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Pharm 845 Final Exam > Dr. Hager: Pharmacotherapy of Anxiety Disorders > Flashcards

Dr. Hager: Pharmacotherapy of Anxiety Disorders Flashcards

1
Q

Excoriation Disorder

A
  • Compulsive skin picking

- With NO obsessive component

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2
Q

Trichotillomania

A
  • Compulsive hair pulling

- With NO obsessive component

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3
Q

Treatment Approach for Anxiety Disorders

A
  • Start with psychotherapy

- Move to medication therapy if needed

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4
Q

Generalized Anxiety Disorder Treatments

A

1) Psychotherapy
2) Hydroxyzine (Atarax, Vistaril)
3) SSRI/SNRI
4) Pregabalin (Lyrica)
5) Benzodiazepine
6) Buspirone (BuSpar)

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5
Q

Fluoxetine (Prozac) MoA

A

-SSRI

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6
Q

Sertraline (Zoloft) MoA

A

-SSRI

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7
Q

Citalopram (Celexa) MoA

A

-SSRI

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8
Q

Escitalopram (Lexapro) MoA

A

-SSRI

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9
Q

Paroxetine (Paxil) MoA

A

-SSRI

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10
Q

Fluvoxamine (Luvox) MoA

A

-SSRI

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11
Q

Vortioxetine (Trintellix) MoA

A
  • SSRI

- 5HT1A partial agonist

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12
Q

Vilazodone (Viibryd) MoA

A
  • SSRI

- 5HT1A partial agonist

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13
Q

Venlafaxine (Effexor) MoA

A

-SNRI

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14
Q

Desvenlafaxine (Pristiq) MoA

A

-SNRI

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15
Q

Duloxetine (Cymbalta) MoA

A

-SNRI

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16
Q

Milnacipran (Savella, Ixel) MoA

A

-SNRI

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17
Q

Serotonin Syndrome

A
  • Rare
  • Discontinue the causative med
  • Use benzodiazepine too
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18
Q

Serotonin Withdrawal Syndrome

A

-Malaise, headache, tremors, sleep disturbances, anxiety
-Causative agents
Venlafaxine (Effexor)
Paroxetine (Paxil)
Sertraline (Zoloft)
Escitalopram (Lexapro)
Fluoxetine (Prozac)
-Treatment: Start fluoxetine (Prozac) and Taper

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19
Q

Trazodone (Desyrel) MoA

A

-5HT2 Antagonist

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20
Q

Nefazodone (Serzone) MoA

A

-5HT2 Antagonist

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21
Q

Mirtazapine (Remeron) MoA

A

-5HT2 Antagonist

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22
Q

Buspirone (BuSpar) MoA

A

-5HT1A agonist

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23
Q

Hydroxyzine (Vistiril/ Atarax) MoA

A

-5HT2 Antagonist

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24
Q

Alprazolam (Xanax) MoA

A

-Short acting benzodiazepine

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25
Q

Oxazepam (Serax) MoA

A

-Short acting benzodiazepine

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26
Q

Temazepam (Restoril) MoA

A

-Short acting benzodiazepine

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27
Q

Lorazepam (Ativan) MoA

A

-Medium acting benzodiazepine

28
Q

Diazepam (Valium) MoA

A

-Long acting benzodiazepine

29
Q

Clonazepam (Klonopin) MoA

A

-Long acting benzodiazepine

30
Q

Chlordiazepoxide (Librium) MoA

A

-Long acting benzodiazepine

31
Q

Possible side effects of benzodiazepines

A
  • Sedation
  • Ataxia
  • Disinhibition
  • Repiratory suppression
  • Decreased REM sleep
32
Q

Are Benzodiazepines safe in pregnancy?

