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18 Cards in this Set
- Front
- Back
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What class of drugs are typically used for rapid relief of acute anxiety symptoms?
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Benzodiapezines
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What class of drugs are typically used for the management of chronic anxiety?
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Anti-depressants
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Name the 5 anti-depressants used in GAD.
What doses are they started at? |
Duloxetine 30 mg/day
Escitalopram 10 mg/day Imipramine 50 mg/day Paroxetine 20 mg/day Venlafaxine 37.5 mg/day |
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What is recommended in pregnant patients needing treatment for GAD?
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Anti-depressants
Benzodiazepines are associated with fetal abnormalities |
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Decreases in the phase 1 oxidation component of hepatic metabolism as well as alterations in volume of distribution and drug accumulation in the tissues as a result of increased adipose pose a increased risk for adverse effects in the elderly. What agents should be avoided? What agents can be given?
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Benzodiazepines with long half-lives should be avoided.
Use a benzo with a short half-life if you have to at all Venlafaxine and citalopram are preferred anti-depressants. |
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Which benzodiazepine should you typically choose and at what dose?
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Lorazepam 1 mg po - can be used PRN - do not use for more than 2-4 weeks.
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How would you counsel a patient on their benzodiazepine therapy?
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Side effects: Sedation - be careful driving/operating machinery
No alcohol! --> Respiratory depression (potentially fatal) Avoid other CNS depressants Do not d/c abruptly No benzo's in the elderly, although if they have been on chronic benzo therapy you will probably have a hard time tapering their regimen. |
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Describe specific strategies in tapering to avoid benzodiazepine withdrawal.
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25% reduction per week until 50% of the original dose is reached.
Then reduce by 1/8 of the original dose per week. |
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What class of drugs are typically used for rapid relief of acute anxiety symptoms?
|
Benzodiapezines
|
|
|
What class of drugs are typically used for the management of chronic anxiety?
|
Anti-depressants
|
|
|
Name the 5 anti-depressants used in GAD.
What doses are they started at? |
Duloxetine 30 mg/day
Escitalopram 10 mg/day Imipramine 50 mg/day Paroxetine 20 mg/day Venlafaxine 37.5 mg/day |
|
|
What is recommended in pregnant patients needing treatment for GAD?
|
Anti-depressants
Benzodiazepines are associated with fetal abnormalities |
|
|
Decreases in the phase 1 oxidation component of hepatic metabolism as well as alterations in volume of distribution and drug accumulation in the tissues as a result of increased adipose pose a increased risk for adverse effects in the elderly. What agents should be avoided? What agents can be given?
|
Benzodiazepines with long half-lives should be avoided.
Use a benzo with a short half-life if you have to at all Venlafaxine and citalopram are preferred anti-depressants. |
|
|
Which benzodiazepine should you typically choose and at what dose?
|
Lorazepam 1 mg po - can be used PRN - do not use for more than 2-4 weeks.
|
|
|
How would you counsel a patient on their benzodiazepine therapy?
|
Side effects: Sedation - be careful driving/operating machinery
No alcohol! --> Respiratory depression (potentially fatal) Avoid other CNS depressants Do not d/c abruptly No benzo's in the elderly, although if they have been on chronic benzo therapy you will probably have a hard time tapering their regimen. |
|
|
Describe specific strategies in tapering to avoid benzodiazepine withdrawal.
|
25% reduction per week until 50% of the original dose is reached.
Then reduce by 1/8 of the original dose per week. |
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Social Anxiety Disorder
Which anti-depressants are indicated for SAD? |
Paroxetine
Sertaline Venlafaxine XR - anorexia, dry mouth, nausea, insomnia, sexual dysfunction |
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What can you give for acute social perfomance situations?
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Beta-blockers
Propranolol 20 mg po 1 hour before perfomance |
