Therapy, Anxiety Disorders

Front 1

patho include

abnormalitites in the --- --- receptor

---- activation

--- dysregulation

---- component

Back 1

GABA BDZ

noradrenergic

serotonergic

genetic

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hypersensitive conditioned fear network centered in the ------

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amygdala

GAD, SAD, PD

Front 3

patho of anxiety disorder

decreased --- tone

hypersensitive brain stem ---- receptors

hyperreactivity of the -- ----

Back 3

dopamingeric

CO2

locus ceruleus

Front 4

psychotx:

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cognitive behavioral tx

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pharcotherapy

acute tx

Back 5

benzodiazepines

physical symptoms

Front 6

therapy

chronic tx

Back 6

antidepressants:

cognitive symptoms

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characteristic features of panic attack and disorder

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anxiety

avoidance

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panic attack

a discrete period of intense ---- or discomfort in which -- or more of the typical symptoms develop -----, reach a peak w/in -- ---, and usually last no more than 20-30 min

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fear

4

10 minutes

Front 9

a panic disorder:

----, unexpected panic attacks w/ at least 1 of the attacks being followed by one month or more of ---- ---- about having additional attacks or worry abou the implications of hte attack or its -----

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persistent concern

consequences

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panic disorders always accompanies agoraphobia

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f

w/ or w/out

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the avoidance of specific situations in which escape might be difficult or in which help may not be available i fa panic attack were to occur

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panic disorder

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nonpharm tx

avoid:

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caffeine

drugs of abus

otc stimulants

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feelings of unreality

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derealization

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being detached from oneself

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depersonalization

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s/s of panic

fear of losing --- or going ----

fear of ----

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control

crazy

dying

Front 16

1st line antidepressants in panic disorder

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ssri's

snri's. . .venlafaxine

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2nd line antidepressants in panic disorder

Back 17

tcas: imipramine

Front 18

3rd line antidepressants for panic disorder

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phenelzine

Front 19

doc for benzo for panic disorder

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clonazepam

Front 20

why is clonazepam doc for panic disorder in the bdz

Back 20

longer acting

less withdrawal

less frequent dosing

Front 21

other agents used in panic disorders

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bb

valproic acid

inositol

clonidine

atypical antipsychotics

given as adjunct or as failire of 1st meds

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GAD:

---- ------ and worry occuring more days than not for at least -- months about a number of events or activities

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excessive anxiety

6

Front 23

psy s/s of gad

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excessive anxiety

worries that are difficult to control

felling keyed up or on edge

poor concentration

mind going blank

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physical s/s

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restlessness

fatigue

muscle tension

sleep disturbances

irritability

Front 25

1st line in gad

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CBT

SSRI and SNRI

Front 26

acute management of gad

Back 26

bdz's

Front 27

2nd line in gad

Back 27

buspirone

Front 28

3rd line for gad

Back 28

tca (imipramine)

Front 29

other agents for gad

Back 29

clonidine

propanolol

atypica antispychotics

riluzole

tiagabine

pregabalin

Front 30

sad

---, ----, and persistent fear of being negatively evaluated in a ----- or performance situation

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intense

irrational

social

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generalized subtype of sad:

fear of many --- situations where --- may occur

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social

embarrassment

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discrete subtype of sad:

fear is limited to -- or --- situations

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1 or 2

ex: performing or public speaking

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sad:

fears of being

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scrutinized

embarrassed

humiliated

Front 34

phy s/s of sad

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blushing

butterflies

diarrhea

sweating

tachycardia

trembling

Front 35

1st line for sad

Back 35

ssri

snri

Front 36

atypical used for sad

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mirtazapine

Front 37

maoi used for sad

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phenelzine

tranylcypromine

Front 38

alternate agents in sad

Back 38

bdz

gabapentin

buspirone

buproprion

topiramate

Front 39

1st line pharm w/ ptsd

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ssri

venlafaxine (snri)

mirtazapine (atypical antidepress)

for acute, continuation, maintenance

Front 40

other ad's for ptsd

Back 40

tca

maoi

Front 41

other agents for ptsd

Back 41

atypical antipsychotics

clolinidine

lithium

anticonvulsants

buspirone

triodothyonine

trazadone

bdz

diphenhydramine

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what's given for nightmares for ptsd

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prazasin

Front 43

t/f

ok to use bdzs for ptsd

Back 43

f

may worsen or impede tx

block out memories and not deal w/ it

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ocd

symptoms of obsession or compulsion that cause marked distress, are --- ----, or significantly impair the individuals ---/--- funcitoning/relationships

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time consuming (take more than 1 hr a day)

routine/social

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t/f

total remisssion of ocd is improbable

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t

Front 46

1st line pharm for ocd

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ssri

Front 47

snri for ocd

atypical ad

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venlafaxine

mirtazapine

Front 48

tca for ocd

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clomipramine:

tca: both 5ht and ne uptake blocker

if 3 ssri's don't work

increased se

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other meds for ocd

Back 49

iv clomipramine

plasma exchange and immunoglobulin

Front 50

adjunct tx for ocd

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atypical antipsychotic

pindolol

clonazepam

buspirone

lithium

trazadone

maoi

topiramate

riluzole

Front 51

which ads have lower seizure threshold

Back 51

all of them

Front 52

which ssri will give have drug withdrawal

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paroxetine (paxil): short t1/2

less withdrawal: fluoxetine: longest t1/2

Front 53

which ssri have no di

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celexa

lexapro

Front 54

ae of ssri

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ha

n/v

sweating

appetite/weight change

restlessness, insominia, anxiety

sex dysfunction

hyponatremia

bruising (watch out w/ pt's on warfarin)

Front 55

which med do you need to watch out for htn and nausea

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velafaxine

Front 56

se of duloxetine

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anticholinergic

drowsiness

nausea

decreased appetite

sweating

sex dysfunction

Front 57

tca that 's good for the elderly

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nortriptyline (ne selective)

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which tca can cause orthostatic hypotension

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nortriptyline

Front 59

which tca is good if low tolerance to antiach effects

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desipramine

Front 60

which has high efficacy, but is poorly tolerated

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imipramine

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se of maoi

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postural hypotension

hepatic complications

antiach se

sedation

sex dysfunction

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worse ad w/ lowering of seizure threshold

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bupropion

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less potent ssri w/ sedative properties

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trazodone

Front 64

ae of trazodone

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priapism

drowsiness

orthostasis

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se of mirtazapine

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sympathetic

wieght gain

sedation

dizziness

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bupropion ci in

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seizure disorders

eating disorders (these can lower seizure threshold)

Front 67

ae of buproprion

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n/v

consipation

dry mouth

ha

nervousness

dermatological rx

little sex dysfunction

Front 68

which med has little sex dysfunction

Back 68

bupropion

Front 69

when does buspirone have little efficacy

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w/ recent bdz use

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which meds will have a low abuse potential over a long time

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long t1/2

chlordiazepoxide

clonazepam

clorazepate

diazepam

Front 71

which meds will have a high level of risk over a long time

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xanax

has Intermediate t1/2 and metabolites

leaves quickly

Front 72

which meds will high level of risk over a short time

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short t1/2

lorazepam

oxazepam

Front 73

is there a need to taper if switching w/in class

Back 73

no

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fluoxetine is a --- inhibitor

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cyp 2d inhibitor

don't give w/ tamoxifen

Front 75

bdz have interactions w/ cyp---

Back 75

3a4