Anxiety

Question 1

a drug that has a calming effect, relieving anxiety and tension. Sedatives are hypnotic drugs administered at lower doses than those needed for sleep (drowsiness common side effect)

Answer 1

Sedative

Question 2

A drug that produces sleep by depressing brain function

Often cause hangover effects in the morning

Answer 2

Hypnotic

Question 3

A drug that reduces anxiety

Answer 3

Anxiolytic

Question 4

medical conditions that can cause patients to have anxiety

Answer 4

MI
asthma
hyperthyroidism
migraine
pain

Question 5

where do benzos act?

Answer 5

allosteric site of GABA

Question 6

MOA of benzos

Answer 6

The binding of benzodiazepines enhances the action of GABA, resulting in a greater entry of chloride ion

Question 7

Meds that decrease ___ help anxiety

Answer 7

norepinephrine

Question 8

Meds that increase ____ at receptors help w/ anxiety

Answer 8

5-HT (serotonin)

Question 9

fear of market place or open spaces

Answer 9

agoraphobia

Question 10

what are the benzos used for anxiety

Answer 10

alprazolam
clonazapam
chlordiazepoxide
clorazepate
diazepam
halazepam
lorazepam
oxazepam

Question 11

most effective and safe med for acute anxiety symptoms

Answer 11

benzos

Question 12

long acting benzos (1-3 days)

Answer 12

chlordiazepoxide
diazepam
flurazepam

Question 13

intermediate acting benzos (10-20 hours)

Answer 13

alprazolam
lorazepam
temazepam

Question 14

short acting benzos (3-8 hours)

Answer 14

oxaepam

traizolam

Question 15

MOA of benzos

Answer 15

potentiate inhibitory activity of GABA

Question 16

which benzos have lower potency

Answer 16

chlordiazepoxide
oxazepam
temazepam

Question 17

what benzos have medium potency

Answer 17

diazepam
estazolam
flurazepam
prazepam
quazepam

Question 18

what benzos have high potency

Answer 18

alprazolam
bromazepam
clonazepam
lorazepam
traizolam

Question 19

ADRs w/ benzos

Answer 19

sedation, fatigue, weakness
decreased memory and recall
ataxia, mental confusion

Question 20

who can you see a paradoxical rxn w/ benzos in

Answer 20

extremes of age

brain injury

Question 21

to D/c benzos what must be done

Answer 21

taper <10-25% every 1-2 weeks

at 50% dose slow-taper further to avoid withdrawal

Question 22

other CNS depressants to not combine w/ benzos

Answer 22

ETOH

opiates

Question 23

what drug inhibits metabolism of long acting BZDs

Answer 23

cimetidine

Question 24

what drug decreases clearance of diazepam

Answer 24

fluoxetine

Question 25

disadvantages of benzos

Answer 25

psychological dependence/ abuse | withdrawal rxns

Question 26

withdrawal symptoms of benzos

Answer 26

confusion, anxiety, agitation, restlessness, insomnia, tension

Question 27

what reverses the affects of benzos

Answer 27

flumazenil (rapidly reverses effects)

Question 28

problem w/ flumazenil

Answer 28

will precipitate withdrawal symptoms (seizures)

Question 29

Not used for anxiety or insomnia Induce tolerance, physical dependency, severe withdrawal symptoms Potentially Fatal Respiratory Depression potent liver inducers- many drug interactions

Answer 29

Barbiturates

Question 30

barbiturates uses

Answer 30

general anesthetic anticonvulsant sedative/ hypnotics- risky

Question 31

MOA of barbiturates

Answer 31

Potentiates GABA action on chloride entry into neuron hyperpolarization Barb receptor on GABA different than Benzo Block excitatory glutamate receptors Anesthetic concentrations block Na+ channels

Question 32

is there an antagonist for barbiturates?

Answer 32

No

Question 33

how are beta blockers useful w/ anxiety

Answer 33

helps w/ physical symptoms- tachycardia, palpitations, tremor, sweating

Question 34

what situations can't you use beta blockers

Answer 34

asthma diabetes CHF

Question 35

drugs used for performance anxiety (ie- public speaking)

Answer 35

propranolol 10 mg prn

Question 36

Treat anxiety d/o | Reduce 5-HT transmission by acting as partial agonist at these receptors

Answer 36

Buspirone (Buspar)

Question 37

advantages of buspirone

Answer 37

dependence unlikely | minimal sedation

Question 38

disadvanatges w/ buspirone

Answer 38

only works well in GAD can cause hypothermia, increased prolactin/ GH P450

Question 39

onset of effects w/ buspirone

Answer 39

onset in 1 weeks, max effects in 4-6 weeks

Question 40

drug for anxiety that reduces calcium influx into the neuron and reduces release of glutamate, NE and substance P

Answer 40

pregabalin

Question 41

antidepressants shown to not be helpful w/ patients who has anxiety

Answer 41

tradazone | bupropion

Question 42

tx of choice for panic disorders

Answer 42

SSRIs

Question 43

antidepressant + benzo can result in what?

Answer 43

jitteriness syndrome | tx by giving smaller dose of antidepressant

Question 44

SSRI may induce what in the first 4 weeks

Answer 44

anxiety, so add a benzo to help

Question 45

the majority of anxiety and panic disorder need what

Answer 45

long-term treatment

Question 46

Tx of anxiety & insomnia, non-addicting

Answer 46

antihistamines