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Psychiatry > Anxiety > Flashcards

Anxiety Flashcards

1
Q

What is needed to make diagnosis of anxiety disorder? (vs. just anxiety)

A
  • some degree of dysfunction

* symptoms for at least 6 months

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2
Q

Anticipatory anxiety?

A

worse before, better after event

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3
Q

In specific phobias, does the person often recognize that the fear is exaggerated or unreasonable?

A

Yes

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4
Q

Generalized Anxiety Disorder

A

Excessive worry and anxiety more days than not

3 or more of:
• Restless, keyed-up, on edge
• Easily fatigued
• Difficulty concentrating/ Mind goes blank
• Irritability
• Muscle tension
• Sleep disturbance
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5
Q

What is Agoraphobia?

A

• Anxiety about being in situations from which
escape is difficult
• Avoidance of these situations or marked
distress/ anxiety about being in these situations
• Often occurs with panic attacks but not
necessarily

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6
Q

Medications w/ anxiolytics target what 3 sets of neurotransmitters in:

  • GAD?
  • PTSD?
  • Panic Disorders?
  • OCD?
A
  • GABA (GAD)
  • Cortisol and Norepinephrine (PTSD)
  • Serotonin (Panic, OCD, probably plays a role in all forms of anxiety)
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7
Q

Adverse effect of using extinction as behavioral method?

A

Escalation of provoking behavior

Ex: child turns on sink for attention

  • –> you ignore it
  • –> child floods bathroom
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8
Q

Benzodiazepines:
Target?
Advantage?
Problems?

A

Target = GABA

Advantage = effective in aborting anxiety

Problems =
• Not useful in prophylaxis
• Tolerance, addiction
• Toxicity in overdose esp with alcohol

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9
Q

Clomipramine: Useful in _____

A

OCD & Social Anxiety Disorder

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10
Q

SSRI/SNRI: Advantage? Disadvantage?

A

Advantage = non addictive, effective in broad range of disorders, lower toxiciy in overdose

Disadvantage = can take 4-12 weeks for effect

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11
Q

Tx: Debilitating anticipatory/ performance anxiety

A

Beta-blockers

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12
Q

Tx: Panic Disorder

A

SSRI

Benzo as adjunct

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13
Q

Tx: PTSD

A

Treatment tends to be symptomatic

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14
Q

Tx: Social Anxiety Disorder

A

SSRI

Clomipramine

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15
Q

Tx: OCD

A

SSRI

Clomipramine

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16
Q

Tx: Generalized Anxiety (GAD)

A

SSRI
SNRI
Buspirone

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17
Q

Diagnosis?

3 or more of:
• Restless, keyed-up, on edge
• Easily fatigued
• Difficulty concentrating/ Mind goes blank
• Irritability
• Muscle tension
• Sleep disturbance
A

Generalized Anxiety Disorder

18
Q

Diagnosis?

• Anxiety about being in situations from which
escape is difficult
• Avoidance of these situations or marked
distress/ anxiety about being in these situations
• Often occurs with panic attacks but not
necessarily

A

Agoraphobia

19
Q

Anxiety does not typically require pharmacologic therapy, but under what conditions would it?

A

When anxiety significantly disrupts a person’s life, or is associated with symptoms such as panic, obsessions and/or compulsions, or disabling
phobias

20
Q

Antianxiety agents include..?

A

Benzodiazepines, Buspirone, SSRI’s, and SNRI’s

21
Q

Continued therapy with Diazepam decreases the __(a)__ effect as tolerance develops while the __(b)__ effect is preserved.

A

a) sedative

b) anxiolytic

22
Q

Diazepam decreases the amount of time spent in ____ sleep

A

stage 4

23
Q

In addition to its anxiolytic & sedative effects, Diazepam is an excellent _____

A

anticonvulsant

24
Q

______ is not water-soluble and the parenteral solution contains propylene glycol (the major ingredient in Sierra automobile antifreeze) as the vehicle

A

Diazepam

25
Q

T or F?

The withdrawal syndrome after abrupt discontinuation of diazepam may not begin for several days or a week or more.

A

True

due to its active metabolite, Nordazepam

26
Q

Adverse effects of Diazepam?

A

Sedation, Amnesia, Ataxia & Ventilatory Depression

27
Q

_____ is converted to diazepam.

A

Chlordiazepoxide

28
Q

_____is an active metabolite of diazepam that is converted to an inactive glucuronide and therefore has a shorter duration of action.

A

Oxazepam

29
Q

_____ has a longer duration of action than Diazepam.

A

Lorazepam

30
Q

_____ is particularly useful in panic disorder & agoraphobia.

A

Alprazolam

31
Q

_____ is used as an anticonvulsant but is also particularly useful in panic disorder.

A

Clonazepam

32
Q

_____ is an inverse agonist at the benzodiazepine receptor & is useful primarily in treating accidental or intentional overdoses.

A

Flumazenil

repeated dosing is often necessary b/c of its shorter duration of action

33
Q

2 benzodiazepines that are also indicated in panic disorder (in addition to GAD)?

A

Alprazolam & Clonazepam

34
Q

Is Buspirone effective in/for…

  • panic attacks?
  • anxiety?
  • sedation?
  • seizures?
  • does tolerance build up?
A 
No
Yes (anxiety)
No
No
No

(note: it’s a 5-HT1A partial agonist w/ little activity at dopamine or GABA receptors)

35
Q

Which is the only SSRI not used to treat depression?

A

Fluvoxamine

36
Q

Among the SSRI’s, _____ is unique in that it may cause congenital cardiac malformations when given during the first trimester.

A

Paroxetine

37
Q

Which 2 symptoms of Serotonin Syndrome are less common signs that are more likely to be associated with a fatal outcome?

A

Coma & Seizures

38
Q

SNRI’s, similar to SSRI’s are very safe, however one difference is that SNRI’s may cause _____.

A

sedation

39
Q

_____ has a similar effect to the SNRI’s but does so via a unique mechanism of action

A

Mirtazapine

40
Q

Mirtazepine is a ___(a)___ and thus increases the release of both __(b)__ & __(c)__ from nerve terminals.

A

a) alpha-2 adrenoceptor antagonist
b) norepinephrine
c) serotonin

41
Q

____ & ____ are the only SSRI’s approved to treat an anxiety disorder (i.e., OCD) in children

A

Fluoxetine & Sertraline

Psychiatry (7 decks)

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