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P. pharm > Exam 2 Study Guide > Flashcards

Exam 2 Study Guide Flashcards

1
Q

What are the symptoms for SSRI discontinuation syndrome

A

(FINISH)
F= Flu like symptoms (aches, pains, chills)
I= Insomnia
N= Nausea
I= Imbalance
S= Sensory disturbance (tremors, sensation of electrical shock)
H= Hyperarousal

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2
Q

What is the first line agent for anxiety disorders? e.g. Social anxiety disorder (SAD)

A

***First line treatment for chronic anxiety, GAD, panic disorder = SSRI

 Treat comorbid depression
 Lack abuse risk
 Low side effect rate

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3
Q

A patient presents with depressive symptoms alongside pain complaints = what medications
will you consider?

A

SNRI’s and TCA’s

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4
Q

Highest anticholinergic effect between TCA/BZO/SSRI?

A

TCA

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5
Q

Venlafaxine (Effexor) notable SEs

A

can be very activating (patients can be restless)
dose-dependent elevated BP

(NOT anticholinergic)

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6
Q

Tx akathisia

A

β-adrenergic receptor antagonists (beta-blockers) are generally most effective in thetreatment of Akathisia

(can use BZO but not first line)

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7
Q

Which Serotonergic agent can cause priapism?

A

Trazodone or escitalopram

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8
Q

Signs serotonin syndrome

A

 muscle spasms, fever, racing heart, headache, and confusion

o S=Shivering
o H=Hyperreflexia/Myoclonic jerks
o I = Increased Temp (Fever)
o V= Vitals Instability (↑↓BP; ↑RR; ↑HR)
o E= Encephalopathy (Confusion)
o R= Restlessness
o S= Sweating (Diaphoresis)

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9
Q

Only tricyclic antidepressant (TCA) thought to be effective in the treatment of obsessive
compulsive disorder (OCD)

A

 clomipramine

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10
Q

Treatment for acute panic attacks =

A

can use benzo short term in addition to long-term SSRI

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11
Q

performance anxiety tx

A

propranolol

o CBT
o 1 st line = SSRI or SNRIs

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12
Q

Best meds for GAD (1st/2nd line)

A

**SSRI (escitalopram, paroxetine) SNRI (duloxetine, venlafaxine)

2nd line= Buspar, SNRI
Can consider short term course of Benzos or augmentation with buspirone (Buspar)

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13
Q

Best meds for SAD

A

SSRI

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14
Q

Best med for Panic attacks

A

initially use benzo (short term)

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15
Q

Panic disorder tx (first line, second line, adjunct);what bzo specifically?

A

Panic disorder
o 1 st line = SSRI, SNRIs
o 2 nd line= TCAs= though limited use
o Adjunct = Benzos USE WITH CAUTION, short-term until other meds reach therapeutic efficacy
 alprazolam is FDA approved for panic d/o

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16
Q

OCD tx (first line class & common meds, second line)

A

Meds + CBT

o 1 st line= SSRI (often need high doses of sertraline, fluoxetine); Luvox
o 2 nd line = SNRI (e.g. venlafaxine) (Clomipramine=Anafranil)

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17
Q

Effects of benzodiazepine use and SE

A

Enhance activity of GABA at GABA-A receptor

  • Potential for abuse and addiction
  • Patient become physical dependent and build tolerance
  • Can be used to treat Akathisia
  • Choice of BDZ depends on time of onset, duration of action and method of metabolism
    OTL= Outside The Liver (oxazepam, temazepam, lorazepam) = not metabolized by
    the liver
  • S/E: Anticholinergic, unusual behaviors, hallucinations, daytime drowsiness,
    amnesia
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18
Q

MOA of benzodiazepines & what effect does it have on body

A

MOA: Potentiate effects of GABA (Remember GABA is inhibitory) → drowsiness, cognitive
impairment, dampening of fear and anxiety, impaired balance, moto control, muscle tone
and coordination, anterograde amnesia.

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19
Q

Risk BZO use in elderly

A

Elderly patients: Increased fall risk, hip fracture risk

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20
Q

What BZO are not metabolized by the liver

A

OTL= Outside The Liver (oxazepam, temazepam, lorazepam) = not metabolized by
the liver

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21
Q

Benzodiazepine withdrawal symptoms:

A

Benzo withdrawal is like ETOH withdrawal
* Insomnia
* Anxiety
* Hand tremors
* Irritability
* Anorexia
* Nausea/vomiting
* Autonomic hyperactivity (diaphoresis, tachycardia, HTN)
* Tonic –clonic seizures = life threatening

Note: Abrupt abstinence after chronic use can be life threatening.

