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Flashcards in Anxiolytics Deck (42):
1

What are anxiolytics?

Anti-anxiety drugs

2

What are the three anxiolytic classes?

Antidepressants
Benzodiazepines
Buspirone

3

Any antidepressant that increases ______ an be given for anxiety.

Seratonic

4

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

Benzodiazepines

5

With all anxiety disorders, _____ is frequently comorbid.

Depression

6

What are benzodiazepines prescribed most commonly for?

Generalized anxiety disorder (GAD)

7

What are SSRIs (antidepressant) used for?

All anxiety disorders

8

What is GAD?

A chronic condition characterized by uncontrollable worrying
-Of all anxiety disorders, GAD is the least likely to remit

9

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

Delayed

10

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

Rapid

11

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

Delayed

12

When are benzodiazepines preferred?

For immediate stabilization, especially when anxiety is severe

13

When are antidepressants and buspirone drugs preferred?

For long term management

14

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

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.

15

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

ETOH (alcohol)

16

What are the side effects of benzodiazepines?

Sedation
Slurred speech
Ataxia

17

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

In patients known to abuse alcohol or other psychoactive substances

18

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?

Best for generalized anxiety= Clonazepam
Most commonly abused=alprazolam

19

What are the 3 safety issues with benzodiazepines?

-Synergistic effect when combined with ETOH
-Habit forming
-Seizure risk when withdrawing

20

Do benzodiazepines treat the cause of anxiety?

No

21

What is the MOA of buspirone?

Unclear

22

Does buspirone work on GABA?

No

23

What does buspirone exert its effect on?

The serotonin system

24

Are there any addiction risks with buspirone?

No

25

What are the 3 advantages of buspirone?

-No sedation
-No tolerance/dependence
-No interaction with ETOH

26

What are the 2 disadvantages of buspirone?

-Slow onset of action (weeks)
-Low efficacy (has been called an expensive placebo)

27

Is buspirone a CNS depressant?

No

28

Is benzodiazepine a CNS depressant?

Yes

29

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

Benzodiazepine

30

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

4; 2 SNRI and 2 SSRI

31

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

Generalized anxiety disorder

32

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.

Panic disorder

33

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.

Panic disorder

34

What are the first line drugs for panic disorders?

SSRIs

35

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?

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

What are the first line of drugs for OCD?

SSRI

37

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.

Social anxiety disorder

38

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

SSRI

39

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

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

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

Post-traumatic stress disorder (PTSD)

41

What are the 3 core symptoms of PTSD?

Reexperiencing
Avoidance/emotional numbing
Hyperarousal

42

What are treatments for PTSD?

SSRIs for first line treatment of PTSD
Additional drugs used: SNRI (venlafaxine), TCAs, and MAOIs