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| Panic Disorder: Benzodiazepines |
[Can Animals Lie Down - KXAV]
Clonazepan (Klonapen)
Alprazolam (Xanax)
Lorazepan (Ativan) - watch for mini-withdrawal
Diazepam (Valium)
(L6, P6) |
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ucbruinette Thu, 18 Mar 2010 05:00:52 GMT |
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| Panic Disorder: Possible Treatments |
1. SSRI's (very low dose)
2. TCAs (side effects)
3. Benzodiazepines (ideal) + antidepressants for at least 1=2 years
4. Psychotherapy (e.g. CBT)
5. Essential psychoeducation
(L6, P6) |
0 |
ucbruinette Thu, 18 Mar 2010 05:00:52 GMT |
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| Panic Disorder: Treatment Goals |
1. Block panic attack with fast acting drugs first
2. Treat comorbidities
3. Achieve remission
4. Maintain remission
(L6, P6) |
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ucbruinette Thu, 18 Mar 2010 05:00:52 GMT |
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| Tiagabine (Gabitril): Uses |
Anticonvulsant
GABA reuptake inhibitors.
Used for PTSD & panic disorder.
(L6, P5) |
0 |
ucbruinette Thu, 18 Mar 2010 05:00:52 GMT |
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| Clonidine (Catapres): Uses |
Alpha-blocker (i.e. alpha adrenergic agonist)
Used for panic disorders (adjunctive)
(L6, P5) & (L6, P9)
(L6, P9) |
0 |
ucbruinette Thu, 18 Mar 2010 04:30:03 GMT |
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| Beta Blockers: Examples, Effects, & Uses |
(NE blocker)
Propranolol (Inderal)
Atenolol (Tenormin)
Reduce symptoms of anxiety (e.g. heart pounding, tremor, sweating)
Used for performance anxiety & social phobias.
(L6, P5) & (L6, P9) |
0 |
ucbruinette Thu, 18 Mar 2010 04:30:03 GMT |
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| Antihistamines: Examples |
[High Definition - Very/Alternatives Bien]
Hydroxyzine (Vistaril, Atarax)
Diphenhydramine (Benadryl) - fast sedation (i.e. 20-30 minutes)
(L6, P8) |
0 |
ucbruinette Thu, 18 Mar 2010 04:30:03 GMT |
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| Buspirone (BuSpar) |
(Atypical antianxiety medication)
Non-sedating
Delayed onset of action (i.e. takes 1-2 weeks to reduce anxiety)
No tolerance or dependence, no habit forming (i.e. not addictive)
[No impairment in psychomotor function]
No interaction with other CNS depressant (e.g. alcohol)
Useful in drug abusers
May cause paradoxical anxiety
(L6, P8) |
1 |
ucbruinette Thu, 18 Mar 2010 08:52:14 GMT |
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| Atypical Benzodiazepines: Examples |
>>E.g. What are the Benzo-like/hypnotic medications?<<
[EEZZQ - PLASD ("Easy" Quiz - "Pleased"]
Estazolam (Prosom)
Eszopiclone (Lunesta)
Zolpiem (Ambien)
Zaleplon (Sonata)
Quazepam (Doral)
[Mostly used for hypnotic purposes.]
(L6, P8) |
1 |
ucbruinette Thu, 18 Mar 2010 04:12:07 GMT |
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| Hypnotics: Examples |
1. Triazolam (Halcion)
2. Temazepan (Restoril)
3. Flurazepan (Dalmane)
(L6, P5) |
0 |
ucbruinette Wed, 17 Mar 2010 21:53:47 GMT |
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| Antianxiety Medication: Least Liver Dependent |
Lorazepam (Ativan)
Temazepan (Restoril)
Oxazepam (Serax)
(L6, P5) |
0 |
ucbruinette Wed, 17 Mar 2010 21:52:31 GMT |
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| Benzodiazepines: Fastest to Slowest Effect & Highest to Lowest Action Potential |
Diazepam (Valium) - fastest & highest
Alprazolam (Xanax)
Lorazepam (Ativan)
Chlordiazepoxide (Librium) - slowest & lowest
(L6, P8) |
0 |
ucbruinette Wed, 17 Mar 2010 21:52:31 GMT |
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| Benzodiazepines: Uses & Effects |
Used for anxiety & insomnia.
Ones with long half-life accumulate/build up in the system - can cause lethargy (e.g. feeling doped)
Most are metabolized in liver.
