Anxiety ClinMed and Pharm Flashcards
Definition of anxiety
fear or apprehension out of proportion to the situation
stress is ok, but anxiety is when it is more than needed
The function of anxiety and arousal systems is to increase ______ to a possibly dangerous situation
alertness
it ups motivation to get out of the danger
Anxiety disorder defined by:
excessive worry about life, worry uncontrolled, restlessness, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbances
Causes significant impairment to functioning. not due to substance or another psych condition
General anxiety disorder
GAD has _____ rates in females and <30 years old. Onset is typically by _____
higher, early 20s
What is the pathophysiology of GAD
GABAergic, serotonergic, norandrenergic in frontal/limbic lobes
Other things on the DDx for GAD
substance induced, other anxiety disorders, adjustment disorder
Treatment of GAD gold standard is ____ and ____
SSRI/SNRI and CBT
CBT= antecedents, beliefs, consequences. ID the maladaptive thoughts and create healthy alternatives
Medication that is rapidly effective for GAD but also not recommended
Benzodiazepines
tolerance, dependance, relapse in SUD, falls, sedation, worsened cognition, lethal with EtOH, HARD to stop. promotes avoiding anxiety symptoms
For GAD: ________ are the medication used but it can takes weeks to work. ___ and ____ are two commonly started
Antidepressants
low dose trazodone, hydroxyzine
Name that anxiety disorder:
fear about social situations, social interactions, being observed, and performing in front of others. Fears rejection. Social situations are avoided.
Social phobia
Social phobia has prevalence of ___%, affecting males/females ___, ____ have another psych disorder
13%, equally, 50%.
increased SUD risk, familial bc dopa
What is the treatment for social phobia?
SSRI/SNRI, β blockers, psychotherapy
lack of improvement if fears not confronted
Are panic attacks a disorder or a symptom?
symptom
What symptoms are associated with panic attacks
palpitations, sweating, trembling shaking, SOB, feeling of choking, nausea, dizziness, chills, parenthesis, fear of losing control, fear of dying
_____ is a sudden onset 5-60 minute duration symptom that can occur in the context of any anxiety disorder or other conditions
Panic Attack
Name that anxiety disorder
recurrent unexpected panic attacks, not substance, not explained by another mental condition
1 of: persistent concern or worry about another panic attack or significant maladaptive change in behavior
Panic disorder
Panic disorder lifetime prevalence of __ in women and __ in men.
Onset is ___
5, 2
mid 20s.
first one usually to ED but then becomes chronic illness with symptom fluctuation.
increased risk of death from SUD or depression
Panic disorder comorbidities include (medical conditions)
IBS, HTN, mitral valve prolapse, fibromyalgia, chronic fatigue, migraine, asthma, allergic rhinitis, sinusitis
Panic disorder can be hereditary, first degree relative up to __%
20
higher concordance with twins
Panic disorder treatment is to combine ___ and ___. Second line is _____, ______, and ______. Avoid caffeine
SSRI/SNRI, psychotherapy
β blocker, MAOIs, TCAs
Why are benzodiazepines unnecessary for panic disorders?
risks and the attack usually subsides before the med becomes bioavailable
Name that anxiety disorder:
Fear of inability escape quickly (public, open spaces, enclosed spaces, standing in lines), fear of being trapped. Can be comorbid with panic disorder
Agoraphobia
sitation cause anxiety-> avoid situation ->impairment
_____ and ______ stressful situations reinforces the anxiety
avoidance and fleeing. Treatment is aimed at staying in the stressful situations
When is an appropriate use of benzodiazepines
before imaging/radiation/flying, alcohol detox, anesthesia, seizures