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22
Q

A known limitation of Benzo tx for insomnia

A

rebound insomnia

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23
Q

Short acting BZO half-life, which BZOs, and indication for use

A

Short Acting = < 6hrs half life
 seizure disorders, Panic attacks
 midazolam (Versed) and alprazolam (Xanax)

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24
Q

Intermediate acting BZOs half life, which BZOs, and indication for use

A

6-20 hours half life
 insomnia, anxiety
 lorazepam, oxazepam, temazepam

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25
Q

Long acting BZO half life, which BZOs, and indication for use

A

(> 20 hours half life)
 Moderate-Severe anxiety
 Good for ETOH withdrawal
 diazepam, clonazepam, chlordiazepoxide, flurazepam

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26
Q

How to treat BZO overdose

A

Give Flumazenil (benzodiazepine antagonist) to reverse effects

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27
Q

MOA of Buspirone (Buspar) = Does it cause dependence?

A

 Partial agonist at 5HT-1A = increases post-synaptic serotonergic activity
 Low potential for abuse/addiction

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28
Q

General rule before switching med reported to be ineffective

A

General Rule:If a patient reports medication is not working, look at the dose, optimize it before switching it.

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29
Q

Benefits of benzodiazepines as compared to antidepressants:

A

rapid onset of action, effective,
well-tolerated

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30
Q

What anxiolytics to consider for patients with substance use

A

Patients with comorbid substance use – consider nonaddictive anxiolytic alternatives (e.g. gabapentin and antihistamines with anxiolytic properties (e.g. diphenhydramine or
hydroxyzine)

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31
Q

Medical conditions that may precipitate anxiety:

A

 Heart disease
 Hyperthyroidism
 COPD/asthma
 Drug abuse
 ETOH/benzo withdrawal
 Chronic pain
 IBS
 Adrenal tumor
 Seizure
 Diabetes mellitus

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32
Q

First line for PTSD

A

SSRI (sertraline or citalopram) or SNRI (venlafaxine)

 FDA approved meds: sertraline (Zoloft) and paroxetine (Paxil)

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33
Q

Treatment for PTSD related flashbacks and nightmares?

A

 Alpha-1 receptor antagonist (Prazosin)= targets flashbacks; nightmares and
hypervigilance

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34
Q

BZO use in PTSD patients

A

Benzodiazepines may interfere with the psychological processes needed to benefit from CBT

Many times PTSD patients also have substance use disorders which benzos should be avoided with

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35
Q

Addictive meds are associated with…

A

Avoid addictive medications (e.g., Benzodiazepines) = high rate of comorbid substance use disorders and lack of efficacy.

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36
Q

dissociative identity disorder (DID) overview (risk factors, associated symptoms, common comorbidity) and first line tx

A
  • Predominantly develops in victims of significant and chronic childhood trauma
  • Patients with DID often cope with PTSD
  • More than one distinct personality state resulting from a fragmented sense of self.
  • More than 70% attempt suicide often with frequent attempts and self-mutilation.
  • 1 st line treatment - Psychotherapy
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37
Q

Are there any drugs specifically indicated for DID?

A

 SSRIs to target comorbid depressive and or PTSD symptoms
 Prazosin- for nightmares
 Naltrexone- reduce self-injurious behaviors

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38
Q

ECT in DID

A

NOTE:ECT is NOT contraindicated in people with Dissociative Identify Disorder (DID) –note
that these patients have depressive symptoms and hence ECT can be considered as a viable
option especially in combination with psychotherapy.

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39
Q

Depersonalization disorder (what is it, comorbidities, predisposing factors)

A

unreality or detachment from one’s body, thoughts, feeling and actions

  • Increased incidence of comorbid anxiety disorders and major depression
  • Predisposing factors: severe stress and trauma
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40
Q

Derealization disorder (what is it, predisposing factors, comorbidities)

A

unreality or detachment from one’s surroundings

  • Increased incidence of comorbid anxiety disorders and major depression
  • Predisposing factors: severe stress and trauma
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41
Q

What foods should be avoided with MAOIs?

