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Nurs 5229 Clinical Pharmacotherapeutics > Anxiety Medications Deck 2 > Flashcards

Anxiety Medications Deck 2 Flashcards

1
Q

Pharmacokinetics of Buspirone

A

well absorbed after oral administration

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2
Q

Dosing Buspirone

A

– Short half‐life: tid regular dose
– Therapeutic Therapeutic effects: effects: initial1 initial1‐2wks; full 4‐12wks
– Initial dose: 5mg bid/tid, then increase 2.5mg‐5mg
qd for moderate anxiety. Range15‐30mg/d

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3
Q

Drug and Food Interactions for Buspirone

A

– Erythromycin and ketoconazole

– Grapefruit juice

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4
Q

Buspirone Side Effects

A
  • Dizziness
  • Headaches
  • Nausea
  • Possible insomnia
  • May decrease sexual dysfunction of SSRIs
  • Drug Interaction: Do not give with MAOIs
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5
Q

Panic attack signs and symptoms

A 
Abrupt surge of intense fear or intense discomfort including at least 4 of the
following:
Trembling/shaking
• Sensations of SOB or
smothering
• Feeling of choking
• Chest pain or
discomfort
depersonalization
• Fear of losing control of
going crazy
• Fear of dying
• Paresthesias
• Nausea/GI distress
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6
Q

Buspirone should monitor

A

liver function

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7
Q

Panic attack treatment

A 
SSRI
Paroxetine, sertraline, fluoxetine
SNRI
Venlafaxine
TCA
MAOI - When all else fails
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8
Q

TCA is used a ____ for panic attack treatment

A

2nd line
start low and go slow
Limited by SE

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9
Q

Agoraphobia

A

Anxiety about being in place or situations
from which escape might be difficult
• Anxiety about being in place or situations for
which help may not be available available for panic
symptom
• Avoidance of specific symptoms

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10
Q

Agoraphobia treatment (4)

A

BZD
TCA
MAOI
SSRI

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11
Q

Social Anxiety Disorder

A

Phobia or fear about being with other people
and in social situations
• Avoidance behavior
• Physical manifestations

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12
Q

Social Anxiety Disorder two types

A

gerneralized

performance

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13
Q

Specific social phobia treatment. What two drugs and their dose. What should you not use these treatments for

A

• Beta‐blockers used for specific social phobia
like performance anxiety
– Atenolol 25‐100mg
– Propranolol 10‐80mg
– Don’t use for athletic performance because it will
decrease cardiac output

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14
Q

OCD

A

Characterized by persistent obsessions and compulsions that cause marked
distress, consume at least 1 hour/day and interfere with ADLs

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15
Q

Cumpulsions

A 
Compulsions
• Checking
• Cleaning/washing
• Repeating
• Counting
• Ordering/arranging
• Hoarding/collecting
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16
Q

Treatment for social anxiety disorders

A

SSRI
BZD
Beta blocker

17
Q

BZD dosing for social anxiety disorder

A

– prn
– Low dose
– Small quantity

18
Q

Berta blocker dosing for social anxiety

A

Propanalol 10‐80mg 1‐2 hours before event

– Do not give for sports performance anxiety

19
Q

Obsessions

A 
Contamination
• Aggression
• Religion (scrupulosity)
• Safety/harm
• Need for exactness and
symmetry
• Somatic fears
20
Q

OCD Treatment

A

SSRI
TCA
Combination - SSRI with neuroleptic, BZD or SRI

21
Q

OCD SSRI

A

Fluoxetine, sertraline, paroxetine, fluvoxamine
– Fewer side effects
– At least 1 year of therapy

22
Q

OCD TCA

A

Clomipramine

– Limited by side effects: wt gain, tremor

23
Q

OCD Combination

A

– SSRI with neuroleptic, BZD, or SRI

24
Q

Post Traumatic Stress Disorder (PTSD)

A 
• Experience of trauma
• Psychological
reexperience
• Persistent avoidance of
• Irritability/outbursts of
anger
• Decreased
Persistent avoidance of concentration
similar traumatic
events
• Decreased sleep
• Hypervigilance
• Exaggerated startle
response
25
Q

A Mnemonic for Screening Patients

for Post‐traumatic Stress Disorder

A

DREAMS

26
Q

DREAMS

A
  • Detachment
  • Reexperiencing the event
  • Event had emotional effects
  • Avoidance
  • Month in duration
  • Sympathetic hyperactivity or hypervigilance
27
Q

PTSD Goals of Therapy

A 
– intrusive thoughts and images,
– phobic avoidance
– pathological hyperarousal
– vigilance
– impulsivity
– depression
28
Q

PTSD Treatment Options

A 
SSRIs (fluoxetine,
paroxetine, sertraline)
– +Trazodone
• NSRIs (venlafaxine)
• Atypical antipsychotics
• Buspirone (not
monotherapy)
• Non‐benzodiazepines
• TCAs (amitriptyline,
imipramine
• MAOIs (phenelzine)
• Antiadrenergics
• Novel antidepressants
Non benzodiazepines
hypnotics
• Benzodiazepines (not
recommended)
• Typical antipsychotics
(not recommended)
• Anticonvulsants

Nurs 5229 Clinical Pharmacotherapeutics (78 decks)

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