Antianxiety meds Flashcards Preview

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Flashcards in Antianxiety meds Deck (33):
1

Benzodiazapine (BZD) drug lists

1. Alprazolam/Xanax
2. Clonazepam/Klonopin
3. Diazepam/Valium
4. Lorazepam/Ativan

2

alprazolam

xanax

3

clonazepam

klonopin

4

diazepam

valium

5

lorazepam

ativan

6

BZD mechanisms

enhance GABA neurotransmission

7

long acting BZDs

clonazepam
diazepa

8

short acting BZDs

alprazolam
lorazepam

9

Efficacy of BZDs

1. quick onset
2. anxiolytic
3. hypnotic
4. muscle relaxation
5. anticonvulsant (DOC for epilepsy) ****
6. amnesic

10

BZD side effects

tolerance/dependence (difficult to taper, caution in patients with substance abuse, potential for w/d)

CNS depression

11

BZD in elderly

use BZD with little renal clearance

LOTs: lorazepam, oxazepam, temazapam

12

BBW of BZDs

concomitant use of bends and opioids may result in death, coma, respiratory depression

13

BZDs schedule

IV controlled

limited to 5 refills/6 month

14

Buspirone

Buspar

mechanism unknown

use for those w/SA issues (not dependent)

drawback: long onset, TID dosing due to short half life

15

Pregabalin

lyrica

16

gabapentin

neurontin

17

Pregabalin/gabapentin

mechanism

NOT synthetic GABA

instead- inhibits glutamate release

glutamate antagonist

18

controlled level: Lyrica

CV substance

19

control level: gabapentin

neurotin

CVI -- reported to OARRS

20

Lyrica/Neurotin side effects

CNS depression

dose accumulation w/ renal insufficiency

21

anti-depressants and anxiety

SSRIs are D.O.C. for several anxiety disorders

some SNRI

may worsen anxiety

22

other agents used in anxiety disorders

1. B-Blockers
2. MAOIs
3. Antihistamines
4. Barbituates
5. Pregabalin/Gabapentin
6. Antipsychoitcs

23

beta blockers in anxiety (use)

symptom control (tachycardia)

24

Antihistamines with anxiety

hydroxyzine

also used for sedating properties

25

Recommendations: generalized anxiety disorders

1. antidepressants
2. BZDs
3. Buspirone
4. Pregabalin, SGAs, valproate
5. CBT, psychotherapy

26

Recommendations: panic disorders

1. antidepressants
2. BZDs
3. CBT, psychotherapy

**buspirone, BBs, antihistamine, SGAs, bupropion, trazodone NOT shown to be effective

-- lose adjuncts

27

Recommendations:

OCD

1. Serotonergic agents effective: SSRI
2. CBT augmenting SSRI
3. Augmentation with haloperidol or SGA may help

** NO benzos

28

Recommendations:
PTSD

1. SSRIs
2. Augment with other agents for specific symptoms
3. BZDs
4. Trauma-focused CBT

29

other agents used in PTSD

prazosin
anticonvlusants
SGAs

30

Prazosin

alpha-1 antagonist

used for PTSD associated nightmares

31

anticonvulsants

used for aggression, anger, depression

32

SGAs PTSD

used for psychotic symptoms

33

Recommendations: social anxiety disorder

1. CBT most effective
2. Antidepressants (12 weeks to work)
3. BZDs as adjunct
4. Gabapentin/Pregabalin