A

Tyramine rich foods: red wine, aged cheese, chicken liver, fava beans, cured meats

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42
Q

Initial/sleep-onset Insomnia=

A

Difficulty initiating sleep

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43
Q

Middle/sleep maintenance insomnia=

A

frequent nocturnal awakenings

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44
Q

Late/sleep offset insomnia=

A

Early morning awakenings

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45
Q

Nonrestorative sleep=

A

waking up feeling fatigues and unrefreshed.

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46
Q

Why should flurazepam be avoided in the elderly?

A

 ANCC question – long half-life, increased risk for confusion and falls

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47
Q

Treatment for insomnia:

A

 Antidepressants = Trazodone (mostly prescribed sedating antidepressant), Remeron (low doses)
Ambien in elderly patients

   o Trazodone is an even safer option for the elderly
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48
Q

Ambien special pt instructions

A

Ambien – take on an empty stomach

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49
Q

Recommended Ambien dose men/women

A

Men: 10mg Women: 5mg

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50
Q

ramelteon (Rozerem) MOA

A
  • DOES NOT Act on benzodiazepine receptors

 MOA – Melatonin agonist – binds to melatonin receptors in brain inhibiting neuronal firing

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51
Q

triazolam (Halcon)

A

short acting benzodiazepine for sleep disorders

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52
Q

Antidepressants Used for sedating properties

A
  • TCA: amitriptyline (Elavil)
  • TCA: doxepin(Sinequan)
  • mirtazapine (Remeron)
  • trazodone
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53
Q

Med for OSA

A

Consider armodafinil (Nuvigil) = indicated for daytime sleepiness associated with OSA

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54
Q

eszopiclone (Lunesta) indication

A

indication helps with staying asleep; maintenance sleep onset. Can be used long-term

55
Q

What’s Narcolepsy

A

Excessive daytime sleepiness and falling asleep in inappropriate places

56
Q

What’s cataplexy

A

brief episodes of sudden bilateral loss of muscle tone

57
Q

Narcolepsy with cataplexy tx& what to avoid with it

A

Treatment: sodium oxybate
 not to be used with alcohol or other
CNS depressants
 due to increased sedation, CNS depression, loss of
consciousness, coma, death

58
Q

sodium oxybate pt education

A

not to be used with alcohol or other CNS depressants

59
Q

True/false:OTC sedative/hypnotics = tolerance to sedating effects can develop rapidly?

A

True

60
Q

Non-pharmacologic sleep Apnea Treatments

A

weight loss; avoidance of ETOH; CPAP; Uvulopalatopharyngoplasty

61
Q

REM suppression drugs & what disease would that be beneficial in

A

SSRI, SNRI (Prozac, Cymbalta, atomoxetine, venlafaxine)

helpful in narcolepsy

62
Q

Restless leg syndrome characteristics and risk factors

A

 The urge to move legs accompanied by unpleasant sensation in the legs,
characterized by relief with movement, aggravation with inactivity.
 Occurs or worsens in the evening.
 1.5 -2 times more likely in males
 Risk factors: age, iron deficiency, antidepressants, antipsychotics, dopamine
blocking antiemetic, antihistamines; strong familial component

63
Q

Tx for restless leg syndrome

A

Remove offending agent; iron replacement

1 st line: Dopamine agonists (pramipexole=Mirapex and ropinirole-Requip) and Benzos
Gabapentin (Neurontin); pregabalin (Lyrica)

Low potency opioids for treatment refractory patients

64
Q

Periodic Limb Movements of sleep (PLMS)

A

RLS associated with involuntary, jerking movements of limbs during sleep

65
Q

Somatic Symptom Disorder

A

 Patient believes they are ill and do not intentionally produce symptoms

66
Q

Factitious Disorder

A

 No external rewards
 Falsifying physical (e.g. seizures/ infection, abdominal pain) and/or
psychological (hallucinations, depression, fever, infection) signs and symptoms
to assume a sick role
 Absence of obvious external reward
 Repeated & long hospitalizations are common

Txt
Collaboration with PCP
Confrontation in non-threatening manner = AMA possible

67
Q

Malingering

A

 External rewards present. Think “mal” = bad
 Intentional reporting of physical or psychological symptoms
 Goal: To achieve personal gain/secondary gain/ external reward (i.e.
avoiding police/incarceration, room & board, narcotics, monetary
compensation)
 Not considered a mental illness

68
Q

Conversion Disorder

A

psychiatric disorder with symptoms affecting sensory or motor function

 Present with at least 1 neurological symptom – sensory/motor which cannot be fully explained by a neurological condition
 La bell indifference: Patients surprisingly calm and unconcerned when describing symptoms

*Tx= CBT (w/ or w/o PT) & education

69
Q

What are ED patients at risk for? Med to avoid?