A

-NOOOOO

33
Q

Treatments for Panic Disorder

A

1) Psychotherapy
2) SSRI/SNRI
3) Imipramine (TCA)
4) Benzodiazepine

34
Q

Imipramine (Tofranil)

A

-TCA

35
Q

Clomipramine (Anafranil) MoA

A

-TCA

36
Q

Amitriptyline (Elavil) MoA

A

-TCA

37
Q

Doxepin (Sinequan) MoA

A

-TCA

38
Q

Trimipramine (Surmontil)

A

-TCA

39
Q

Desipramine (Norpramin)

A

-TCA

40
Q

Nortriptyline (Nortrilen)

A

-TCA

41
Q

Protriptyline (Vivactil) MoA

A

-TCA

42
Q

Maprotyline (Ludiomil) MoA

A

-TCA

43
Q

Amoxapine (Asendin) MoA

A

-TCA

44
Q

Treatment of Social Anxiety Disorder

A

1) Psychotherapy
2) SSRI/SNRI
3) Gabapentinoid
4) Benzodiazepine
5) MAOI

45
Q

Isocarboxazid (Marplan) MoA

A

-MAOI

46
Q

Phenelzine (Nardil) MoA

A

-MAOI

47
Q

Tranycypromine (Parnate)

A

-MAOI

48
Q

Selegiline (Zelepar) MoA

A

-MAOI

49
Q

Possible side effects of MAOIs

A
  • Hypertensive crisis

- Diastolic BP > 120

50
Q

Linezolid (Zyvox) MoA

A

-MAOI

51
Q

Give an example of some foods that contain tyramine and must be avoided when taking MAOI

A
  • Aged cheese
  • Smoked meat
  • MSG
  • Fermented fruit, veggies, soy
  • Unfiltered beer, wine
  • Dark chocolate
52
Q

List some foods that are safe to eat when taking an MAOI

A
  • Fresh/Frozen/Canned fruits/veggies
  • Cottage/ricotta cheese
  • Yogurt
  • Ice cream
  • Milk
  • Nuts
  • Peanut butter
53
Q

Which drugs will not increase the risk of serotonin syndrome when given with MAOIs

A
  • Benzodiazepines

- Diphenhydramine

54
Q

What are some side effects associated with MAOIs

A
  • Orthostatic hypotension
  • Hypertensive crisis
  • Agitation/sedation
  • Insomnia/hypersomina
  • GI/ sexual side effects
55
Q

What is a sufficient washout period for most antidepressants?

A

-10 to 14 days

56
Q

Acute Stress Disorder Treatments

A
  • Cognitive Behavioral Therapy

- Prolonged Exposure Therapy

57
Q

What agents are INEFFECTIVE in treatment of acute stress disorder

A
  • SSRIs
  • Propranolol
  • Benzodiazepines
58
Q

PTSD Treatments

A

1) Psychotherapy
2) SSRI/SNRI
3) Prazosin Augmentation
4) TCAs
5) Antipsychotic augmentation?

59
Q

Effects of Benzodiazepines in PTSD

A
  • INEFFECTIVE
  • Worsen PTSD severity
  • Aggression
  • Depression
  • Substance abuse
60
Q

OCD Treatments

A

1) Psychotherapy
2) SSRI/SNRI
3) Clomipramine
4) Augmentation with Risperidone or Quetiapine

61
Q

In which disease states are benzodiazepines safe and effective

A

-Panic disorder

62
Q

What are some side effects associated with Clomipramine

A
  • Orthostatic hypertension
  • Blurry vision
  • Sedation
  • Constipation
  • QTc elongation
63
Q

What are some contraindications for treatment with imipramine

A
  • Intraventricular conduction delay
  • Evidence of recent MI
  • QTc interval >450ms
64
Q

Agents associated with weight gain

A
  • Olanzapine
  • Gabapentin
  • Amitriptyline
  • Mirtazipine
  • Quetiapine
  • Risperidone
65
Q

Agents associated with weight loss

A
  • Topiramate
  • Bupropion
  • Fluoxetine
66
Q

Which disease states do we NOT use benzodiazepines

A
  • PTSD

- OCD

Pharm 845 Final Exam (7 decks)

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