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Psychopharmacotherapy > Anxiety, OCD, and PTSD > Flashcards

Anxiety, OCD, and PTSD Flashcards

1
Q

What are the goals of pharmacotherapy in treating anxiety?

A

Control symptoms

  • Rapid onset of action
  • No potential for abuse, dependence, or withdrawal
  • Efficacy on comorbidity

Prevent Relapse

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2
Q

What are the first line agents to be used for performance type of anxiety?

A

Propranolol

Atenolol

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3
Q

How do beta blockers help reduce anxiety?

A

Decrease HR

Reduce tremors

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4
Q

What conditions are contraindications for beta-blockers?

A

Bradycardia or Heart block
Asthma or COPD
Angle-closure glaucoma
Diabetics

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5
Q

What BZDs are used to treat anxiety?

A 
Alprazolam
Chlordiazepoxide
Clonazepam
Clorazepate
Diazepam
Lorasepam
Oxazepam
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6
Q

List BZDs from longest to shortest halft life.

A 
Diazepam
Clonazepam
Temazepam
Lorazepam
Alprazolam
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7
Q

In regards to eating, when should benzos be taken?

A

On an empty stomach and without antacids.

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8
Q

Return of original symptoms.

A

Relapse

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9
Q

Return of original symptoms at a greater intensity than before.

A

Rebound

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10
Q

Occurrence of symptoms not previously experienced.

A

Withdrawal

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11
Q

What are the signs of severe BSD withdrawal?

A

Hallucinations
Delirium
Seizures

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12
Q

Withdrawal symptoms on discontinuation of long-term use.

A

Dependence

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13
Q

Compulsive use of a substance depsite negative consequences.

A

Addiction

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14
Q

What factors increase the risk of BZD dependence?

A

Longer-term treatment
Higher dosage
Higher-potency
Shorter-half-life

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15
Q

What type of anxiety disorders are SSRIs indicated for?

A 
Panic anxiety
OCD
GAD
PTSD
Social anxiety
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16
Q

Which SNRI can be used to treat GAD, social anxiety disorder, panic disorder, and PTSD?

A

Venlafaxine

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17
Q

Which TCAs were used to treat PD/PDA and GAD?

A

Imipramine
Desipramine
Doxepin

18
Q

Which TCA is still widely used for treating OCD?

A

Clomipramine

19
Q

How can you avoid the “jitteriness” when starting someone on a TCA?

A

Start low and go slow

20
Q

What anxiety disorders can MAOI be used to treat?

A

Panic disorder

Social anxiety disorder

21
Q

What are the two most commonly used MAOIs?

A

Phenelzine

Tranylcypromine

22
Q

What antihistamine is commonly used to treat anxiety disorders?

A

Hydroxyzine

23
Q

What are the major side effects of hydroxyzine?

A

Drowsiness

Dry mouth

24
Q

What is the benefit of using hydroxyzine?

A

No risk of dependance

25
Q

What other medications should be avoided in conjunction with hydroxyzine?

A

Alcohol
Narcotics
CNS depressants
TCAs

26
Q

What is the MOA of buspirone?

A

Partial agonist of 5-HT1A

27
Q

What is the indication for buspirone?

A

GAD

28
Q

How long might it take buspirone to work?

A

4-6 weeks

29
Q

In what way are BZDs superior to treating anxiety disorders than buspirone?

A

More rapid response

Slightly more effective at treating somatic symptoms

30
Q

What anticonvulsants are used to treat anxiety disorders?

A

Gabapentin
Divalproex
Pregabalin

31
Q

What is the main anxiety disorder gabapentin can be used to treat?

A

Social anxiety

32
Q

What is the benefit of using gabapentin over other drugs for anxiety?

A

Few DDI

Less potential for abuse

33
Q

What anxiety disorders can be treated with divalproex?

A

Resistant panic disorder

34
Q

What anxiety disorders can pregabalin be used to treat?

A

GAD

Social anxiety disorder

35
Q

What is the main benefit of using pregabaline over other anticonvulsants?

A

Well tolerated in patients with hepatic dysfunction.

36
Q

What medication has been show to help reduce nightmares, improve sleep, reduce hyperarousal, numbing, and reexperiencing?

A

Prazosin

37
Q

What other anticonvulsants have been shown to have some efficacy in treating PTSD?

A

Topiramate
Lamotrigine
Levetiracetam

38
Q

What aren’t antipsychotics used to treat anxiety?

A

Little evidence exists to support their use at this time.

39
Q

When can atypical antipsychotics be used to treat anxiety?

A

When more established agents have been exhausted.

40
Q

What is the appropriate first step if anxiety and depression copresent?

A

Treat depression first

Psychopharmacotherapy (8 decks)

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