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NAPLEX - OUR cards > Anxiety disorders > Flashcards

Anxiety disorders Flashcards

1
Q

Drugs that can incr anxiety

A 
Albuterol (used incorrectly or too much)
antipsychotics
Bupropion
Caffeine (high doses)
sudafed
Levothyroxine
stimulants
steroids
illict drugs
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2
Q

Comorbidities that can increase anxiety

A

hyperthyroidism

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3
Q

1st line treatment for anxiety disorders

A

certain SSRIs and SNRIs

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4
Q

Which SSRI/SNRI are approved in anxiety disorders? 96 total)

A 
Escitalopram
Fluoxetine
Paroxetine
Sertraline
Duloxetine
Venlafaxine XR
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5
Q

Doses of SSRI/SNRIs used

A

usually have the initial dose used for depression

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6
Q

Buspar

A

buspirone

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7
Q

Buspar use

A

adjunctively with antidepressants (2nd-line)

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8
Q

Buspar MOA

A

unknown

has affinity for 5HT1a and 5HT2

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9
Q

Buspar side effects

A

Nausea
dizziness
drowsiness
HA

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10
Q

Buspar clinical pearls

A 
do not use w/ MAO iinhibitors or w/in 14 days of use 
takes 2-4 weeks to be effective
titrate by 5mg/day every 2-3 days
Max 30 mg BID
take with or w/o food, but be consistent
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11
Q

Buspar metabolism

A

major CYP3A4 substrate

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12
Q

Other 2nd line options for anxiety

A

TCA’s (not FDA approved)
Hydroxyzine (sedating, doesn’t treat underlying condition)
Lyrica: used for pts w/ nerve pain + anxiety

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13
Q

Indication for beta blockers (propranolol) in anxiety disorders

A

Use for performance anxiety

take 10-40 mg of propranolol 1 hr prior to event

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14
Q

BZD MOA

A

potentiate GABA (inhibitory NT)

anxiolytic
anticonvulsant
sedative
some muscle relaxant properties

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15
Q

recommended duration of BZD therapy

A

1-2 weeks then d/c

HA, GOOD ONE

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16
Q

BZD boxed warnings

A

use with opioids can result in sedation, respiratory depression, coma, death

17
Q

BZD contraindications

A 
acute narrow-angle glaucoma
sleep apnea
severe resp disease
severe liver disease (clonazepam, diazepam)
myasthenia gravis
18
Q

BZD warnings

A 
dependence and tolerance w/ long-term use; must taper slowly when d/c
amnesia
cns dpression
potential for abuse
Pregnancy - birth defects
19
Q

BD side effects

A 
somnolence
dizziness
weakness
ataxia
lightheadedness
20
Q

diazepam clinical pearls

A

lipophilic
fast onset
long t1/2

21
Q

alprazolam clinical pearls

A

fast onset
high abuse potential
contraindicated with strong CYP3a4 inhibitors (ketoconazole, etc)

22
Q

BZDs used for alcohol withdrawal symptoms

A

lorazepam
diazepam
chlordiazepoxide

23
Q

BZDs safer in elderly and pts with hepatic impairment

A

lorazepam
oxazepam
temazepam
LOT

24
Q

What duration requires tapering of BZDs?

A

more than 10 days

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