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NURS 572 Ch 35
Pharm Ch 35 Anxiety disorders like this frickin class!
Question | Answer |
---|---|
types of anxiety disorders with physical and psychological manifestations | GAD, panic attack, OCD, SAD, PTSD |
What 2 classes of drugs can be used for specific types of anxiety disorders | BNZ and SSRIs indicated for selective anxiety disorders |
Name 1 individual anxiolytic agents | buspirone |
Properties of BNZ that make them useful axiolytics | rapid action, tolerance develops to sedation, psychomotor slowing. HOWEVER long term dependence possible. Same SEs but less likely when used in lower doses |
very short acting BNZ axiolytic | alprazolam - oral |
intermediate acting BNZ anxiolytic | lorazepam - oral-IV-IM |
SSRIs have longer onset, but are useful with pts concomitant depression - name one approved by FDA for anxiety | Paroxetine - short acting |
paroxetine SSRI anxiolytic approved - SEs | HA, N, insomnia and weight gain all are compliance limiting |
buspirone class | individual agent, MOA unclear, does NOT bind GABA, may bind Ser, Dopa |
Does buspirone have CNS effects? | no, there is no sedation, interactions or cross tolerance with CNS drugs |
Does buspirone interact with BNZs | no, since it does not bind GABA there is no dependence potential, no cross tolerance |
what is the best indication for buspirone | due to several day onset, is best for chronic anxiety |
what is the advantage of buspirone | calms down without sleepiness. no tolerance develops |
buspirone metabolism | EXTENSIVE first pass effect, GRAPEFRUIT JUICE lowers first pass --> more drug in serum |
ADRs buspirone | well tolerated, HA, N, nervousness |
What atypical antidepressant indicated ONLY for GAD | venlafaxine (dose dependent HTN) |
does venlafaxine have A-1, H-1, muscarinic action | no, atypical antidepressants tend to block reuptak of 5HT - Nor - Dopa in varying combinations |
What TCA is indicated specifically for OCT ONLY | clomipramine whose MOA is at 5HT/Nor with blocking action at A-1, H-1 and muscarinic receptors |