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Questions and Answers
What are the major medications used to treat anxiety disorders?
What are the major medications used to treat anxiety disorders?
Benzodiazepines, Atypical anxiolytics, SSRI antidepressants
What is the select prototype medication under the Benzodiazepine classification?
What is the select prototype medication under the Benzodiazepine classification?
Alprazolam (Xanax)
What is the classification of the following medications: Diazepam (Valium), Lorazepam (Ativan), Clonazepam (Klonopin), Clorazepate (Tranxene), Oxazepam, Chlordiazepoxide (Librium)?
What is the classification of the following medications: Diazepam (Valium), Lorazepam (Ativan), Clonazepam (Klonopin), Clorazepate (Tranxene), Oxazepam, Chlordiazepoxide (Librium)?
Benzodiazepine (sedative hypnotic anxiolytic)
What enhances the inhibitory effects of gamma-aminobutyric acid in the CNS?
What enhances the inhibitory effects of gamma-aminobutyric acid in the CNS?
What are the therapeutic uses of Benzodiazepines?
What are the therapeutic uses of Benzodiazepines?
What are common adverse reactions to benzodiazepines?
What are common adverse reactions to benzodiazepines?
In which patients are benzodiazepines contraindicated?
In which patients are benzodiazepines contraindicated?
Benzodiazepines should be used short-term due to the risk for what?
Benzodiazepines should be used short-term due to the risk for what?
Benzodiazepines interact with other ________ and can cause respiratory depression.
Benzodiazepines interact with other ________ and can cause respiratory depression.
What should be avoided to prevent withdrawal manifestations of benzodiazepines?
What should be avoided to prevent withdrawal manifestations of benzodiazepines?
Benzodiazepines should be administered with _________ to prevent GI upset.
Benzodiazepines should be administered with _________ to prevent GI upset.
What is the select prototype medication under the atypical anxiolytic classification?
What is the select prototype medication under the atypical anxiolytic classification?
What is much less likely with buspirone than with other anxiolytics?
What is much less likely with buspirone than with other anxiolytics?
What can buspirone be used to treat?
What can buspirone be used to treat?
What are the common adverse reactions associated with buspirone?
What are the common adverse reactions associated with buspirone?
What is contraindicated in patients taking buspirone?
What is contraindicated in patients taking buspirone?
Use buspirone cautiously in elderly patients with what condition?
Use buspirone cautiously in elderly patients with what condition?
Buspirone cannot be taken concurrently with ________ due to the risk of hypertensive crisis.
Buspirone cannot be taken concurrently with ________ due to the risk of hypertensive crisis.
The effects of buspirone can take up to ________ week(s) to notice the first therapeutic effects.
The effects of buspirone can take up to ________ week(s) to notice the first therapeutic effects.
For full benefit, buspirone may take ______ to ______ weeks.
For full benefit, buspirone may take ______ to ______ weeks.
What is the select prototype medication under the SSRI classification?
What is the select prototype medication under the SSRI classification?
What classification do the following medications belong to: Sertraline (Zoloft), Escitalopram (Lexapro), Fluoxetine (Prozac), Fluvoxamine (Luvox)?
What classification do the following medications belong to: Sertraline (Zoloft), Escitalopram (Lexapro), Fluoxetine (Prozac), Fluvoxamine (Luvox)?
What selectively inhibits serotonin reuptake without affecting dopamine or norepinephrine?
What selectively inhibits serotonin reuptake without affecting dopamine or norepinephrine?
Paroxetine (Paxil) produces CNS depression which can lead to what?
Paroxetine (Paxil) produces CNS depression which can lead to what?
Paroxetine (Paxil) may take up to ____ weeks to produce therapeutic medication levels.
Paroxetine (Paxil) may take up to ____ weeks to produce therapeutic medication levels.
What is an SSRI antidepressant that can be used to treat GAD, panic disorder, OCD, social anxiety disorder, trauma/stress-related disorders, and depressive disorders?
