Term
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Definition
| fear or apprehension of something dreadful |
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Term
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Definition
when it interferes with normal life
when it interferes with part of another disease |
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Term
| physiological effects of anxiety |
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Definition
restlessness
tachycardia
tension
hypertension
sweating
dyspnea without identifiable cause
avoidance behavior
arousal
decrease in concentration |
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Term
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Definition
generalized anxiety disorder (GAD)
panic disorder
obsessive compulsive disorder (OCD)
social anxiety disorder or social phobia
post-traumatic stress disorder (PTSD)
social phobias
anxiety associated with other medical issues |
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Term
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Definition
drugs: cocaine, beta agonists, psychostimulants
diseases: CHF, COPD, diagnosis of terminal diseases
withdrawal: antidepressants, anxiolytics, drugs of abuse |
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Term
| norepinephrine in anxiety |
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Definition
| over firing of locus ceruleus |
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Term
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Definition
counteracts stimulatory effects of excess NE
GAD, panic |
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Term
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Definition
5HT1a receptors targeted in treatment
GAD, panic, OCD, social anxiety |
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Term
| corticotropin-releasing factor (CRF) and HPA axis |
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Definition
hyperregulation
suppression after treatment of PTSD |
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Term
| drug treatments for anxiety |
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Definition
benzodiazepines
buspirone (BuSpar)
antidepressants
beta blockers |
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Term
| norepinephrine in anxiety |
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Definition
over-firing in locus ceruleus
GAD, panic, PTSD, OCD, social anxiety |
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Term
| benzodiazepines (receptor, SE's, tolerance) |
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Definition
bind to the receptor on GABAa: increases Cl- influx, decreased neuronal firing
side effects: sedation, anterograde amnesia, confusion
tolerance: occurs with sedative and anticonvulsant effects, NOT seen with anxiolytic effects |
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Term
|
Definition
counteracts stimulatory effects of excess NE
GAD, panic |
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Term
|
Definition
5HT1a receptors targeted in treatment
GAD, panic, OCD, social anxiety |
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Term
| corticotropin-releasing factor (CRF) and HPA axis |
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Definition
hyperregulation
suppression after treatment in PTSD |
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Term
| anxiolytic benzodiazepines |
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Definition
alprazolam (Xanax)
Chlordiazepoxide (Librium(
clonazepam (klonopin)
diazepam (valium)
lorazepam (ativan)
oxazepam (serax) |
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Term
| considerations for benzodiazepines |
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Definition
pharmacokinetics:
short half-life: reach steady state faster, more likely to have rebound anxiety
long half-life: active metabolites, accumulation, drowsiness, amnesia
potential for dependence and/or abuse
short-term use preferred |
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Term
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Definition
partial agonist on brain 5HT1a receptors
moderate affinity for brain dopamine D2 receptors
longer onset of action than BZD
little abuse potential
Uses: GAD, social anxiety, or cormorbid depression; adjunct use with OCD, PTSD
not good for panic disorders |
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Term
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Definition
little or no sedation
no CNS depression
no muscle relaxation
little abuse, tolerance, or withdrawal |
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Term
| disadvantages of buspirone |
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Definition
slow onset: 1-2 weeks for onset, 2-3 weeks for full effect
not for severe anxiety
not for panic attacks
best in naive patients |
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Term
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Definition
1st line treatment for OCD and panic
other uses: social anxiety, PTSD, GAD
doses are usually higher than ones used for treatment of depression
panic disorders: start with very low doses, titrate doses up slowly
SE's: nausea, diarrhea, sweating, decreased libido, anorexia |
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Term
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Definition
fluoxetine (Prozac)
paroxetine (paxil)
sertraline (zoloft)
fluvoxamine (Luvox)--only FDA-approved for OCD
citalopram (Celexa)--unlabeled use for OCD
escitalopram (lexapro)--only FDA-approved for GAD |
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Term
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Definition
TCA
primarily inhibits serotonin reuptake
2nd line therapy for OCD
often used in combination with SSRIs
SE's: may be the same or slightly more severe than other TCAs |
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Term
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Definition
FDA-approved uses: GAD, social anxiety disorder, panic disorder
unlabeled/investigation use: OCD
drug interactions: CYP2D6 substrate
only SSRI up to 150mg/day
SNRI once 150mg/day exceeded
dosage range-75-300mg/day |
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Term
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Definition
FDA-approved use: GAD
drug interactions: CYP1A2 and CYP2D6 substrate/inhibitor
SNRI across all doses
dosage range-60-120mg/day |
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Term
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Definition
beta blocker
uses: social anxiety, PTSD-nightmares
CNS penetration-lipophilic
decreased peripheral symptoms of anxiety
monitor cardiovascular effects: HR, BP
SE's: hallucinations, vivid dreams, lethargy, impotence |
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Term
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Definition
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Term
| doxepin (Sinequan, discontinued) |
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Definition
TCA
unlabeled/investigational anxiolytic activity |
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Term
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Definition
alpha2 agonist
uses: panic attacks, anxiety associated with drug withdrawal |
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Term
| investigational anxiolytics |
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Definition
| serotonin receptor antagonists, GABA uptake blocker, partial benzodiazepine receptor agonists |
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