Exam 3: anxio Flashcards
Which benzos follow different hepatic metabolic pahtways?
Oxazepam
Temapzepam
Lorazepam
What drugs can CAUSE anx
- Anticonvulsants: CBZ, phenytoin
- Antidepressants (early in treatment): bupropioin, SSRI, TCA
__ - HTN: clonidine and felodipine
__ - ABX: quinolones, isoniazid
__ - Bronchodilators: albuterol, theophylline
- Corticosteroids: prednisone
__ - DA agonsit: amantadine, levodopa
__ - Herbal agens: ginseng, ecstaasy, THC
- Withdrawal, stimulants, ilicit substances
___ - ACh toxicity
- Digoxin toxicity
First line for pretty much an anxiety disorder
SSRI and SNRI approved for indicaiton and nonpharm
if using buspirone for anx is the adminsitration scheudled or PRN
scheduled
Which benzos re approved for anx
alprazolam
chlorazepoxide
clonazepam
clorazepate
diazepam
lorzepam
Which benzo has a higher chance of misuse and euphoria potential
diazepam
whcih benzo is a prodrug requiring an acidic stomach
clroazepate
whch benzos are hgih potency
alprazolam and clonazpeam
which benzos can also be used for panic
alprazolam
clonazepam
relative/absolute CI for benzos
- allergy
- substance abuse hx
- myasthenia gravis
- severe hepatic impairement ← lorazepam would be the safer choice as it doesn’t have calssic CYP metabolism
- respitratory disorders
- preggers (can cause a cleft palate)
- narrow angle glaucoma
- conmittant opioid use
benzo AE
- dependence
- irritability
- agression
- exitation
- impulsivity (paradoxical disinhibition)
- retrograde amnesia (higher chance with alprazolam)
- complex sleep behaviors
benzo withdarawal ae
rebound anx
risk of seizure
preffered therapy in spcific phobias
CBT
SAD pharmacothperay optiosn
- first line:
- approved SSRI and SNRI
- can use
- gabapentin
- pregabalin -
- beta blockers (propranolol) to help with sx only
- benzos in people who have failed response to antidepressant
pregabalin signficant AE
rhabdo
ocular s/s
