Anxiolytics Flashcards
what are the types of anxiety disorders
- generalized anxiety disorder
- panic disorder
- social anxiety disorder
- other:
- separation anxiety disorder
- specific phobia
- selective mutism
- agoraphobia
- substance/medication-induced anxiety disorder
- anxiety disorder due to another medical consition
- other specified anxiety disorder
- unspecified anxiety disorder
what is the common link between MDD and anxiety disorders
5HT
what are the symptoms of generalized anxiety disorder
- excessive anxiety or worry
- muscle tension
- restlessness
- fatigue
- impaired concentration
- irritability
- insomnia
what are the symptoms of panic disorder- recurrent attacks
- shortness of breath
- dizziness or faintness
- palpitations
- sweating
- trembling or shaking
- nausea
- dizziness
- paresthesias
- hot flashes or chills
- chest pain
- feelings of choking
- discomfort or fear
what are the symptoms of social anxiety disorders
- fear or anxiety about social situations
- concern regarding scrutiny from others
- concern regarding humiliation embrrassment
- fear of rejection
- concern regarding offending others
what are the first line therapies for generalized anxiety disorder
- SSRI and SNRI pregabalin
- buspirone
- BZD
what are the first line therapies for panic disorder
-SSRI and SNRI
- BZD
what are the first line therapies for social anxiety disorder
- SSRI
- BZD
BZD is for _____ use
short term
what are the side effects of SSRIs important to dentistry
- increased risk for bleeding and bruising due to decreased platelet aggregation
- bruxism
what are the drug interactions with SSRIs with opiod medications (codeine, hydrocodone, and oxycodone)
- pharmacokinetic interaction
- drugs that inhibit CYP450 2D6 prevent the metabolism of codeine; hydrocodone and oxycodone to an active medication
- outcome: pain relieving effects are reduced
- antidepressants: paroxetine and fluoxetine
what are the FDA approved uses for pregabalin and MOA
- postherpetic neuralgia, neuropathic pain due to diabetic neuropathy and spinal cord injury, seizures, and fibromyalgia
- considered first line agent in treatment for GAD (no FDA approval)
- MOA: unknown
what are the side effects of pregabalin
- dizziness, sedation, ataxia, blurred vision, and weight gain
- no life threatening side effects
- no oral side effects
- safe in overdose
- low risk for drug interactions
what are the uses for gabapentin and MOA
- FDA uses: postherpetic neuralgia and seizures
- used off label for anxiety both scheduled and prn
- limited evidence for use in anxiety
- MOA: unknown
what are the common side effects of gabapentin
- dizziness, sedation and ataxia
- no life threatening side effects
- no oral side effects
- safe in overdose
- low risk for drug interactions
what is the MOA and use for buspirone (buspar)
- MOA: 5HT1A partial agonist
- uses: FDA approval for GAD (not recommended as first line therapy)
- used as adjunctive therapy with an antidepressant for treatment refractory depression
describe the safety, onset of action of buspirone
- no abuse or withdrawal potential
- safe in overdose situations
- low risk for drug interactions
- onset of action 4-6 weeks
what are the side effects of buspirone
- GI
- sedation
- insomnia
- agitation
- headache
- weakness
- dizziness
- no serious side effects
- no oral side effects
what are the common uses on benzodiazepines in treatment of anxiety
- panic attacks (acute treatment only- NOT panic disorder)
- anxiety (short term tx only)
- seizures
- insomnia
- muscle relaxant
- acute alcohol withdrawal
- acute mania
- acute agitation
- PRN before medical/dental procedure
benzos work on what receptors
GABA
what is the onset of action, duration of action and main use of midazolam (Versed)
- rapid
- ultrashort
- anesthetic
what is the onset of action, duration of action and main use of triazolam (Halcion)
- rapid
- ultrashort
- hypnotic
what is the onset of action, duration of action and main use of alprazolam (xanax)
- rapid
- short
- anxiolytic
how fast is ultra rapid
less than 15 mins
