CNS - Anxiety Flashcards
Acute treatment of anxiety?
Benzodiazepines-
short term use
Lowest effective dose
Chronic treatment of Anxiety?
SSRI
(Sertraline, Citalopram, Escitalopram, Fluoxetine)
If physical symptoms of anxiety such as tremors, fast heart rate, palpitations occur?
Propranalol
Long acting benzodiazepines?
Diazepam
Alprazolam
Chlorodiazepoxide hcl
Clobazem
Short acting benzodiazepines?
Lorazepam
Oxazepam
Which benzodiazepines can induce hepatic coma?
Mostly Long acting benzodiazepines
(Although both can)
Which benzodiazepines is preferred in vulnerable pt?
Short acting Benzodiazepines
Preferred in elderly and Hepatic impairment
Risk associated with short acting benzodiazepines?
Greater risk of withdrawal symptoms
Use 2-4wks only!!
Benzodiazepines paradoxical effects?
- Agrresion
- Hostility
- Anxious
- Excited
- Talkative
Benzodiazepines overdose med?
Flumazenil
Can you drive with benzodiazepines?
No as causes sedation, drowsiness!
What should be avoided with benzodiazepines?
- Alcohol
- CYP inhibitors
- Depressants
Which benzodiazepines have legal driving limit?
Clonazepam
Oxazepam
Lorazepam
Diazepam
Flunitrazepam
Temazepam
COLD FT**
Dependence of benzodiazepines signs?
Anxiety
Weight loss
Tremors
Loss of appetite
How to help with dependence of benzodiazepine?
1) convert to one nightly dose of diazepam
2) reduce by 1-2mg (1/10th larger dose) every 2-4wks
3) Reduce further (0.5mg near end)
