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Behavioral Pharm


Drugs that relieve anxiety are called what? Anxiolytics
At what dose would you use benzodiazapines and barbituates compared to use for sleep aid? lower dose
benzodiazapines exert what kind of dose dependent amnesic effects? anterograde amnesia
describe some anxiety disorders treated via anxiolytics generalized anxiety, social anxiety, acute procedural anxiety, panic attacks/disorders, phobias, OCD, PTSD
what is the first line drug class used for generalized anxiety disorder? SSRI
what is the second line drug class used for GAD? SNRI (equally as good as SSRIs but not available as genetic yet), tricyclic antidepressants, benzos, buspirone
describe the significance of Buspirone relieves anxiety without causing marked sedatin, hypnotic, or euphoric effects. takes one week to see effects (not for acute anxiety), may work by acting as a partial agonist of 5HT receptors, does not work on GABA, no anxiety rebount or withdrawal w/ D/C
what liver enzyme breaks down buspirone? CYP3A4
what are some adverse drug reactions ofr Buspirone? nonspecific chest pain, tachycardia, palpitations, dizziness, nervousness, tinnitis, GI distress, paresthesias, and dose dependent pupillary constriction. BP may be sig elev in patients taking MAOIs
what pregnancy category is Buspirone? B
what are the first line drug classes for GAD? SSRI,
what are the second line drug classes for GAD? MAOI's (not FDA approved), takes four to six weeks to exhibit effects, up to sixteen weeks for full effect
what is the first line drug class for non-generalized anxiety (ex: performance anxiety) first line: beta blockers, benzos. (effects seen within minutes, used "as needed"
what is the drug of choice class for acute procedural anxiety? benzos (used to induce anxiolysis and/or sedation), administered as IV prior to procedure
how do benzodiazepines work? increase frequency of the chloride channel opening the GABA-A receptors
what pharmacological agent can act as a GABA-mimetic? phenobarbital (at high doses)
what CV effects are seen with sedative hypnotics in patients with CV compromise? impaired cardiac function (hypovolemia, CHF, etc), normal doses cause CV depression (medullary vasomotor centers)
what respiratory problems do sedative hypnotics cause in patients with respiratory compromise? significant respiratory depression
CV and respiratory side effects with sedative hypnotics are more prominent when the drug is given via what? IV
on a graph of CNS increasing CNS effects (sedation, hypnosis, anesthesia, coma) vs. increasing dose, what does the barbituate curve look like? linearly increases, because the GABA channel stays open for longer periods of time, so it is difficult to stop it, and barbs cross the BBB faster
on a graph of CNS increasing CNS effects (sedation, hypnosis, anesthesia, coma) vs. increasing dose, what does the benzodiazepine curve look like? it plateaus
list some pros with using Benzodiazepines for anxiety rapid onset of action, relatively high therapeutic index, lower risk of drug interactions based on liver enzyme induction, minimal effects on CV or autonomic function
what are some cons with using benzodiazepines for anxiety? dependence, CNS depression and amnestic effects, additive depressive effects with other CNS depressants
what is the first line drug of choice class for panic attacks/disorders? SSRIs,second line: SNRIs, benzo(used more frequently with panic attacks because of long term effect, quick onset), tricyclic antidepressants
what is the first line treatment for phobias? cognitive behavioral therapy
what is the treatment choice for phobias if the stimulus cannot be avoided (ex: flying) benzodiazepines. short acting ones are preferred.
what is the drug of choice for phobias if the stimulus cannot be avoided long term (ex: if someone hates flying, and is a flight attendent for their job) SSRIs
what is the first line treatment class of choice for OCD? SSRI (all are approved except citalopram and escitalopram, tricyclic antidepressants, SNRIs are well tolerated but not FDA approved
what is the first line treatment for PTSD? SSRI, second line: SNRI, benzos rarely studied but used frequently to treat symptoms of anxiety and hyperarousal-not used in pts with substance abuse history, can be used in acute settings under appropriate care
what are examples of when benzodiazepines can be used first line? hypnotics, sleep aids, sedation, anti-anxiety, peri-operative state, suppress seizures, spasticity reduction, withdraw agents
a person gets nervous every tie he has to meet new people. he has a job in sales. what sales of medications would be appropriate? SSRIs
a person gets nervous every time he has to make a presentation at work. this happens at least four times a year. he stutters, sweats, and fears he will make a mistake in front of his colleagues, what class of medicaitons would be appropriate? beta blockers, benzodiazepines
Created by: aferdo01