Anxiolytics Flashcards

1
Q

What are anxiolytics?

A

Anti-anxiety drugs

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2
Q

What are the three anxiolytic classes?

A

Antidepressants
Benzodiazepines
Buspirone

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3
Q

Any antidepressant that increases ______ an be given for anxiety.

A

Seratonic

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4
Q

Out of the three classes, which is the most addictive?

A

Benzodiazepines

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5
Q

With all anxiety disorders, _____ is frequently comorbid.

A

Depression

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6
Q

What are benzodiazepines prescribed most commonly for?

A

Generalized anxiety disorder (GAD)

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7
Q

What are SSRIs (antidepressant) used for?

A

All anxiety disorders

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8
Q

What is GAD?

A

A chronic condition characterized by uncontrollable worrying

-Of all anxiety disorders, GAD is the least likely to remit

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9
Q

Antidepressants: Rapid onset of relief or delayed onset of relief?

A

Delayed

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10
Q

Benzodiazepines: Rapid onset of relief or delayed onset of relief?

A

Rapid

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11
Q

Buspirone: Rapid onset of relief or delayed onset of relief?

A

Delayed

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12
Q

When are benzodiazepines preferred?

A

For immediate stabilization, especially when anxiety is severe

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13
Q

When are antidepressants and buspirone drugs preferred?

A

For long term management

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14
Q

Where do the benefits of benzodiazepines derive from, aka the MOA?

A

Enhancing responses to GABA (an inhibitory neurotransmitter)

Review: GABA is an amino acid neurotransmitter- it is a relaxer and slows the process in the brain down. This is why benzodiazepine is a good drug for anxiety.

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15
Q

The side effects of benzodiazepines are similar to what other drug?

A

ETOH (alcohol)

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16
Q

What are the side effects of benzodiazepines?

A

Sedation
Slurred speech
Ataxia

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17
Q

Because of the abuse potential of the benzodiazepines, what patients should benzodiazepines be used with caution?

A

In patients known to abuse alcohol or other psychoactive substances

18
Q

Of the 13 benzodiazepines, there are 6 that are approved for anxiety. Which one is the best for generalized anxiety?
Which one is the most commonly abused?

A

Best for generalized anxiety= Clonazepam

Most commonly abused=alprazolam

19
Q

What are the 3 safety issues with benzodiazepines?

A
  • Synergistic effect when combined with ETOH
  • Habit forming
  • Seizure risk when withdrawing
20
Q

Do benzodiazepines treat the cause of anxiety?

A

No

21
Q

What is the MOA of buspirone?

A

Unclear

22
Q

Does buspirone work on GABA?

A

No

23
Q

What does buspirone exert its effect on?

A

The serotonin system

24
Q

Are there any addiction risks with buspirone?

A

No

25
Q

What are the 3 advantages of buspirone?

A
  • No sedation
  • No tolerance/dependence
  • No interaction with ETOH
26
Q

What are the 2 disadvantages of buspirone?

A
  • Slow onset of action (weeks)

- Low efficacy (has been called an expensive placebo)

27
Q

Is buspirone a CNS depressant?

A

No

28
Q

Is benzodiazepine a CNS depressant?

A

Yes

29
Q

Which anti-anxiety drug is more suitable to give PRN or for patients who need immediate relief?

A

Benzodiazepine

30
Q

How many antidepressants have been approved to be given for anti anxiety?

A

4; 2 SNRI and 2 SSRI

31
Q

What anxiety disorder is this: chronic condition characterized by uncontrollable worrying?

A

Generalized anxiety disorder

32
Q

What anxiety disorder is this: patients experience recurrent panic attacks, characterized by palpations, pounding heart, chest pain, derealization or depersonalization, and fear of dying or going crazy.

A

Panic disorder

33
Q

Many patients with _____ experience agoraphobia, a condition characterized by anxiety of being in places or situations from which escape might be embarrassing or difficult, or in which help might be unavailable if a panic attach should occur.

A

Panic disorder

34
Q

What are the first line drugs for panic disorders?

A

SSRIs

35
Q

What anxiety disorder is this: persistent obsessions and compulsions that cause marked distress, consume at least 1 hour a day and significantly interfere with daily living?

A

Obsessive-compulsive disorder

*Side note review: the limbic nuclei associated with OCD is cingulate gyrus; with severe OCD, the anterior cingulate gyrus may be cut out–sometimes this completely cures a patient with severe OCD

36
Q

What are the first line of drugs for OCD?

A

SSRI

37
Q

What anxiety disorder is this: characterized by an intense, irrational fear of being scrutinized by others, or of doing something that could be embarrassing or humiliating.

A

Social anxiety disorder

38
Q

What are the first-line drugs for most patients with social anxiety disorder?

A

SSRI

39
Q

When is treatment with a benzodiazepine preferred to an SSRI for a patient with social anxiety disorder?

A

When the disorder is limited to fear of speaking or performing in public. These situations arise infrequently, so PRN treatment of a benzodiazepine may be preferred to long-term treatment of an SSRI

40
Q

What anxiety disorder is this: develops following a traumatic event that elicited an immediate reaction of fear, helplessness, or horror

A

Post-traumatic stress disorder (PTSD)

41
Q

What are the 3 core symptoms of PTSD?

A

Reexperiencing
Avoidance/emotional numbing
Hyperarousal

42
Q

What are treatments for PTSD?

A

SSRIs for first line treatment of PTSD

Additional drugs used: SNRI (venlafaxine), TCAs, and MAOIs