Study Anxiety Flash Cards

 
Pile Management Card
Anxiety

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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)
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)
Anxiety: Treatment
Stress Management
CBT
Relaxation
Psychotherapy
Exercise
Medication [try all before meds, unless severe]

(L6, P3)
Anxiety: Neurotransmitter
Gamma-aminobutyric (GABA) - anxiety & CD [i.e. compulsive disorder]

(L6, P2)
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)
Panic Disorder: Benzodiazepines
[Can Animals Lie Down - KXAV]

Clonazepan (Klonapen)
Alprazolam (Xanax)
Lorazepan (Ativan) - watch for mini-withdrawal
Diazepam (Valium)

(L6, P6)
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)
Panic Disorder: Treatment Goals
1. Block panic attack with fast acting drugs first
2. Treat comorbidities
3. Achieve remission
4. Maintain remission

(L6, P6)
Tiagabine (Gabitril): Uses
Anticonvulsant

GABA reuptake inhibitors.

Used for PTSD & panic disorder.

(L6, P5)
Clonidine (Catapres): Uses
Alpha-blocker (i.e. alpha adrenergic agonist)

Used for panic disorders (adjunctive)

(L6, P5) & (L6, P9)

(L6, P9)
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)
Antihistamines: Examples
[High Definition - Very/Alternatives Bien]

Hydroxyzine (Vistaril, Atarax)
Diphenhydramine (Benadryl) - fast sedation (i.e. 20-30 minutes)

(L6, P8)
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)
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)
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)
Hypnotics: Examples
1. Triazolam (Halcion)
2. Temazepan (Restoril)
3. Flurazepan (Dalmane)

(L6, P5)
Antianxiety Medication: Least Liver Dependent
Lorazepam (Ativan)
Temazepan (Restoril)
Oxazepam (Serax)

(L6, P5)
Benzodiazepines: Fastest to Slowest Effect & Highest to Lowest Action Potential
Diazepam (Valium) - fastest & highest
Alprazolam (Xanax)
Lorazepam (Ativan)
Chlordiazepoxide (Librium) - slowest & lowest

(L6, P8)
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)
Oxazepram (Serax)
(Benzodizaepine - Antianxiety medication)

[Used a lot, but not talked about.]

(L6, P4)
Alprazolam (Xanax)
(Benzodiazepine - Antianxiety medication)

[Used and abused a lot; highest dependency/addictive potential.]

(L6, P4)
Lorazepan (Ativan)
(Benzodiazepine - Antianxiety medication)

[Calms you down and puts you to sleep; most commonly used with less side effects.]

(L6, P4)
Chlordiazepoxide (Librium)
(Benzodiazepine - Antianxiety medication)

1957 - [First/oldest.]

(L6, P4)
Diazepam (Valium)
(Benzodiazepine - Antianxiety medication)

[Longest half-life.]

(L6, P4)
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)
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)
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