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PRE-REG-Thuri > NERVOUS SYSTEM - ANXIETY > Flashcards

NERVOUS SYSTEM - ANXIETY Flashcards

1
Q

What is anxiety?

A

Normal emotion, can be severe, disabling + chronic

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2
Q

What are 5 symptoms of anxiety?

A

Worry

Fear

Restlessness

Irritability

Difficulty concentrating

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3
Q

List 6 physical symptoms?

A

Palpitations

Tremors

Muscle tension

Sweating

SOB

Insomnia

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4
Q

What are the 2 main classes of anxiolytic drugs?

A

Benzodiazepines

Beta blocker

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5
Q

What are 2 drugs used for chronic anxiety?

A

SSRI

Propranolol - physical symptoms

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6
Q

List 4 short acting benzodiazepines?

A

Triazolam
Midazolam
Oxazepam
Lorazepam

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7
Q

What 3 benzodiazepines are also used in insomnia treatment?

A

Diazepam

Oxazepam

Lorazepam

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8
Q

What are 5 long acting benzodiazepines?

A

Chlordiazepoxide

Diazepam

Clorazepate

Flurazepam

Clobazam

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9
Q

What is the risk of long acting benzos in elderly patients?

A

Can induce hepatic coma

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10
Q

What type of benzos is best used in elderly patients?

A

Short acting benzos

e.g. lorazepam, oxazepam, midazolam

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11
Q

What schedule drug is benzodiazepines?

A

Sch 4 part 1

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12
Q

What 4 drug classes can be used to treat anxiety?

A

5HT1a alpha = buspirone

Antidepressant

Anti-epileptic

Anti-psychotic

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13
Q

What is MOA of benzodiazepines?

A

Increasing binding of GABA at GABAa receptors.

Causes CNS depressant effects

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14
Q

What is clobazam used in also?

A

Epilepsy

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15
Q

What is chlordiazepoxide used for?

A

Acute alcohol withdrawal

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16
Q

What 2 benzodiazepines can be used in dental procedures?

A

Lorazepam

Diazepam

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17
Q

Which 5-ht1A agonist is used for anxiety and does NOT cause dependancy?

A

Buspirone

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18
Q

What is indication of benzos?

A

Short term use for anxiety

19
Q

How long is benzos used for in anxiety?

A

Short term (2-4 weeks)

20
Q

What dose of benzos to give in elderly?

A

Half dose

21
Q

When to give a half dose of benzos?

A

Elderly

Liver impairment

22
Q

Why should benzos be typically avoided in elderly?

A

Can cause falls/sedation/ confusion

23
Q

What is a paradoxical effect ?

A

increase in hostility, aggression and anxiety

24
Q

What is an antidote for benzodiazepine overdose?

A

Flumazenil

25
Q

Can you drive whilst taking benzodiazepines?

A

Avoid IF feeling drowsy

26
Q

What 6 benzodiazepines have a legal driving limit? (COLD FT)

A

Clonazepam
Oxazepam
Lorazepam
Diazepam

Flunitrazepam
Temazepam

27
Q

What effect is seen in patients taking benzodiazepines?

A

paradoxical effect

28
Q

What warning label is on benzos?

A

This med makes you sleepy. If you feel sleepy, do not drive or use machinery. Do not drink alcohol

29
Q

What condition is a caution as benzos can cause muscle weakness?

A

Myasthenia gravis

30
Q

What are the 5 SEs of Benzos ? CRAMPS

A

CNS depression
Respiratory depression
Ataxia
Muscle weakness
Paradoxical effect
Sedation

31
Q

What is a mhra warning for benzos related to respiratory depression?

A

Benzos + opiod can cause CNS depressant effects.

Monitor signs of resp depression.

32
Q

How to monitor respiratory depression?

A

Slow/ shallow breathing

Sedation

Blue lips

33
Q

What is a risk of using benzodiazepines?

A

Dependence + tolerance

34
Q

How to avoid dependence or tolerance?

A

Avoid prolonged use + abrupt withdrawal

35
Q

What does alcohol + benzos do?

A

Increase CNS depression effects such as sedation

36
Q

What 6 drug classes interact with benzos to cause sedation?

A

Alcohol

Opioids

Antihistamines

Anti-psychotics,

Barbiturate

Z-drug

37
Q

What are the 5 symptoms of benzodiazepine withdrawal?

A

Anxiety

Sweating

Weight Loss

Tremors

Loss of appetite

38
Q

What 3 steps done to deal with withdrawal of long-term benzos?

A

1) convert benzo meds into equivalent diazepam ON dose

2) Then reduce dose of diazepam by 1 to 2 mg every 2-4 weeks (wait for all symptoms to go)

3) reduce diazepam dose by 0.5mg near end.

39
Q

What 2 benzos are occasionally given IV for panic attacks?

A

Lorazepam

Diazepam

40
Q

What 3 benzos act for a shorter time and have no hangover effect?

A

Loprazolam, lormetazepam, and temazepam

41
Q

When can benzodiazepine withdrawal syndrome may develop at any time after stopping long acting?

A

3 weeks

42
Q

When can benzodiazepine withdrawal syndrome may develop at any time after stopping SHORT acting?

A

occur within a day

43
Q

What are 6 Symptoms of benzo withdrawal syndrome?

A

insomnia, anxiety, loss of appetite + body-weight, tremor, perspiration, tinnitus, and perceptual disturbances

44
Q

How long does Withdrawal symptoms for long-term users take to RESOLVE?

A

6-18 months

PRE-REG-Thuri (44 decks)

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