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*Pharm III > Anxiety > Flashcards

Anxiety Flashcards

1
Q

a drug that has a calming effect, relieving anxiety and tension. Sedatives are hypnotic drugs administered at lower doses than those needed for sleep (drowsiness common side effect)

A

Sedative

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2
Q

A drug that produces sleep by depressing brain function

Often cause hangover effects in the morning

A

Hypnotic

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3
Q

A drug that reduces anxiety

A

Anxiolytic

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4
Q

medical conditions that can cause patients to have anxiety

A 
MI
asthma
hyperthyroidism
migraine
pain
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5
Q

where do benzos act?

A

allosteric site of GABA

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6
Q

MOA of benzos

A

The binding of benzodiazepines enhances the action of GABA, resulting in a greater entry of chloride ion

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7
Q

Meds that decrease ___ help anxiety

A

norepinephrine

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8
Q

Meds that increase ____ at receptors help w/ anxiety

A

5-HT (serotonin)

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9
Q

fear of market place or open spaces

A

agoraphobia

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10
Q

what are the benzos used for anxiety

A 
alprazolam
clonazapam
chlordiazepoxide
clorazepate
diazepam
halazepam
lorazepam
oxazepam
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11
Q

most effective and safe med for acute anxiety symptoms

A

benzos

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12
Q

long acting benzos (1-3 days)

A

chlordiazepoxide
diazepam
flurazepam

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13
Q

intermediate acting benzos (10-20 hours)

A

alprazolam
lorazepam
temazepam

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14
Q

short acting benzos (3-8 hours)

A

oxaepam

traizolam

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15
Q

MOA of benzos

A

potentiate inhibitory activity of GABA

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16
Q

which benzos have lower potency

A

chlordiazepoxide
oxazepam
temazepam

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17
Q

what benzos have medium potency

A 
diazepam
estazolam
flurazepam
prazepam
quazepam
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18
Q

what benzos have high potency

A 
alprazolam
bromazepam
clonazepam
lorazepam
traizolam
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19
Q

ADRs w/ benzos

A

sedation, fatigue, weakness
decreased memory and recall
ataxia, mental confusion

20
Q

who can you see a paradoxical rxn w/ benzos in

A

extremes of age

brain injury

21
Q

to D/c benzos what must be done

A

taper <10-25% every 1-2 weeks

at 50% dose slow-taper further to avoid withdrawal

22
Q

other CNS depressants to not combine w/ benzos

A

ETOH

opiates

23
Q

what drug inhibits metabolism of long acting BZDs

A

cimetidine

24
Q

what drug decreases clearance of diazepam

A

fluoxetine

25
Q

disadvantages of benzos

A

psychological dependence/ abuse

withdrawal rxns

26
Q

withdrawal symptoms of benzos

A

confusion, anxiety, agitation, restlessness, insomnia, tension

27
Q

what reverses the affects of benzos

A

flumazenil (rapidly reverses effects)

28
Q

problem w/ flumazenil

A

will precipitate withdrawal symptoms (seizures)

29
Q

Not used for anxiety or insomnia
Induce tolerance, physical dependency, severe withdrawal symptoms
Potentially Fatal Respiratory Depression
potent liver inducers- many drug interactions

A

Barbiturates

30
Q

barbiturates uses

A

general anesthetic
anticonvulsant
sedative/ hypnotics- risky

31
Q

MOA of barbiturates

A

Potentiates GABA action on chloride entry into neuron hyperpolarization
Barb receptor on GABA different than Benzo
Block excitatory glutamate receptors
Anesthetic concentrations block Na+ channels

32
Q

is there an antagonist for barbiturates?

A

No

33
Q

how are beta blockers useful w/ anxiety

A

helps w/ physical symptoms- tachycardia, palpitations, tremor, sweating

34
Q

what situations can’t you use beta blockers

A

asthma
diabetes
CHF

35
Q

drugs used for performance anxiety (ie- public speaking)

A

propranolol 10 mg prn

36
Q

Treat anxiety d/o

Reduce 5-HT transmission by acting as partial agonist at these receptors

A

Buspirone (Buspar)

37
Q

advantages of buspirone

A

dependence unlikely

minimal sedation

38
Q

disadvanatges w/ buspirone

A

only works well in GAD
can cause hypothermia, increased prolactin/ GH
P450

39
Q

onset of effects w/ buspirone

A

onset in 1 weeks, max effects in 4-6 weeks

40
Q

drug for anxiety that reduces calcium influx into the neuron and reduces release of glutamate, NE and substance P

A

pregabalin

41
Q

antidepressants shown to not be helpful w/ patients who has anxiety

A

tradazone

bupropion

42
Q

tx of choice for panic disorders

A

SSRIs

43
Q

antidepressant + benzo can result in what?

A

jitteriness syndrome

tx by giving smaller dose of antidepressant

44
Q

SSRI may induce what in the first 4 weeks

A

anxiety, so add a benzo to help

45
Q

the majority of anxiety and panic disorder need what

A

long-term treatment

46
Q

Tx of anxiety & insomnia, non-addicting

A

antihistamines

*Pharm III (8 decks)

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