Anxiety Ott Flashcards
drugs that can cause anxiety
albuterol
caffeine
decongestants
levothyroxine
stimulants
steroids
buspirone is approved for what disorder
generalized anxiety disorder
buspirone target dose
10-15 mg TID
how long for buspirone efficacy
3-4 weeks for initial
why are benzos not really recomended as first line?
abuse potential
not good to be on long term
acute withdrawal of benzos can lead to what?
life-threatening seizures
warnings with benzos
other CNS depressants, opioids
benzos with no active metabolite
alprazolam
lorazepam
clonazepam
oxazepam
benzos with long acting metabolite
diazepam
clorazepate
chlordiazepoxide
side effects of benzos
sedation
paradoxical excitement
swallowing difficulties
memory impairment
psychomotor impairment
benzo taper off lasts
weeks to months
can we give benzos in elderly
Beers, >65 is a risk
elderly preferred benzos
lorazepam, oxazepam, temazepam
hydroxyzine is fda approved for what
generalized anxiety disorder
hydroxyzine is the most commonly used what
as needed drug for anxiety or insomnia instead of a benzo
risk with hydroxyzine
QTC
side effects with hydroxyzine
sedation and anticholinergic
hydroxyzine in elderly?
avoid
propranolol useful for
performance and situational anxiety
doses of propranolol that are effective
low doses
what history to watch out for with propranolol
asthma, cardiovascular
natiral products for anxiety
Kava, St Johns Wort, passionflower, valerian, chamomile
when could we consider gabapentenoids
pt with bipolar and anxiety/neuropathic pain
qutiapine in sleep?
no
first line therapy for all anxiety disorders
SSRis, SNRis
buspirone for generalized too
atypical antipsychotics could be used for what
OCD (treatment resistant)
atypical antipsychotics we could use for OCD / anxiety
aripiprazole, risperidone
gerneralized anxiety disorder diagnosis
excessive anxiety / worry for at least 6 months
three symptoms:
restlessness
easily fatigued
concentration
irritable
muscle tension
sleep disturb
SNRIs especially useful if what
patient has a pain syndrome
benzodiazepine use in GAD
bridge therapy
cover time till SSRi/SNRi onset
what is social anxiety
fear about social, performance situations in which pt fears embarrassment/humiliation
social anxiety disorder treatment
SSRI
beta blocker (non generalized performacnce social anxiety)
panic disorder criteria
recurrent panic attacks
4 sx: sweating, palpitations, nausea, dixxy, fear of losing control, going crazy
at least one followed by concerns or changes
panic disorder treatment
SSRis
SNRIs - venlafaxine
benzos - last line
obsessions
intrusive thoughts causing anxiewty
complusions
repetitive behaviors
OCD treatment
SSRis
second line: clomipramine
symptom reduction with OCD
25-50%
OCD augmentation therapy with antipsychotics
risperidone, aripiprazoleq
cardinal signs of PTSD
flashbacks
reexperience
avoidance
hypervigilance
treatment of PTSD
SSRI/SNRi
drug helpful for nightmares in PTSD
prazosin
which drug class should not be used with PTSD
benzos
jitteriness can occur with what drug classes
SSRI,SNRI
start with lower doses
non drug treatments are especially helpful in PTSD with waht
events occuring over a long period of time