A

 Anorexia and bulimia are risk factors for developing cardiac arrhythmias due to electrolyte disturbances (e.g. ↓K+)
 NOTE: Avoid Bupropion (Wellbutrin) in all eating disorder patients = lowers seizure threshold

70
Q

Anorexia nervosa

A

 Preoccupation with their weight, body image and being thin
 Types (Restricting type & Binge-eating/purging type)
 Intense fear of gaining weight or becoming fat
 Restriction of calorie intake
 Low body weight
NOTE: Pharmacotherapy may not
be a useful treatment modality for
most patients with Anorexia

71
Q

Bulimia Nervosa & tx

A

 Binge eating with behaviors intended to counteract weight gain (e.g. vomiting, laxative use, enemas/diuretics, fasting, excessive exercise)
 Embarrassed by their binge eating and are overly concerned with body weight
 Usually maintain normal body weight (may be overweight)
 Tx:
o Antidepressant + therapy (CBT, IPT, group therapy)
o First line= SSRIs
o fluoxetine (Prozac) 60-80mg /day is the only FDA approved med

72
Q

Binge eating disorder and tx (class and specific med)

A

 Not fixated on their body shape and weight
 Recurrent episodes of binge eating
 No compensatory behaviors (i.e. vomiting and laxative use)
 Usually, obese
Txt.
- First line= SSRIs (Lexapro)
- Psychotherapy (CBT, IPT)
Others:
- Vyvanse (FDA approved)- stimulant that suppresses appetite
- Topamax= associated with weight loss
- Orlistat (Xenical) – inhibits pancreatic lipase = decrease amount of fat absorbed from the GI

73
Q

Pamela, a 26-year-old college student presents today with symptoms of anxiety attacks
lasting 10-20 min w/ symptoms of diaphoresis, palpitations, tremor, dizziness and inability to
concentrate at school. The PMHNP has diagnosed her w/ panic disorder without agoraphobia. What medication will the PMHNP consider for Pamela?

A.Clonazepam
B.Bupropion
C.Lithium
D. Fluoxetine

A

D. fluoxetine

74
Q

George, a patient with PTSD presents to the outpatient clinic today w/ reports of middle
insomnia secondary to increased nightmares. The PMHNP knows that this class of
medication is used specifically to treat these symptoms.

A. Benzodiazepines
B. Beta blockers
C. SSRIs
D. Alpha blockers

A

D. Alpha blockers

75
Q

What class of drugs are commonly used in OTC sleep aids?

A. Antihistamine
B. Beta blockers
C. Benzodiazepines
D. NMDA antagonists

A

A. Antihistamine

76
Q

FDA approved indications for sertraline use

A

sertraline – MDD, OCD, panic disorder, PTSD, PMDD, SAD

77
Q

FDA approved indications for buspirone use

A

GAD, not for MDD

78
Q

Why give SSRI rather than rapid acting?

A

Longer-acting, longer half-life

79
Q

How to taper off SSRI

A

Average half-life: 2 weeks is wash out period, fluoxetine longer 4-5 weeks

Bridge with short-acting – hydroxyzine pam, low dose clonidine,
propranolol; 25mg Seroquel (addiction);

do no harm and avoid dependence

80
Q

First step for 30 yo male with OCD, MDD started on fluoxetine low dose and does not feel meds are working.

A

Optomize dose

81
Q

Best med: Demenia pt. – increase bx at night, wandering, poor sleep, sleeps during day

A

trazodone

82
Q

33 yo male with GAD, started on Prozac 1 week ago complaining of worsening symptoms. No
sign. hx and denies SI

A

continue fluoxetine and start alprazolam because of initial activating impact of
fluoxetine and no hx of SI

83
Q

Social phobia tx

A

CBT
1st line = SSRI or SNRIs
* Benzos can be used as scheduled or PRN
* Beta blockers such as atenolol (50-100mg) and propranolol (20-40mg) 1 hour before
performance or public speaking

84
Q

List of anxiety disorders

A

Specific phobia
Social anxiety disorder
Panic disorder
Agoraphobia
Generalized anxiety disorder
Separation anxiety disorder

85
Q

Brain circuit associated with fear (panic & phobia)?

