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PHRM 845 > L? pharmtx of anxiety - Ott > Flashcards

L? pharmtx of anxiety - Ott Flashcards

(56 cards)

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1
Q

6 drugs/classes that can cause anxiety

A
  • albuterol ->jittery
  • caffeine (high doses)
  • decongestants (sudafed)
  • levothyroxine -> jittery and amped up
  • steroids
  • stimulants -> ADHD meds
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2
Q

what is the MOA/class of buspirone (buspar)

A

serotonin (5HT-1a) receptor agonist

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3
Q

what is buspirone approved for use in? (only 1 thing)

A

GAD

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4
Q

target dose of buspirone

A

10-15mg tid

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5
Q

how long does it take for buspirone to reach initial efficacy?

A

3-4 weeks

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6
Q

T or F: Benzos have lower efficacy in some studies when compared to ssri’s in the treatment of anxiety disorders

A

False, they actually show better efficacy but are used less because of abuse potential

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7
Q

Acute withdrawal of benzos may lead to what

A

life-threatening seizures

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8
Q

there is a specific warning for the use of benzos with what other CNS depressant class?

A

opioids

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9
Q

T or F: Benzos without an active metabolite are less likely to accumulate, and have fall risk

A

True

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10
Q

Benzos with a long-acting active metabolite may lead to hangover and fall risk, especially in elderly

A

true

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11
Q

which 4 benzos do NOT have an active metabolite? **

A

alprazolam
lorazepam
clonazepam
oxazepam (tf is this one)

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12
Q

which 3 benzos DO have an active metabolite?

A

Diazepam
clorazepate
chlordiazepoxide

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13
Q

5 side effects of benzos *

A
  • sedation
  • paradoxical excitement (weird)
  • swallowing difficulties
  • impairment of memory and recall
  • psychomotor impairment
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14
Q

T or F: D/C of benzos has a surprisingly fast taper period of days to weeks

A

false, slow taper weeks to months

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15
Q

which 3 benzos are appropriate in elderly pts

A

(LOT)
Lorazepam
Oxazepam
Temazepam

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16
Q

T or F: Hydroxyzine is FDA approved in GAD and PTSD

A

false, just GAD

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17
Q

Used most commonly “as needed” for anxiety or insomnia instead of a benzo
A. Buspirone
B. Propranolol
C. Hydroxyzine

A

C. Hydroxyzine

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18
Q

T or F: Hydroxyzine has a QTc prolongation risk

A

True

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19
Q

T or F: Hydroxyzine is safe to use in elderly due to its 5HT2a antagonizing effects

A

False, avoid use due to anticholinergic side effects and fall risk

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20
Q

Decrease physiological sxs of acute anxiety (tachycardia, sweating, flushing):
A. Buspirone
B. Propranolol
C. Hydroxyzine

A

B. Propranolol

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21
Q

useful for performance and situational anxiety:
A. Buspirone
B. Propranolol
C. Hydroxyzine

A

B. Propranolol

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22
Q

T or F: propranolol should be used in high doses for the tx of anxiety

A

false, low doses like 10-20 mg bid-tid

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23
Q

what should be evaluated/checked for before starting a pt on propranolol for anxiety? **

Study These Flashcards
A

asthma and cardiovascular conditions

24
Q

4 natural products ott mentioned in class for the tx of anxiety

Study These Flashcards
A

st johns wort
passionflower
valerian
chamomile

25
in what cases what gabapentinoids be considered as anxiety tx?
pt with bipolar disorder + anxiety sxs or comorbid neuropathic pain
26
T or F: quetiapine has anxiolytic effects
False, the METABOLITE of it has anxiolytic effects
27
T or F: sleep medicine does not endorse the use of quetiapine for insomnia **
true (say this one outloud so it sticks)
28
what drug classes are 1st line for all anxiety disorders?
ssris and snris
29
Atypical antipsychotics are not fda approved for anxiety disorders but there has been clinical evidence for efficacy in what?
treatment-resistant OCD (abilify and risperidone)
30
How long does excessive anxiety/worry need to be present to be considered GAD?
at least 6 months
31
sxs of GAD include at least 3 of which 6 sxs?
restlessness easily fatigued difficulty concentrating irritability muscle tension sleep disturbances
32
ssris take how long for initial onset of sxs relief in GAD?
2-4 weeks
33
SNRIs may be useful first line in what scenario? ***
if the pt also has a pain syndrome (use duloxetine) **
34
what drug class requires "bridge therapy" to cover time until the onset of an ssri/snri
benzos
35
Monitor for anticholinergic side effects in which of the following? A. Buspirone B. lorazepam C. Duloxetine D. Hydroxyzine
D. Hydroxyzine
36
duration of sxs for social anxiety disorder last at least how long
6 months (common theme here)
37
2 fda approved ssris for social anxiety **
paroxetine and sertraline *
38
which fda-approved SNRI may be useful if SSRI therapy fails for social anxiety? *
venlafaxine (so technically 2nd line)
39
what drug class may be useful in non-generalized performance related social anxiety?
beta blockers -> propranolol
40
an abrupt surge of intense fear or discomfort is called a what
panic attack
41
7 physical/psychological sxs of panic attacks (try your best)
- sweating - palpitations - nausea - dizziness - fear of losing control - "going crazy" lol - fear of dying
42
how many of the 7 physical/psychological sxs of panic attacks must be present to be considered a panic attack?
4/7
43
2nd line tx of panic disorder
SNRI-> venlafaxine
44
T or F: benzos could be considered 1st line for tx of panic disorder due to CNS depressant effects
false, only considered if there is an inadequate response to serotonergic drugs
45
what two benzos could be used for panic disorder
alprazolam and clonazepam
46
********************* what percentage reduction can be expected for sx reduction in the tx of OCD after initial therapy
25-50% ***
47
if a pt with OCD fails multiple ssri's what is the 2nd line treatment option? ***
Clomipramine (TCA)
48
T or F: Clomipramine is useful as 2nd line in OCD because of its low serotonergic effects
false, it is very serotonergic
49
what drug is useful in pts with PTSD that experience nightmares **
prazosin
50
T or F: benzos are recommended in PTSD
false, you dont wanna use them
51
T or F: polytherapy is common in PTSD
true, you want to target specific sxs
52
T or F: Pts with PTSD are less likely to partake in substance use
false, dipshit
53
Cognitive behavioral therapy and what may be helpful in the tx of PTSD ***
eye movement desensitization and reprocessing ***
54
what syndrome can result from the use of SSRIs and SNRIs when treating anxiety disorders **
"jitteriness" syndrome (she said this would be on the exam btw)
55
what two forms of therapy are "mainstays" of tx for anxiety disorders
psychotherapy and cognitive behavioral therapy
56
T or F: In PTSD, drug therapy may be more effective in combat trauma compared to civilian trauma
false, better use in civilian trauma

PHRM 845 (34 decks)

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