Pharm II Exan 2 (Chapter 35 - Management of Anxiety Disorders)

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Generalized anxiety disorder

characteristics
Uncontrolled worrying that last 6 months or long er
Generalized anxiety disorder

treatment (nondrug)
Supportive therapy
cognitive behavioral therapy
biofeedback
relaxation training
Generalized anxiety disorder

drug therapy
Benzodiazapines (first drug choice)
-alprazolam
-lorazepam
buspirone (BuSpar)
Buspirore (BuSpar)
Generalized anxiert disorder medicaiton
non CNS depresant
does not cause sedation
has no abuse potential
does not intensify the effects of CNS depressants
major disadvantage - ANIOLYTIC EFFECTS develop slowly
pharmocokinetics
- well absorbed followng oral administration
Buspirone (BuSpar)

adverse effects
Dizziness
nausea
headache
nervousness
lightheadedness
excitement
Buspirone (BuSpar)

drug and food interactions
Erythromycin and ketoconazole
greape fruit juice
Buspirone (BuSpar)

tolerance, dependence and abuse
No withdrawal symptoms have been observed
Buspirone (BuSpar)

preparations, dosage, administration
Tablets - intial dosage is 5,h 3x/day
may increase yp with a maximum of 60mg/day
Antidepressants

- only these are approved for GAD
Venlafaxine (effexor XR)
duloxetine (cymbalta)
paroxetine (paxil)
---short and long term
escitalopram (lexapro)
Characteristics of Panic disorder
Palpitations, pounding heart, racing heartbeat
chest pain or discomfort
senstaiton of shortness of breath
feeling of choking
dizziness, lightheadedness
nausea or abdominal discomfort
derealization or deprersonalizaiton
fear of losing control
fear of dying
tingling or numbness in the hands
flush or chills
can lead to AGORAPHOBIA
Panic disorder

treatment (antidepressants)
Selective serotonin reuptake inhibitors
trycyclic antidepressants
monoamne oxidase inhibitors
Panic disorer

treatment (benzodiazepine)
Second like drugs for panic disorder due to risk of abuse and dependence
Panic disorder

treatment
Cognitive behavioral therapy (CBT)
drug therapy
---- should last a least 6-9 months
Obsessive compulsive disorder

characteristics
Potentially disabling condition
persistent obessions
--recureent, persisstsnt thought/impulsive/image
compulstions - ritualized behavior
Obsessive compulsive disorder

treatment
Behavioral therapy
drug therapy
--- SSRIs