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CNS > Anxiety > Flashcards

Anxiety Flashcards

1
Q

Which of the following medication are not for acute anxiolysis? (select all that apply)

A. Pregabalin (Lyrica)

B. Buspirone ( Buspar)

C. Hydroxyzine (Vistaril)

D. Lorazepam ( Ativan)

A

A, B

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2
Q

Gary is picking up Prazosin from your pharmacy for the first time. You counsel him on. What are some counseling points you go over? (select all that apply)

A. This medication will cause dizziness, drowsiness, headache, orthostatic hypotension

B.Additive hypotensive effects when combined with other antihypertensive medications

C. This medication will cause sedation, anterograde amnesia, headache, and orthostatic hypotension

D. Additive hypotensive effects when combined with other CYP3A4 medications

A

A,B

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3
Q

How long is the adequate trial for PTSD?

A. 2-4 weeks

B. 4-6 Weeks

C. 6-8 Weeks

D. 10-12 Weeks

A

C

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4
Q

Which of the following are appropriate adjunct therapies for Social anxiety disorder?

A. Pregabalin ( Lyrica)

B. Hydroxazine ( Vistaril)

C. Metoprolol Succinate (Toprol XL)

D. Propranolol (Inderal)

A

D.

Note: Benzodiazepines are debatable

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5
Q

Yo and Dr. Scratch and Sniff agree that Trina has GAD, what do you recommend that Dr. Scratch and Sniff initiates?

A. Risperidone ( Risperdal)

B. Buspirone (Buspar)

C. Quetiapine ( Seroquel)

D. Sertraline (Zoloft)

A

D. Sertraline

First line therapy of Generalized Anxiety Disoder is Sertraline

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6
Q

Sue was diagnosed with panic disorder. Which of the following are appropriate therapies? (select all that apply)

A. Fluoxetine (fluoxetine)

B. quetiapine (seroquel) w/ Fluoxetine (prozac)

C. Duloxetine ( Cymbalta)

D. Paroxetine (Paxil) with lorazepam ( ativan)

E. Clonazepam (Klonopin)

A

A, C, D,

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7
Q

Gary is diagnosed with PTSD, he is given paroxetinem but he comes back to the clinic and complains that he is still having nightmares. What do recommmend?

A. Tamsulosin (flomax)

B. Doxasozin ( cardura)

C. Prazosin ( minipress)

D. Terasozin (Hytrin)

A

C.

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8
Q

Mary is 25 yo patient complaining of constipation and sedation and sometimes blurred vision. What medication is Mary taking?

a. Lithium
b. carbamazepine
c. hydroxyzine
d. buspirone

A

c

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9
Q

Which of the following benzodiazepines is not a long acting? (select all that apply)

A. Lorazepam (ativan)

B. Oxazepam ( serax)

C. Alprazolam (xanax)

D. Diazepam ( valium)

A

A, B, C

The long acting spell out CDC

the short acting spell SOLA using the brand and generic

(Serax Oxazepam Lorazepam Ativan)

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10
Q

What does william most likely present with?

A. Generalized Anxiety

B. Panic Disoder

C. Socialized Anxiety

D. None of the above

A

A.

  1. Excessive anxiety and worry for more than 6 months
  2. Anxiety or worry associated with more than 3 of the following…

Restlessness or feeling keyed up

being easily fatigued

difficulty concentrating or mind going blank

irritability

muscle tension

sleep disturbance (insomnia)

  1. Distress/ impairment in social occupational or in other areas.

* NOT due to another medical condition/ psychiatric disorder

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11
Q

Which benzodiazepines have an onset of 20-40 min?

A. Lorazepam (Ativan)

B. Alprazolam ( Xanax)

C. Clonazepam ( Klonopin)

D. Diazepam ( Valium)

A

A, C

klonopin is 20-40

ativan is 20-30

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12
Q

Which of the following are adverse effects buspirone? (select all that appy)

A. Headache

B. Nausea

C. Drowsiness

D. Dizziness

E. Xerostomia

F. Sedation

A

A, B, C, D

Sedation and xerostomia are ADR for hydroxyzine

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13
Q

What disorder does JD most likely have?

