Chapter 67: Anxiety Disorders Flashcards
Which key drugs cause anxiety?
Albuterol (if used too frequently or incorrectly) Antipsychotics (e.g., aripiprazole, haloperidol) Bupropion Caffeine, in high doses Decongestants Illicit drugs Levothyroxine (if therapeutic OD occurs) Steroids Stimulants Theophylline
What are natural products used for anxiety & their warnings/SE
- St. John’s Wort (strong 3A4 inducer, causes photosensitivity & is serotonergic)
- Valerian (some products may be contaminated with liver toxins)
- Passionflower is safe & “possibly effective”
- Kava (severe liver damage, NOT recommended)
Which drug class is recommended first line for anxiety
SSRIs
SSRIs will not provide immediate relief of anxiety. They take at least ____ at higher doses for a noticeable effect
4 weeks
Which medication is a more favorable add-on medication than BZDs in elderly patients d/t less sedation
Buspirone
Buspirone will not provide immediate relief of anxiety. It will take at least ____ for effect
2-4 weeks
Which medication can be used short-term, as needed, as an alternative to BZDs
Hydroxyzine (Vistaril)
Which medications are not FDA approved for anxiety but has shown benefit in patients with anxiety and neuropathic pain
pregabalin (Lyrica)
gabapentin (Neurontin)
Which medication is not FDA approved for anxiety but can reduce symptoms of stage fright or performance anxiety (e.g., tremor, tachycardia)
propranolol (Inderal LA)
MOA of buspirone is unknown, but its effects may be due to its affinity for which receptors
5-HT1A
and
5-HT2
CI for buspirone
Do not use with MAOi within 14 days
Which medication used for anxiety could you give someone with a history of drug abuse
Buspirone
MOA of BZDs
Enhance GABA,
which is an inhibitory neurotransmitter
causes CNS depression
Which drug class can be useful for short-term treatment of acute anxiety that is preventing restful sleep and disrupting life (i.e., recent death of a loved one, natural disaster, etc.)
benzodiazepines
Due to the risk of dependency, benzodiazepines should only be used for ____ and then discontinued. If used for longer periods of time, they must be tapered off slowly to prevent withdrawal symptoms
1-2 weeks
