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23 Cards in this Set
- Front
- Back
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What are the classifications of anxiety disorders?
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GAD, panic, agongaphobia, OCD, phobic, acute, PTSD
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What is the structural pathophysiology of anxiety?
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hypothalamus - initiate fight of flight response via CRF
release NE, activates peripheral SNS amygdala- center of body's fear response hippocampus- coordinates memories from multiple sensory inputs HORMONAL- Cortisol |
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What is the neurological pathophysiology of anxiety?
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serotonin- inhibitatory HP A and locus ceruleus
GABA acid Dopamine - reward in brain epi/norepi |
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What is the tx of free floating anxiety?
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excess worry for more than 6 months
BZDs, psychotherapy and anticonvulsants |
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What is the tx for panic disorder?
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4 attack within 4 weeks
BZDs, TCA's, SSRIs MOAIS and behavior techniques |
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how do you treat phobic disorders?
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beta blockers
MAOIs or SSRIs |
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How do you treat OCD?
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clomipramine
SSRi behavorial therapy |
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How do you treat ASD?
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bZD
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How do you treat PTSD?
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SSRI
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BZD
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act at GABA and BZD receptor
short term use psysiologic dependencty after 4 weeks and need to taper |
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Buspirone
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partial agonist of 5HT1 receptor
requires multiple daily doses n/dizziness & somnolence |
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SSRIs
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paroxetine - most sedating
fluoxetine - anxiety worse than better for OCD and panic disorder and GAD 3-6 weeks to work |
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Tricyclic Antidepressants
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imipramine
clomipramine depression/anxiety and panic disorder limit because of AE |
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MAOIs
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panic disorder atypcial refractory depression
block breakdown of serotonin and NE no tyramine DDI with narcotics |
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Non SSRIs
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effects conc of serotonin +/-
mirtazapine anxiety but cause wt gain bupropion venlafaxine |
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Antihistimines
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hydroxyzine
AE- sedation, decreased cognition, anticholnergic SE's useful with substance abuse and itch related anxiety |
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Anticonvulsants
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augmentation therapy
tiagabine gabapentin- enhance GABA Valproate, lamotrigine, topiramate |
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Non pharmacologic therapy
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avoid caffiene
psychotherapy reduce unnecessary stress |
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OCD
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fluxetine
fluvoxamine sertraline parosetine venlafaxine |
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Panic
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fluxetine
sertraline parosetine |
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Social anxiety
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parosetine
venlafaxine |
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GAD
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parosetine
venlafaxine |
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PTSD
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parosetine
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