxiety Flashcards

1
Q

Is an anxiety disorder self-limiting?

A

No

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2
Q

What is the most common anxiety disorder?

A

GAD =
Generalised Anxiety Disorder

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3
Q

What physiological symptoms can be associated with anxiety?

A

-Fearful anticipation
-Irritability
-Worrying thoughts
-Insomnia
-Night terrors

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4
Q

What physical symptoms can be associated with anxiety?

A

-Dry mouth
-Headache
-Palpitations
-Constriction of chest
-Breathlessness
-Hyperventilation

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5
Q

What is first line for anxiety?

A

SSRI’s

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6
Q

What benzodiazepines help with anxiety?

A

Lorazepam, Diazepam, Oxezepam, Clobazam

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7
Q

What antipsychotics can be used for anxiety?

A

-Risperidone
-Olanzapine
-Quetiapine
-Pericyazine

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8
Q

What medications can be use for GAD?

A

-Venlafaxine
-Duloxetine

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9
Q

If SSRI is not tolerated and patient has a panic disorder, what should be offered?

A

Tricyclic antidepressants
-Clomipramine
-Imipramine

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10
Q

What can be used for GAD, Epilepsy and Neuropathic pain?

A

Pregabalin

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11
Q

What other treatment is unlicensed for anxiety but useful for depression, sleep issues and anxiety?

A

Mirtazapine
-Has a anti-histamine side effect to help with sleep

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12
Q

How long does it take for Buspirone to have an effect for anxiety?

A

4 weeks at 10mg TDS

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13
Q

What can Propranolol help with in anxiety?

A

10-120mg OD for palpitations

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14
Q

What antihistamines can be used for anxiety?

A

Promethazine and Hydroxyzine

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15
Q

What anti-depressants are licensed for GAD?

A

SSRI - Escitalopram, Paroxetine
SNRI - Venlafaxine, Duloxetine, Pregabalin

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16
Q

What anti-depressants are licensed for panic disorders?

A

SSRI’s - Escitalopram, Citalopram, Sertraline, Paroxetine
SNRI - Venlafaxine

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17
Q

What antidepressants are licensed for OCD?

A

SSRI - Escitalopram, Sertraline, Paroxetine, Fluoxetine

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18
Q

What antidepressants are licensed for social anxiety disorder?

A

SSRI’s - Escitalopram, Sertraline, Paroxetine

SSNI - Venlafaxine

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19
Q

What antidepressants are licensed for PTSD?

A

SSRI’s - Sertraline, Paroxetine

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20
Q

What is Clomipramine (TCA) licensed for?

A

Obsessional and phobic states

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21
Q

What is Propranolol licensed for?

A

Relief of situational anxiety and generalised anxiety symptoms, particularly those of somatic type

22
Q

Can SSRI’s worsen symptoms initially?

A

Yes - Low dose and increase as s/e with tolerability

23
Q

How long do you need to wait to see response from SSRI’s for Anxiety?

A

12 WEEKS

24
Q

What dose of escitalopram do we start at for anxiety?

A

5mg/day

25
Q

What dose of Fluoxetine do we start at for Anxiety?

A

5-10mg/day

26
Q

What dose paroxetine do we start at for anxiety?

A

Paroxetine 5-10mg/day

27
Q

What dose Sertraline do we start at for anxiety?

A

25mg/day

28
Q

What dose Citalopram do we start at for anxiety?

A

5-10mg/day

29
Q

When do we increase the dose of antidepressants in anxiety?

A

Every two weeks or as tolerated

30
Q

What can be prescribed alongside the SSRI’s initially to help with anxiety?

A

Benzodiazepines

31
Q

How many weeks does it take for diazepam to not have any effect?

A

4 weeks - leave plenty of time in-between dose reductions

32
Q

If anxiety doesn’t go away and lasts for at least 6 months, what can this be classed as?

A

GAD

33
Q

Can people with GAD be suicidal?

A

Yes

34
Q

When is the onset of GAD?

A

Early adulthood and tends to evolve with age.

35
Q

What is the DSM IV criteria for GAD?

A

Must have both Major symptoms and 3 Additional symptoms.

36
Q

What are the two major symptoms of GAD?
must have both

A

-Excessive anxiety and worry about a number of events and activities
-Difficulty controlling the worry

37
Q

What are the additional symptoms of GAD?
must have 3/6

A

-Restlessness or feeling keyed up or on edge
-Being easily fatigued
-Difficulty concentrating or mind going blank
-Irritability
-Muscle tension
-Sleep disturbance

38
Q

What is the differential diagnosis of GAD?

A

-Depression
-Schizophrenia
-Dementia
-Substance misuse
-Physical illness - Hypo or Thyrotoxicosis

39
Q

Step 1 of GAD: All known and suspected presentations of GAD, what do we do?

A

Identification and assessment - active monitoring

40
Q

Step 2 of GAD: Diagnosed GAD that has not improved after education or marked functional impairment. What do we do?

A

-Low intensity psychological interventions
-Individual non-facilitated self-help
-Individual guided self-help and psychoeducational groups

41
Q

Step 2 of GAD: GAD with an inadequate response to step 2 interventions or marked functional impairment. What do we do?

A

Choice of a high-intensity psychological intervention (CBT/applied relaxation) or a drug treatment.

42
Q

Step 4: Complex treatment-refractory GAD and very marked functional impairment, such as self-neglect or high risk of self-harm. What do we do?

A

-Highly specialist treatment such as complex drug and or psychological treatment regiments; input from MDT, crisis, day hospitals or inpatient care.

43
Q

What is first line for GAD?

A

SSRI’s (fluoxetine or sertraline off-license)
Venlafaxine
Pregabalin
Mirtazapine

44
Q

How should beta-blockers be used for GAD?

A

Low dose short-term

45
Q

How should antihistamines be used for GAD?

A

Low dose short-term

46
Q

What is first line for OCD?

A

Clomipramine

47
Q

What is first line for Social Anxiety?

A

SSRI’s - Escitalopram or Venlafaxine

48
Q

What is first line for Panic Disorders?

A

First line - SSRI’s such as Escitalopram, Sertraline, Citalopram and Paroxetine

49
Q

What is second line for panic disorders?

A

Imipramine or Clomipramine. If SSRI not suitable or no improvement after 12-week course.

50
Q

What is used for mod/severe panic disorders?

A

Venlafaxine

51
Q

Benzodiazepines are not recommended for use in Panic disorders but when could they be used?

A

In Emergency Management

ai exam 2 (16 decks)

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