Cns 2 - Test 2 - Anxiety Disorders

Front 1

What is the most common type of anxiety disorder?

Specific phobia, GAD, PD, or SAd?

Back 1

Specific phobia is the most common form of anxiety disorder (8.7%)

Followed by SAD (6.8%), GAD (3.1%), PD (2.7%)

Front 2

Which key brain feature is responsible for assessment of fear & learned response to fear?

Back 2

Amygdala (temporal lobe)

Front 3

Which key brain feature is responsible for fear response?

Back 3

Locus ceruleus (brain stem)

Front 4

What key brain feature is responsible for consolidation of traumatic memory & fear conditioning?

Back 4

Hippocampus

Front 5

What key brain feature is repsonsible for neuroendocrine & autonomic response to a threat?

Back 5

Hypothalamus

Front 6

_____ is effective for Generalized Anxiety Disorder (GAD), but not Panic Disorder (PD).

Back 6

Buspirone

Front 7

Term for "anxiety about being in places or situations where escape is difficult".

Back 7

Agoraphobia

Front 8

First-line treatment for Generalized Anixiety Disorder (GAD) includes: ______, ______, _______, & ______.

(*hint: 4 drugs...)

Back 8

First-line treatment for Generalized Anixiety Disorder (GAD) includes:

Duloxetine (Cymbalta) - SNRI
Escitalopram (Lexapro) - SSRI
Paroxetine (Paxil) - SSRI
Venlafaxine XR (Effexor XR) - SNRI

Front 9

Second-line treatment for Generalized Anxiety Disoder (GAD) includes: ______, ______, _______, & ______.

(*hint: 1 class & 3 drugs...)

Back 9

Second-line treatment for Generalized Anxiety Disoder (GAD) includes:

Benzodiazepines
Buspirone (Buspar)
Imipramine (Tofranil) - TCA
Sertraline (Zoloft) - SSRI

Front 10

First-line treatment for Panic Disorder (PD): ____ & ____

(*hint: 1 class & 1 drug)

Back 10

SSRI's

Venlafaxine XR (Effexor XR) - SNRI

Front 11

Second-line treatment for Panic Disorder (PD): ____, ____, ____, & ____

(*hint: 4 drugs....)

Back 11

Second-line treatment for Panic Disorder (PD):

Alprazolam (Xanax) - BZD
Clomipramine (Anafranil) - TCA
Clonazepam (Klonopin) - BZD
Imipramine (Tofranil) - TCA

Front 12

First-line treatment for Social Anxiety Disorder (SAD): ____, ____, ____, & ____

(*hint: 4 drugs...)

Back 12

First-line treatment for Social Anxiety Disorder (SAD):

Escitalopram (Lexapro) - SSRI
Fluvoxamine (Luvox) - SSRI
Sertraline (Zoloft) - SSRI
Venlafaxine XR (Effexor XR) - SNRI

Front 13

Second-line treatment for Social Anxiety Disorder (SAD): ___ & ___

(*hint: 2 drugs...)

Back 13

Citalopram (Celexa) - SSRI
Clonazepam (Klonopin) - BZD

Front 14

BZD: ____ is a prodrug - converted in liver

Back 14

Clorazepate (Tranxene)

Front 15

BZD: ____ & _____ bypass phase 1 oxidation --> less likely to have PK interactions

Back 15

Lorazepam (Ativan) & Oxazepam (Serax)

Front 16

Approved dosage range (mg/day) of Alprazolam (Xanax)?

Back 16

0.75 - 4

Front 17

Approved dosage range (mg/day) of Chlordiazepoxide (Librium)?

Back 17

Approved dosage range (mg/day) of Chlordiazepoxide (Librium)?

15 - 100

Front 18

Approved dosage range (mg/day) of Clonazepam (Klonopin)?

Back 18

Approved dosage range (mg/day) of Clonazepam (Klonopin)?

1 - 4

Front 19

Approved dosage range (mg/day) of Clorazepate (Tranxene)?

Back 19

Approved dosage range (mg/day) of Clorazepate (Tranxene)?

7.5 - 60

Front 20

Approved dosage range (mg/day) of Diazepam (Valium)?

Back 20

Approved dosage range (mg/day) of Diazepam (Valium)?

2 - 40

Front 21

Approved dosage range (mg/day) of Lorazepam (Ativan)?

Back 21

Approved dosage range (mg/day) of Lorazepam (Ativan)?

0.5 - 10

Front 22

Approved dosage range (mg/day) of Oxazepam (Serax)?

Back 22

Approved dosage range (mg/day) of Oxazepam (Serax)?

30 - 120

Front 23

Generalized Anxiety Disorder: ___ are preferred agents for pregnant patients.

Back 23

Antidepressants (SSRI's & TCA's)

Front 24

___ is FDA approved for Panic Disorder (PD) with or without agoraphobia.

Back 24

Alprazolam (Xanax)

Front 25

BZD bind to GABA-A alpha-2 subunit --> anxiolytic/sedation effect?

BZD bind to GABA-a alpha-1 subunit --> anxiolytic/sedation effect?

Back 25

alpha-2 --> anxiolytic

alpha-1 --> sedation

Front 26

BZD pharmacokinetics:

___ & ___ are less lipophilic & have a slower absorption time

Back 26

Lorazepam (Ativan) & Oxazepam (Serax)

Front 27

BZD pharmacokinetics:

IM administration of ___ & ___ should be AVOIDED - erratic absorption & painful

Back 27

diazepam (Valium) & chlordiazepoxide (Librium)

Front 28

BZD PK:

___ (drug) undergoes nitroreduction

Back 28

clonazepam (Klonopin) undergoes nitroreduction

Front 29

BZD PK:

Diazepam is also metabolized by ____ (in addition to CYP 3A4)

Back 29

CYP 2C19

Front 30

BZD PK:

Long acting drugs, like ____ & ___, are metabolized to DMDZ (active metabolite)

Back 30

clordiazepoxide (Librium)

diazepam (Valium)

Front 31

BZD PK:

___ is a prodrug converted to DMDZ in the GI tract under acidic pH

(Don't take with antacids!)

Back 31

clorazepate (Tranxene)

Front 32

Panic Disorder (PD)

What is the maintenance Tx time?

Back 32

12 to 24 months

Front 33

___ (drug class) & ___ (drug) are NOT effective in SAD.

Back 33

TCA's & Fluoxetine

Front 34

PTSD: ____ (drug class) are first-line agents.

___ & ___ (drugs) are FDA approved for acute treatment

Back 34

SSRIs

Sertraline & Paroxetine

Front 35

PTSD: ____ was NOT effective!

Back 35

Buproprion

Front 36

PTSD: Maintenece Tx for at least ___ months.

Back 36

12 months

Front 37

5 FDA approved drugs for treatment of OCD?

Back 37

5 FDA approved drugs for treatment of OCD:

clomipramine
fluvoxamine
fluoxetine
paroxetine
sertraline

Front 38

Which drug class is the first-line treatment for OCD?

Back 38

SSRI's

Front 39

Therapy for OCD should last how long?

Back 39

1 to 2 years