ch 30 Flashcards
psychological components of anxiety
fear
apprehension
dread
uneasiness
physical components of anxiety
tachycardia palpitations trembling dry mouth sweating weakness fatigue SOB
characteristic of Generalized Anxiety Disorder
psychological manifestations vigilance tension apprehension poor concentration difficulty falling asleep or staying asleep
somatic manifestations
trembling
muscle tension
restlessness
autonomic
palpitations
sweating
cold clammy hand
first line for GAD
SSRIs
SNRIs
Buspirone
what meds are approved for GAD
SNRI
Velafaxine (Effexor XR)
Duloxetine (Cymbalta)
SSRIs
Paroxetine (Paxil)
Escitalopram (Lexapro)
Velafaxine side effects
nausea - subsides with time headache anorexia nervousness sweating daytime somnolence insomnia HTN
Buspirone (BuSpar)
anxiolytic
short treatment of anxiety
most common reactions for Buspirone (BuSpar)
dizziness nausea headache nervousness sedation lightheadedness excitement
Levels of Buspirone (BuSpar) can be greatly increased by
erythromycin
ketoconazole
grapefruit juice
what 2 benzodiazepines are approved for anxiety are used most often
alprazolam (Xanax)
lorazepam (ativan)
characterized by recurrent, intensely uncomfortable episodes known as attacks peak in a few min and dissipate within 30 min
panic attacks
panic disorder
other things you can do to help with panic disorder
avoid caffeine and sympathomimetics
avoid sleep deprivation
regular aerobic exercise
first line for panic disorder
SSRI
fluoxetine (Prozac)
Paroxetine (paxil)
sertraline (Zoloft)
disabling condition characterized by persistent obsessions and compulsions that cause marked distress, consume at least 1 hour a day and significantly interfere with daily living
OCD
a recurrent, persistent thought, impulse or mental image that is unwanted and distressing and comes involuntarily to mind despite attempts to ignore or supress
obsession
a ritualized behavior or mental act that the patient is driven to perform in response to his or her obsessions.
compulsion
treatment with OCD
drugs and behavioral therapy ( exposed to source of fears while being encouraged to refrain from compulsion)
optimal is both
last resort is deep brain stem
4 SSRIs Fluoxetine (prozac) fluvoxamine (Luvox) Sertraline (zoloft) paroxetine (Paxil) and 1 TCA (clomipramine) are approved to treat SSRIS are preferred
characterized by an intense, irrational fear of situations in which one might be scrutinized by others or might do something that is embarrassing or humiliating
Social Anxiety Disorder (SAD)
SAD characteristics
intense anxiety that manifests as blushing, stuttering, sweating, palpitations, dry throat, muscle tension, twitches)
difference between generalized and performance SAD
generalized - fears nearly all social and performance situations
performance - limited to public speaking or performance
SAD treatment
psychotherapy and drug therapy
SSRIs are first line for most
Paroxetine (Paxil)
Sertraline (Zoloft)
initial effects take 4 weeks to develop, optimal is 8-12 weeks
Benzodiazepines (clonazepam (Klonopin), alprazolam (Xanax)). - rapid relief and can be used PRN
Propanolol (Inderal) - performance anxiety
take 1-2 hours before scheduled performance
develops after a traumatic event that elicited an immediate reaction of fear, helplessness, or horror.
PTSD
what are the 3 core symptoms of PTSD
re-experiencing an event
avoiding reminders of the event
persistent state of hyperarousal
what is the most common anxiety disorder
Social Anxiety Disorder
PTSD treatment
psychotherapy and with drugs
trauma focused therapy and stress inoculation training (exposure therapy) - repeatedly reimagine traumatic events as a way to make those events lose their power.
SSRIs
Fluoxetine
Paroxetine
Sertraline
SNRI
Velafaxine
mirtazapine
TCA - amitriptyline or imipramine
maoi
(phenelzine)
med for OCD
paxil
sonata helps with what part of sleep?
falling asleep
anxiety disorder what could you take daily
Buspar
when withdrawing Antiepileptic drugs taper
slowly over 6 weeks to several months
flagyl and alcohol
no -disulfiram reaction