What is an SSRI antidepressant that can be used to treat GAD, panic disorder, OCD, social anxiety disorder, trauma/stress-related disorders, and depressive disorders?
What is an SSRI that treats OCD, social anxiety disorder, and PTSD?
What is an SSRI that treats OCD, social anxiety disorder, and PTSD?
What is an SSRI that treats GAD and OCD?
What is an SSRI that treats GAD and OCD?
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Study Notes
Major Classifications of Anti-Anxiety Medications
- Benzodiazepines: Sedative hypnotic anxiolytics that enhance the effects of gamma-aminobutyric acid (GABA) in the central nervous system.
- Atypical anxiolytics: Non-barbiturate options, including buspirone.
- SSRI antidepressants: Selective serotonin reuptake inhibitors used to manage anxiety symptoms.
Prototype Medications
- Alprazolam (Xanax) represents the benzodiazepine classification.
- Buspirone is the prototype for atypical anxiolytics.
- Paroxetine (Paxil) is the representative SSRI for anxiety treatment.
Common Benzodiazepines
- Include:
- Diazepam (Valium)
- Lorazepam (Ativan)
- Clonazepam (Klonopin)
- Clorazepate (Tranxene)
- Oxazepam
- Chlordiazepoxide (Librium)
Therapeutic Uses of Benzodiazepines
- Effective for:
- Generalized anxiety disorder (GAD)
- Seizures
- Insomnia
- Muscle spasms
- Alcohol withdrawal
- Induction of anesthesia
- Amnesia prior to surgery
Adverse Reactions to Benzodiazepines
- May cause:
- CNS depression
- Anterograde amnesia
- Acute toxicity (oral or IV)
- Paradoxical response (opposite effect)
- Withdrawal symptoms upon discontinuation
Contraindications for Benzodiazepines
- Not recommended for patients who are:
- Pregnant
- Suffering from sleep apnea
- Experiencing respiratory depression
- Diagnosed with glaucoma
- Having liver or renal dysfunction
Use and Dependency Concerns with Benzodiazepines
- Short-term use is advised due to dependency risk.
- Abrupt discontinuation can lead to withdrawal; tapering is recommended over several weeks.
- Should be taken with meals or snacks to avoid gastrointestinal upset.
Atypical Anxiolytic Characteristics
- Buspirone is the atypical anxiolytic with lower dependency risk compared to benzodiazepines.
- It does not induce sedation or potentiate effects of other CNS depressants.
- Indicated for panics, social anxiety disorder, OCD, and PTSD.
Adverse Reactions to Buspirone
- Common side effects include:
- Dizziness
- Nausea
- Headaches (HA)
- Lightheadedness
- Agitation
Precautions with Buspirone
- Contraindicated during breastfeeding.
- Used with caution in elderly patients with renal or liver dysfunction.
- Should not be taken with MAOIs or within 14 days post-MAOI treatment to avoid hypertensive crisis.
Onset of Effect for Buspirone
- Therapeutic effects can be seen within one week, with full benefits realized after 3 to 6 weeks.
Characteristics of SSRIs
- Paroxetine (Paxil) is the primary SSRI for anxiety.
- SSRIs, like sertraline (Zoloft), escitalopram (Lexapro), and fluoxetine (Prozac), can treat a variety of anxiety disorders.
- Paroxetine selectively inhibits serotonin reuptake, allowing serotonin to remain in synaptic junctions while not affecting dopamine or norepinephrine uptake.
SSRIs and Side Effects
- Paroxetine may contribute to insomnia due to CNS depression.
- It has a long half-life and can take about four weeks to reach therapeutic levels.
- Other SSRIs provide effectiveness in treating GAD, panic disorder, OCD, and PTSD.
Summary of Related SSRIs
- Sertraline (Zoloft) treats OCD, social anxiety disorder, and PTSD.
- Escitalopram (Lexapro) is used for GAD and OCD.
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