(L6, P5) |
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ucbruinette Wed, 17 Mar 2010 21:52:31 GMT |
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| Antianxiety Medication |
1. Benzodiazepines
2. Hypnotics
3. Atypical Benzodiazepines
4. Antihistamines
5. Beta Blockers (NE blocker)
6. Alpha Blocker - Clonidine (Catapres)
7. Anticonvulsant - Tiagabine (Gabitril)
Ideal treatment is about 6 months.
(L6, P5)
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3 |
ucbruinette Thu, 18 Mar 2010 08:45:27 GMT |
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| Oxazepram (Serax) |
(Benzodizaepine - Antianxiety medication)
[Used a lot, but not talked about.]
(L6, P4) |
0 |
ucbruinette Wed, 17 Mar 2010 21:00:36 GMT |
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| Alprazolam (Xanax) |
(Benzodiazepine - Antianxiety medication)
[Used and abused a lot; highest dependency/addictive potential.]
(L6, P4) |
0 |
ucbruinette Wed, 17 Mar 2010 21:00:36 GMT |
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| Lorazepan (Ativan) |
(Benzodiazepine - Antianxiety medication)
[Calms you down and puts you to sleep; most commonly used with less side effects.]
(L6, P4) |
0 |
ucbruinette Wed, 17 Mar 2010 21:00:36 GMT |
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| Chlordiazepoxide (Librium) |
(Benzodiazepine - Antianxiety medication)
1957 - [First/oldest.]
(L6, P4) |
0 |
ucbruinette Wed, 17 Mar 2010 21:00:36 GMT |
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| Diazepam (Valium) |
(Benzodiazepine - Antianxiety medication)
[Longest half-life.]
(L6, P4) |
0 |
ucbruinette Wed, 17 Mar 2010 20:59:25 GMT |
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| Benzodiazepines: Examples |
>>know<<
[Don't Call Christine Late At One Tonight - Varies Lately, Karen Already X-ed Serious Relationship]
1. Diazepam (Valium)
2. *Chlordiazepoxide (Librium) - 1957
3. Clonazapan (Klonopin)
4. Lorazepan (Ativan)
5. Alprazolam (Xanax)
6. Oxazepam (Serax)
(Antianxiety medication)
(L6, P4) |
1 |
ucbruinette Wed, 17 Mar 2010 21:54:37 GMT |
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| Anxiety: Classic Medications |
1. Benzodiazepines (i.e. Sedative Hypnotics)
Antianxiety medication (concerns about dependence)
2. Atypical Antianxiety
Buspar (Buspirone)
3. TCA & SSRIs
4. Antiseizure Medication
Gabapentin
(L6, P4) & (L6, P5) |
0 |
ucbruinette Wed, 17 Mar 2010 20:59:25 GMT |
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| Anxiety: Treatment |
Stress Management
CBT
Relaxation
Psychotherapy
Exercise
Medication [try all before meds, unless severe]
(L6, P3) |
1 |
ucbruinette Thu, 18 Mar 2010 08:38:45 GMT |
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| Anxiety Symptoms |
>>Know at least 5-6 symptoms<<
1. Trembling, feeling shaky, restlessness, muscle tension
2. Shortness of breath, smothering sensation
3. Sweating, cold hands & feet
4. Light-headedness & dizziness
5. Diarrhea and/or frequent urination
6. Feelings of unreality (derealization)
7. Impaired attention & concentration
8. Nervousness, edginess, or tension
9. Initial insomnia (i.e. difficulty falling asleep)
10. Rapid heartbeat (i.e. tachycardia)
11. Tingling of the skin (i.e. paresthesias)
(L6, P2) |
1 |
ucbruinette Thu, 18 Mar 2010 06:58:39 GMT |
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| Anxiety: Neurotransmitter |
Gamma-aminobutyric (GABA) - anxiety & CD [i.e. compulsive disorder]
(L6, P2) |
1 |
ucbruinette Thu, 18 Mar 2010 08:37:10 GMT |
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| Some Types of Anxiety Disorders |
Generalized Anxiety Disorder (GAD)
Specific Phobias
Social Phobias
Panic Disorder
Obsessive-Compulsive Disorder (OCD)
Post-Traumatic Stress Disorder (PTSD)
(Total of 12 anxiety disorders]
(L6, P1) |
1 |
ucbruinette Wed, 17 Mar 2010 21:54:59 GMT |
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| Anxiety v. Panic Attack |
>>Know onset & intensity<<
Symptoms differ in onset, duration, & intensity.
Anxiety - gradual, prolonged, & mild to moderate intensity; generally after a stressor.
Panic attack - very sudden, 1-30 minutes, severely intense (with or without stressors)
(L6, P1) |
0 |
ucbruinette Wed, 17 Mar 2010 20:57:38 GMT |
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