A

amygdala-centered

86
Q

Brain circuit associated with worry (anxious misery, apprehension, expectation, obsessions)?

A

cortico-striatal-thalamic-cortical

87
Q

SSRIs are first line in what anxiety disorders

A

chronic anxiety, GAD, panic disorder

88
Q

Benefits of SSRIs over other meds

A

tx comorbid depression
lack of abuse risk
low SE risk

89
Q

what patient populations to be cautious in with benzos d/t abuse/misuse risk

A

substance abuse, personality disorder, chronic pain

90
Q

How to avoid BZO withdrawal adverse effects

A

taper 10% total dose/week
physical AND behavioral taper
common to convert from SA to LA to facilitate more comfortable taper

91
Q

BZO with highest abuse potential

A

alprazolam (Xanax) d/t short half life/rapid onset

92
Q

midazolam/Versed use

A

medical/surgical settings
half life < 6 hrs

93
Q

lorazepam/Ativan use

A

panic attacks, ETOH/sedative-hypnotic detox
with haldol for acute agitation

intermediate acting, half life 6-20 hrs

94
Q

oxazepam/Serax use

A

ETOH/sedative-hypnotic detox

intermediate acting, half life 6-20 hrs

95
Q

temazepam/Restoril- what is of particular concern? (High risk of… )

A

high potential for dependence

96
Q

diazepam/Valium use
Is it typically prescribed for anxiety?

A

GAD, severe ETOH withdrawal and seizures

Rapid onset

Less commonly prescribed for anxiety d/t Euphoria

long acting, half life > 20 hrs

97
Q

clonazepam/Klonopin- when to avoid

A

Avoid in renal dysfunction
Longer half life- 1-2x daily dosing

half life > 30 hrs

98
Q

which BZOs have longest half life

A

chlodiazepoxide (intermediate onset, half life 20-110 hrs)
and
diazepam (rapid onset, half life 30-100 hrs)

99
Q

Which has the Highest anticholinergic effects: Benzo vs. TCA vs. SSRIs

A

TCAs

100
Q

propranolol/Inderel for anxiety (class, which anxiet disorders/situations, SE, contraindications)

A

Beta blocker

Used off-label
Useful for panic attacks and performance anxiety related effects (i.e. palpitations, sweating and tachycardia
Also used for Akathisia

S/E: Bradycardia, hypotension

*Beta blockers can be fatal in a cocaine overdose

*Contraindicated in asthma or COPD d/t bronchospasm risk

101
Q

hydroxyzine for anxiety (dosing, effects, SE, effect in relation to benzos)

A
  • Fairly wide dosage range
  • Individuals respond quite differently to different doses
  • For some, 12.5mg is not tolerated, for others 50mg is minimally effective
  • Generally start at 25mg once or twice daily, sometimes splitting tablet in half for lower dose
  • Sedating (can help with sleep)
  • Sometimes weight gain, sometimes paradoxical response
    ** Again, better if “benzo naïve”
102
Q

Which anticonvulsants can help anxiety

A
  • Gabapentin (“PRN” or scheduled) (works on voltage-sensitive Ca2+ channels, not GABA)
  • Pregabalin
  • Tiagabine
  • Sometimes lamotrigine, oxcarbazepine (as scheduled)

*Gabapentin most frequently used in this class, but does now have “street value”

103
Q

What to use INITIALLY for panic attacks

A

benzos

104
Q

Flumazenil use/important consideration

A

Flumazenil is a short-acting intravenously administered antagonist to benzodiazepines that can reverse overdoses or anesthesia from benzodiazepines but can also induce seizures or withdrawal in patients dependent upon benzodiazepines.

105
Q

Benzo of choice for panic disorder

A

alprazolam

106
Q

Benzo of choice for social anxiety disorder

A

clonazepam

107
Q

TCA or SSRI for OCD & what meds specifically

A

SSRI first (: fluoxetine, fluvoxamine (Luvox), sertraline, paroxetine)
TCA clomipramine more effective but SSRI better tolerated

FDA approved: Sertraline, Fluoxetine, Fluvoxamine

108
Q

Difference between dissociation and depersonalization

A

Dissociation:
defense mechanism that protects from anxiety by emotionally separating; disruption in integrated sense of self

Depersonalization:
unreality or detachment from one’s body, thoughts, feeling and actions

109
Q

What should you augment PTSD tx with in severe or resistant cases

A

Augment with Atypical antipsychotic in severe or treatment resistant cases.

