Chapter 5 Pt 1 Flashcards
what are the signs and symptoms of anxiety
constitutional: fatigue, diaphoresis, shivering
cardiac: chest pain, palpitations, tachycardia, hypertension
pulmonary: SOB, hyperventilation
neurologic/msk: vertigo, lightheadedness, paresthesias, tremors, insomnia, muscle tension
GI: abdominal discomfort, anorexia, nausea, emesis, diarrhea, constipation
what medications/substances can cause anxiety
alcohol (intox/withdrawal) sedatives, hypnotics, or anxiolytics (withdrawal) cannabis (intox) hallucinogens (intox) stimulants (intox/withdrawal) caffeine (intox) tobacco (into/withdrawal) opioids (withdrawal)
pathological anxiety occurs when?
symptoms are excessive, irrational, out of proportion to the trigger or are without an identifiable trigger
te criteria for most anxiety disorders involve symptoms that
cause clinically significant distress or impairment in social and/or occupational functioning
primary anxiety disorders can be diagnosed only after what
determining the signs and symptoms are not caused by physiological effects of substance, medication or medical condition
what neurotransmitters are implicated in axiety
norepinephrine
serotonin
GABA
what is the most common form of psychopathology
ANXIETY
lifetime prevalence of 30% in women and 19% in men
what is treatment for anxiety
psychotherapy for milder presentations
combination treatment with pharmaco therapy for moderate to severe
what medical conditions can cause anxiety
neurologic: epilepsy, migraines, brain tumors, multiple sclerosis, Huntingtons disease
endocrine: hyperthyroidism, thyrotoxicosis, hypoglycemia, pheochromocytoma, carcinoid syndrome
metabolicL Vitamin B12 deficiency, lyte abnormalities, porphyria
Resp: asthma, COPD, hypoxia, PE, pneumonia, pneumothorax
Cardiovascular: CHF, angina, arrhythmia, MI
what medication used to treat anxiety can make depression worse
benzos
what is first line tx for anxiety
SSRI and SNRI
what should one do in the short term while waiting the 4-6 weeks for SSRI or SNRI to become effective
bridge with BENZOS
what type of anxiety are beta-blockers used for
performance anxiety and panic attacks
how long should one provide medication for anxiety
symptomatic relief and continue treatment for at least 6 months before attempting to titrate off
what is panic disorder
recurrent, UNEXPECTED panic attacks without an identifiable trigger
one or more of the panic attack followed by ≥1 month of continuous worry about experiencing subsequent attacks or their consequences
not caused by substance, meds, or medical condition
who is at greater risk of panic disorder
those with 1st degree relatives wit it
what psychosocial factors come into play with panic disorder
increased incidence of stressors (especially loss) prior to onset
history of childhood physical or sexual abuse
when a patient presents with a panic attack, one must rule out what
potentially life treating conditions such as: heart attack, thyrotoxicosis, or thromboembolism
what is the course of panic disorder
chronic
waxes and wanes
relapses common with discontinuation of medication
up to 65% of patinets with panic disorder also have what
MDD
what is the best treatment for panic disorder
pharmacotherapy and CBT
SSRI first line