A. Generalized Anxiety Disorder

B. Schizophrenia

C. PTSD

D. Panic Disorder

A

C

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14
Q

Which of the following is NOT an adjunct therapy for generalized anxiety disorder?

A. Bupropion (Wellbutrin)

B. Buspirone ( Buspar)

C. Pregabalin ( Lyrica)

D. Hydroxyzine (vistaril)

A

A.

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15
Q

Which of the following are pharmacologic options for Jim who was diagnosed with social anxiety? (Select all that apply)

A. Fluoxetine ( Prozac)

B. Quetiapine (Seroquel)

C. Duloxetine (Cymbalta)

D. Sertraline ( Zoloft)

E. Buspirone (Buspar)

A

A, D

NOTE: only venlafaxine is approved for SAD

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16
Q

Which of the following medications inhibits exicitatory neurotransmitter release (glutamate, NE)?

A. Diazepam (Valium)

B. Buspirone (Buspar)

C. Pregabalin (Lyrica)

D. Hydroxyzine ( Vistaril)

A

C. Pregabalin

17
Q

Which of the following is true about buspirone? (Select all that apply)

A. Takes 4-6 weeks to see full clinical effects

B. Not related mechanistically to benzodiazepines ( Limits abuse potential)

C. Useful in situations requiring immediate anxiolysis

D. Best when it is monotherapy

E. This medication must be taken consistently ( 2-3 times a day to work

A

B, E

a is wrong because it takes 2 weeks to see full clinical effects

c is wrong because it doesnt work as an anxiolytic

d is wrong bc this is an adjunct therapy

18
Q

True or False

After adequate trial and good response to treatment of GAD treatement should be continued:

greater than 6 months if 1 anxiety episode

greater than 1 year if 2 anxiety episodes

indefinete treatment if 3 or more anxiety episodes

A

False

after adequate trial and good response to treatement, treatement should be continued for at least 1 year

this is for MDD

19
Q

JD was diagnosed with PTSD, he is given an SSRI. What does the SSRI not going to helpt with?

A. Reexperience

B. Arousal

C. Negative alternation in cognition and mood

D. Avoidence

A

D. Avoidence

20
Q

Select all that Apply. Which of the following are adverse effects for buspirone?

A. Sedation

B. Constipation

C.Dizziness

D. Drowsiness

E. Nausea

A

C,D,E

a and b are adverse side effects for hydroxazine

21
Q

What could Donald be diagnosed with?

A. Genralized Anxiety Disorder

B. Panic Disorder

C. Social Disorder

D. Acute Bipolar Disoder

A

A. GAD

  1. Excessive anxiety and worry for more than 6 months
  2. Anxiety or worry associated with more than 3 of the following…

Restlessness or feeling keyed up

being easily fatigued

difficulty concentrating or mind going blank

irritability

muscle tension

sleep disturbance (insomnia)

  1. Distress/ impairment in social occupational or in other areas.

* NOT due to another medical condition/ psychiatric disorder

22
Q

Match the following onset to the benzodiazepine.

I. 60

II <15

III. 20-40

IV. 20-30

A. Clonazepam ( Klonopin)

B. Diazepam ( Valium)

C. Alprazolam ( Xanax)

D. Lorazepam ( Ativan)

A

I. C

II. B

III. A

IV. D

23
Q

Trina is a 28 yo presenting to the clinic… you sit with Dr. Scratch and Sniff while he interviews. What condition does Trina have?

A. Generalized Anxiety Disorder

B. Panic Disoder

C. Social Anxiety Disoder

D. Acute Mania

A

A. GAD

  1. Excessive anxiety and worry for more than 6 months
  2. Anxiety or worry associated with more than 3 of the following…
  • Restlessness or feeling keyed up
  • being easily fatigued
  • difficulty concentrating or mind going blank
  • irritability
  • muscle tension
  • sleep disturbance (insomnia)
  1. Distress/ impairment in social occupational or in other areas.

* NOT due to another medical condition/ psychiatric disorder

24
Q

Donald was prescribed fluoxetine (Prozac) 2 weeks prior, he says they are not working, he still feels anxious and worked up. He is adherent to the medication. What are options you can recommend Dr. Scratch and Sniff can do? (select all that apply)

A. Increase the dose

B. Switch to another SSRI

C. Switch to Buspirone

D. Switch to an SNRI

E. Add Buspirone

A

A, B, D, E

NOTE you can also add the pregabalin, Hydroxyzine, and benzodiazepine

25
Q

Trina got diagnosed with GAD and was given an SSRI, how often should she be monitored?

