Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
75 Cards in this Set
- Front
- Back
patho include
abnormalitites in the --- --- receptor ---- activation --- dysregulation ---- component |
GABA BDZ
noradrenergic serotonergic genetic |
|
hypersensitive conditioned fear network centered in the ------
|
amygdala
GAD, SAD, PD |
|
patho of anxiety disorder
decreased --- tone hypersensitive brain stem ---- receptors hyperreactivity of the -- ---- |
dopamingeric
CO2 locus ceruleus |
|
psychotx:
|
cognitive behavioral tx
|
|
pharcotherapy
acute tx |
benzodiazepines
physical symptoms |
|
therapy
chronic tx |
antidepressants:
cognitive symptoms |
|
characteristic features of panic attack and disorder
|
anxiety
avoidance |
|
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 |
fear
4 10 minutes |
|
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 ----- |
persistent concern
consequences |
|
panic disorders always accompanies agoraphobia
|
f
w/ or w/out |
|
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
|
panic disorder
|
|
nonpharm tx
avoid: |
caffeine
drugs of abus otc stimulants |
|
feelings of unreality
|
derealization
|
|
being detached from oneself
|
depersonalization
|
|
s/s of panic
fear of losing --- or going ---- fear of ---- |
control
crazy dying |
|
1st line antidepressants in panic disorder
|
ssri's
snri's. . .venlafaxine |
|
2nd line antidepressants in panic disorder
|
tcas: imipramine
|
|
3rd line antidepressants for panic disorder
|
phenelzine
|
|
doc for benzo for panic disorder
|
clonazepam
|
|
why is clonazepam doc for panic disorder in the bdz
|
longer acting
less withdrawal less frequent dosing |
|
other agents used in panic disorders
|
bb
valproic acid inositol clonidine atypical antipsychotics given as adjunct or as failire of 1st meds |
|
GAD:
---- ------ and worry occuring more days than not for at least -- months about a number of events or activities |
excessive anxiety
6 |
|
psy s/s of gad
|
excessive anxiety
worries that are difficult to control felling keyed up or on edge poor concentration mind going blank |
|
physical s/s
|
restlessness
fatigue muscle tension sleep disturbances irritability |
|
1st line in gad
|
CBT
SSRI and SNRI |
|
acute management of gad
|
bdz's
|
|
2nd line in gad
|
buspirone
|
|
3rd line for gad
|
tca (imipramine)
|
|
other agents for gad
|
clonidine
propanolol atypica antispychotics riluzole tiagabine pregabalin |
|
sad
---, ----, and persistent fear of being negatively evaluated in a ----- or performance situation |
intense
irrational social |
|
generalized subtype of sad:
fear of many --- situations where --- may occur |
social
embarrassment |
|
discrete subtype of sad:
fear is limited to -- or --- situations |
1 or 2
ex: performing or public speaking |
|
sad:
fears of being |
scrutinized
embarrassed humiliated |
|
phy s/s of sad
|
blushing
butterflies diarrhea sweating tachycardia trembling |
|
1st line for sad
|
ssri
snri |
|
atypical used for sad
|
mirtazapine
|
|
maoi used for sad
|
phenelzine
tranylcypromine |
|
alternate agents in sad
|
bdz
gabapentin buspirone buproprion topiramate |
|
1st line pharm w/ ptsd
|
ssri
venlafaxine (snri) mirtazapine (atypical antidepress) for acute, continuation, maintenance |
|
other ad's for ptsd
|
tca
maoi |
|
other agents for ptsd
|
atypical antipsychotics
clolinidine lithium anticonvulsants buspirone triodothyonine trazadone bdz diphenhydramine |
|
what's given for nightmares for ptsd
|
prazasin
|
|
t/f
ok to use bdzs for ptsd |
f
may worsen or impede tx block out memories and not deal w/ it |
|
ocd
symptoms of obsession or compulsion that cause marked distress, are --- ----, or significantly impair the individuals ---/--- funcitoning/relationships |
time consuming (take more than 1 hr a day)
routine/social |
|
t/f
total remisssion of ocd is improbable |
t
|
|
1st line pharm for ocd
|
ssri
|
|
snri for ocd
atypical ad |
venlafaxine
mirtazapine |
|
tca for ocd
|
clomipramine:
tca: both 5ht and ne uptake blocker if 3 ssri's don't work increased se |
|
other meds for ocd
|
iv clomipramine
plasma exchange and immunoglobulin |
|
adjunct tx for ocd
|
atypical antipsychotic
pindolol clonazepam buspirone lithium trazadone maoi topiramate riluzole |
|
which ads have lower seizure threshold
|
all of them
|
|
which ssri will give have drug withdrawal
|
paroxetine (paxil): short t1/2
less withdrawal: fluoxetine: longest t1/2 |
|
which ssri have no di
|
celexa
lexapro |
|
ae of ssri
|
ha
n/v sweating appetite/weight change restlessness, insominia, anxiety sex dysfunction hyponatremia bruising (watch out w/ pt's on warfarin) |
|
which med do you need to watch out for htn and nausea
|
velafaxine
|
|
se of duloxetine
|
anticholinergic
drowsiness nausea decreased appetite sweating sex dysfunction |
|
tca that 's good for the elderly
|
nortriptyline (ne selective)
|
|
which tca can cause orthostatic hypotension
|
nortriptyline
|
|
which tca is good if low tolerance to antiach effects
|
desipramine
|
|
which has high efficacy, but is poorly tolerated
|
imipramine
|
|
se of maoi
|
postural hypotension
hepatic complications antiach se sedation sex dysfunction |
|
worse ad w/ lowering of seizure threshold
|
bupropion
|
|
less potent ssri w/ sedative properties
|
trazodone
|
|
ae of trazodone
|
priapism
drowsiness orthostasis |
|
se of mirtazapine
|
sympathetic
wieght gain sedation dizziness |
|
bupropion ci in
|
seizure disorders
eating disorders (these can lower seizure threshold) |
|
ae of buproprion
|
n/v
consipation dry mouth ha nervousness dermatological rx little sex dysfunction |
|
which med has little sex dysfunction
|
bupropion
|
|
when does buspirone have little efficacy
|
w/ recent bdz use
|
|
which meds will have a low abuse potential over a long time
|
long t1/2
chlordiazepoxide clonazepam clorazepate diazepam |
|
which meds will have a high level of risk over a long time
|
xanax
has Intermediate t1/2 and metabolites leaves quickly |
|
which meds will high level of risk over a short time
|
short t1/2
lorazepam oxazepam |
|
is there a need to taper if switching w/in class
|
no
|
|
fluoxetine is a --- inhibitor
|
cyp 2d inhibitor
don't give w/ tamoxifen |
|
bdz have interactions w/ cyp---
|
3a4
|