110
Q

General prescribing sequence in primary insomnia

A
  • short-intermediate acting benzo receptor agonist (zolpidem, eszopiclone, temazepam) or remelteon
  • alternate from above if first choice ineffective
  • sedating antidepressant (trazodone, mirtazapine, amitriptyline, doxepin)
  • combine BzRA or ramelteon and sedating antidepressant
  • other sedating agents: gabapentin, tiagabine, atypical antipsychotic
111
Q

Are zaleplon, triazolam, and ramelteon for sleep onset or sleep maintenance?

A

sleep onset

112
Q

Are eszopiclone, zolpidem, temazepam for sleep onset or sleep maintenance?

A

BOTH

113
Q

Are suvorexant and doxepin for sleep onset or sleep maintenance?

A

sleep maintenance

114
Q

OTC sedative/hypnotics= tolerance to sedating effects can develop rapidly, True/False?

A

true

115
Q

Why should Flurazepam be avoided in the elderly?

A

Low doses of flurazepam appear to be safe for elderly individuals, but they are susceptible to unwanted central nervous system depression at high doses. Sedation.

116
Q

First line and considerations for sleep disorders in elderly

A

Always consider sleep hygiene as first-line

Sedative hypnotics are more likely to cause side effects when used (i.e. memory impairment, ataxia, paradoxical excitement and rebound insomnia) = Trazodone is a safer options

117
Q

First line tx narcolepsy & then narcolepsy with cataplexy

A

narcolepsy= modafinil
w/ cataplexy= sodium oxybate

118
Q

REM suppressive drugs

A

SSRI, SNRI (Prozac, Cymbalta, atomoxetine, venlafaxine)

119
Q

Activating serotonergic agent that may cause sx that look like restless leg syndrome

A

venlafaxine/Effexor may trigger symptoms consistent with Restless Leg Syndrome (RLS)

120
Q

La bell indifference

A

Patients surprisingly calm and unconcerned when describing symptoms, often seen with conversion disorder

121
Q

What class of medications can help reduce obsessions and severe fearful preoccupations associated with psychosomatic disorders

A

SSRI

122
Q

What’s the biggest risk concern with anorexia and bulimia?

A

Anorexia and bulimia are risk factors for developing cardiac arrhythmias due to electrolyte disturbances (e.g. _K+)

123
Q

only FDA approved med for bulimia

A

fluoxetine 60-80 mg/day

124
Q

The mechanism of action of this medication for Binge Eating Disorder is
the inhibition or pancreatic lipase which decreases the amount of fat
absorbed from the GI tract = _____________________________

A

Orlistat

125
Q

This stimulant medication is FDA approved for Binge Eating Disorder =

A

Lisdexamfetamine dimesylate

126
Q

First line treatment for Binge Eating Disorder = __

A

SSRI

127
Q

Part of the brain that is implicated in PTSD- responsible for memory and learning

A

*hippocampus
also: amygdala, and medial prefrontal cortex

128
Q

Chronotherapy

A

bright light therapy to help w/ insomnia

129
Q

should elderly patients be given benadryl for insomnia

A

no avoid; moderately anticholinergic

130
Q

Illness anxiety disorder

A
  • Preoccupation with having/acquiring a serious illness
  • Somatic symptoms not present or mild in intensity
  • Increased anxiety about health
  • Performs excessive health related behaviors/maladaptive behaviors
    Persists for at least 6 months

Txt
- Regularly scheduled visits with one primary care physician
- CBT
- SSRI for comorbid anxiety & depressive symptoms; other appropriate psychotropic medications.

131
Q

What class of medications can help reduce obsessions and severe fearful preoccupations associated with psychosomatic disorders

A

SSRIs

132
Q

Tx anorexia nervosa

A
  • CBT, family therapy
  • SSRI for comorbid anxiety and depression
  • May use olanzapine/Zyprexa to treat preoccupation with weight and food
  • Premeal anxiolytic (e.g. Alprazolam) to encourage eating by decreasing anticipatory anxiety
133
Q

Patient with OCD and Bulimia – what treatment of choice will your select?

A

fluoxetine; tx OCD & only SSRI approved for bulimia

P. pharm (8 decks)

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