A. once every 2 weeks until stable, then every 6 months

B. After 6-8 weeks, if not 10-12 weeks

C. once every 2 weeks until stable, then once a month

D. After 4-8 weeks

A

C

26
Q
A
27
Q

Which of the following statements is false about hydroxyzine?

a. Hydroxazine helps target co-morbidities
b. May be taken scheduled or PRN
c. Available PO and IM
d. can be a helpful when acute anxiolysis is needed

A

a.

28
Q

What is the mechanism of action of Vistaril? (select all that apply)

A. 5-HT2 receptor antagonist

B. H1 receptor antagonist

C. 5-HT2 receptor agonist

D. H1 receptor agonist

E. 5-HT1A receptor antagonist

A

A,B

29
Q

What disorder does Katie most likely have?

A. Generalized Anxiety Disorder

B. Panic Disorder

C. Social Anxiety

D. None of the above

A

B. Panic Disorder

  1. Sudden Unexpected and intense feeling of extreme fear reaching a peak in less than 10 minutes
  2. feelings of fear must be accompanied by at least 4 of the following….
    - palpitations or tachycardia, SOB, Dizziness, trembling,
    - feeling of chocking, numbness and tingling, hot and cold flashes
    - abdominal discomfort or nausea, fear of dying, fear or going crazy or losing control
  3. Recurrent unexpected panic attack
  4. More than 1 attack has been followed by more for more than a month
  5. persistent concern or worry about additional attacks or their consequenses
  6. Significant maladaptive change in behavior
30
Q

What is the brand name of Oxazepam?

A. Ativan

B. Librium

C. Klonopin

D. Serax

A

D. Serax

ativan is lorazepam

librium is chlrodiazepoxide

klonopin is clonazepam

31
Q

Which of the following benzapines is intermediate duration?

A. Oxazepam ( Serax)

B. Alprazolam (Xanax)

C. Clonazepam ( Klonopin)

D. Diazepam ( Valium)

A

B. alprazolam

32
Q

What does sue most likely have?

A. Generalized Anxiety

B. Panic Disorder

C. Social Anxiety Disoder

A

B. Panic Disorder

  1. Sudden Unexpected and intense feeling of extreme fear reaching a peak in less than 10 minutes
  2. feelings of fear must be accompanied by at least 4 of the following….
    - palpitations or tachycardia, SOB, Dizziness, trembling,
    - feeling of chocking, numbness and tingling, hot and cold flashes
    - abdominal discomfort or nausea, fear of dying, fear or going crazy or losing control
  3. Recurrent unexpected panic attack
  4. More than 1 attack has been followed by more for more than a month

persistent concern or worry about additional attacks or their consequenses

Significant maladaptive change in behavior

33
Q

Which of the following is the MOA of Buspirone?

A. 5-HT receptor antagonist and H1 receptor antagonist

B. Serotonin 5-HT1A receptor partial agonist at pre-synaptic 5-HT receptors

C. Inhibits excitatory neurotransmitter release ( glutamate, NE)

D. None of the above

A

B.

a is for hydroxyzine

c is for pregabalin

34
Q

What does Jim most likely present with?

A. Generalized Anxiety Disoder

B. Panic Disoder

C. Social Anxiety

D. Post Traumatic Stress Disorder

A

C.

  1. Marked fear or anxiety about 1 or more social situation where the person is exposed to possible scruitinity by others
  2. individual fears she/ he will act in a way or show anxiety symptoms
  3. Fear or anxiety or avoidance must be present for more than 6 months
35
Q

Gary is diagnosed with PTSD, he is given prazosin 1mg PO qHS. He comes back to the pharmacy and says the prazosin is not working. How do you manage his therapy?

A. change him to another alpha-1 antagonist

B. change him to another alpha-1 agonist

C. Titrabe by 1mg every 2-3 days, then 2-5mg per week

D. Titrate by 2-5mg every 2-3 days, then 1mg per week

A

C.

Max dose is 16mg

CNS (9 decks)

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