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3 Psychiatry > Pharmacology of Anxiolytic Drugs > Flashcards

Pharmacology of Anxiolytic Drugs Flashcards

1
Q

benzodiazepines should be used in anxiety for less than _ weeks

A

2 weeks

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2
Q

what symptoms are present in both anxiety and depression?

A

concentration
fatigue
sleep
arousal

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3
Q

if you have 1 anxiety disorder you’re more likely to get another T or F

A

T

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4
Q

what does the amygdala do?

A

integrates sensory and cognitive info

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5
Q

an increase in cortisol is carried out by what structure?

A

hypothalamus

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6
Q

what part of the brain is responsible for the autonomic symptoms in anxiety?

A

locus coeruleus

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7
Q

which part of the brain is responsible for reexperiencing/traumatic memories?

A

hippocampus

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8
Q

effect of GABA on the amygdala and CSTC circuits?

A

reduces activity of neurons there

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9
Q

main GABA receptor in anxiety?

A

GABA-A

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10
Q

benzodiazepines have what effect on GABA-A receptors in terms of their binding?

A

positive allosteric modulator (GABA binds to one site, benzo binds to other side)

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11
Q

benzodiazepines __ neuron firing rate after binding to GABA-A

A

decrease

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12
Q

valium is another name for…

A

diazepam

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13
Q

pharm effects of benzos?

A 
reduce anxiety and aggression
hypnosis
sedation
muscle relaxation
anti-convulsant effect
anterograde amnesia
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14
Q

clinical uses of benzos?

A 
acute Tx of extreme anxiety
hypnosis
alcohol withdrawal
mania
delirium
status epilepticus
acute tranquilisation
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15
Q

antagonist for benzos?

A

flumazenil

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16
Q

problems with benzos?

A

impaired coordination

tolerance

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17
Q

symptoms of benzo withdrawal

A 
abdo cramps
increased anxiety/panic attacks
autonomics
blurred vision
low mood
poor concentration
tingling in hands and feet
restlessness
18
Q

rapid withdrawal of benzodiazepines can cause what symptoms?

A 
confusion
psychosis
convulsions
tachycardia
sweating
tremor 
HT
19
Q

presentation of acute benzo withdrawal can mimic what condition?

A

delirium tremens

20
Q

how to withdraw benzos?

A

take daily dose of diazepam at night
reduce dose every 2-3 weeks by 2mg
reduce further
stop completely

21
Q

how long should you decrease the dose of benzos before stopping

A

4 weeks to a year

22
Q

how long does it take for serotonin levels to increase after taking an SSRI?

A

hours

23
Q

1st and 2nd line medication for panic disorder

A
  1. SSRI

2. tricyclics

24
Q

what SSRIs are good for GAD?

A

escitalopram

paroxetine

25
Q

when would B blockers be helpful in the treatment of anxiety

A

somatic symptoms eg palpitations/tremor

26
Q

1st to 6th line Tx for GAD?

A
  1. psychoeducation
  2. self help, psychoeducation groups
  3. CBT or SSRI
  4. SNRI or other SSRI
  5. pregabalin
  6. combine CBT and drugs
27
Q

what SNRI would you use for GAD?

A

venlaflaxine

28
Q

how long should you wait for an effect of treatment in GAD?

A

up to 12 weeks

29
Q

how long should you treat GAD?

A

treat for 18 months and stop gradually

30
Q

1st-4th line Tx of panic disorder

A
  1. self help
  2. CBT
  3. SSRI
    4, tricyclics
31
Q

how long should you treat panic disorder?

A

6 months

32
Q

what drugs should not be used in panic disorder?

A

benzos

sedating antihistamines

33
Q

1st-6th line treatment for OCD

A
  1. CBT + ERP/self help
  2. intensive psychological intervention or SSRI eg fluoxetine
  3. increase dose after 4-6 weeks
  4. SSRI + CBT and ERP
  5. clomipramine
  6. add antipsychotic OR clomipramine + citalopram
34
Q

how long should treatment of OCD be managed?

A

1 year

35
Q

when would watchful waiting be 1st line for a PTSD patient?

A

mild

<4 weeks from trauma

36
Q

what Tx should be given within 3 months of trauma in PTSD?

A

trauma focussed CBT

hypnotic meds for sleep disturbance

37
Q

Tx for PTSD after 3 months

A

trauma focussed CBT or EMDR

38
Q

what medication, if any, should you give for PTSD?

A

paroxetine

mirtazepine

39
Q

1st to 5th line treatment for social anxiety

A
  1. individual CBT
  2. SSRI
  3. SSRI + CBT
  4. change SSRI or SNRI
  5. MAOI
40
Q

1st and 2nd line SSRIs for social anxiety

A
  1. escitalopram or sertraline

2. fluoxetine or fluvoxamine

41
Q

what MAOI should be given for social anxiety?

A

phenelzine

3 Psychiatry (28 decks)

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