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Flashcards in Anxiolytic Deck (22)
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1

What are the 4 essentials of diagnosis for anxiety? 

Overt anxiety or an overt manifestation of a coping mechanism (such as a phobia) or both

Not limited to an adjustment disorder

Somatic symptoms referable to the autonomic nervous system or to a specific organ system (eg, dyspnea, palpitations, paresthesias)

Not a result of physical disorders, psychiatric conditions (eg, schizophrenia), or drug abuse (eg, cocaine)

2

What are common CV medical illnesses associated with anxiety sx? 

angina

arrhythmias

cardiomyopathy

congestive heart failure

hypertension

ischemic heart disease

mitral valve prolapse

myocardial infarction

3

What are common endocrine & metabolic illnesses associated with anxiety sx? 

Cushing disease

diabetes

hyperparathyroidism

hyperthyroidism

hypothyroidism

hypoglycemia

hyponatremia 

hyperkalemia

pheochromocytoma

vitamin B12 or folate deficiencies

4

What are common GI illnesses associated with anxiety sx? 

Crohn disease

irritable bowel syndrome

ulcerative colitis

peptic ulcer disease

5

What are common Neurological medical illnesses associated with anxiety sx? 

Migraine

seizures

stroke

neoplasms

poor pain control

6

What are common Respiratory system illnesses associated with anxiety sx? 

Asthma, chronic obstructive pulmonary disease, pulmonary embolism, pneumonia

7

What are the 5 1st line drugs for GAD 

Duloxetine

Escitalopram

Paroxetine

Sertraline

Venlafaxine XR

8

What are the 4 2nd line drugs for GAD? 

Benzodiazepines

Buspirone

Imipramine

Pregabalin

9

Alternative drugs for GAD 

Hydroxyzine

Quetiapine

10

1st line drugs for panic disorder? 

SSRIs

Venlafaxine XR

11

2nd line for panic disorder? 

Alprazolam

Citalopram

Clomipramine

Clonazepam

Imipramine

12

Alternative drugs for panic disorder? 

Phenelzine

13

6 1st line drugs for social anxiety d/o? 

Social anxiety disorder

Escitalopram

Fluvoxamine CR

Paroxetine

Sertraline

Venlafaxine XR

14

2nd line drugs for social anxiety disorder? 

Clonazepam

Citalopram

15

Alternative drugs for social anxiety disorder? 

Gabapentin

Phenelzine

Pregabalin

16

partial agonist at 5-HT receptors and possibly D2 receptors

interacts with the 5-HT1A subclass of brain serotonin receptors as a partial agonist

minimal CNS depressant effects (it does not affect driving skills)

no anticonvulsant or muscle relaxant properties

MOA of which drugs? 

selective anxiolytic

17

What are the PK of anxiolytics? 

slow onset of action (>1 week)

oral activity

forms active metabolite

interactions with CYP3A4 inducers and inhibitors

short half-life

18

Indications for using Buspirone? 

used in GAD

less effective in panic disorders

19

Adverse effects of Buspirone

GI distress, tachycardia

paresthesia

20

Dependency of Buspirone

tolerance development is minimal with chronic use

little rebound anxiety or withdrawal symptoms on discontinuance

21

Is Buspirone safe in pregnancy? 

Yes

22