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  1. Type of anxiety disorder
    • -Phobia
    • -Paanic
    • -Social
    • -OCD
    • -PTSD
    • -GAD
  2. What is the most prevalent pysch disorder
    • Anxiety
    •   lifetime prevalent rate is 14.6%
    •   young onset (chidhood-early adult)
    •   can hav somatic symptoms
    •   Can be debilitating
  3. What must be considered to distinguish  anxiety from a pathological anxiety
    Pathological anxiety;excessiveness, irrationality, and physiological and/or functional impairment  

    Nonpathological is a regulated adaptive behavior
  4. Which physiologocal systems has been associated with anxiety
    hypothalmic-pituitary-adrenal axis
  5. OCD, pain disorder, and phobia
    have been linked to genetic predisposition

    Look for Family Hx of anxiety disorders.
  6. PTSD and GAD
    Is tributed to enviormental influences

    • GAD=exposure in early childhood.
    • PTSD= a significant event
  7. S/S of anxiety
    • insomnia
    • chest pain or palpation
    • nausea/vomiting/diarrhea= GI distress
    • dyspnea
    • tremors
    • dizziness
    • myalgia
    • H/A
    • hyperhydrosis
    • dialted pupil
    • tachycardia/>BP
    • Cold/clammy
  8. Which medical condition can cause anxiety
    • PE
    • Hyperthyroidism
  9. Medication/drugs that can cause anxiety
    • Methylphenidate (ritalin), aderal
    • theophylline

    • Herbal
    •   Ephera

    • Social drugs
    •   Caffiene
    •   cocaine
    •   amphentamine
    •   nicotine

    Think of any drugs that are stimulus can cause anxiety

    20% of dx anxitey disorder abuse drug as attempt to self medicate.
  10. Prior to diagnosing anxiety disorder based on s/s
    Clinician must first r/o any and all possible pathological and pharmological causes before estabilshing this as the dx.

    • Must r/o hypoxia, hypoglycemia.
    • No drug causing condition (withdraw)
    • Do toxicology study
  11. Tretment of anxiety
    • Education
    • combination of medication and therapy is most effective.
    • -SRRI (first line)
    •    tritrated to high dose than in depression
    • -Benzodiazipine (concern of abuse)
    •    rapid response
    •    ideal with panic disorder with infrequent exposure
    •   -specfic phobia  and in desentizing therapy
    •   -use with SSRI at beggining of therapy for coverage while SSRI is being titrated. 
    • Buspirone
    •   -with SSRI if concern of benzo abuse or if needing to stop Ben and SSRI is inadequate
    •   -SSRI and Bus for GAD and social anxiety
    •   -slow acting (2-6 week) compared to Ben
    •  Pyschotherapy
    •    cog-behhavioral
  12. Name the benzodiazepone and duration
    • Alprazolam-xanax (short)
    • Chloridiazepoxide-Librum (long)
    • Clonazapam-Klonopin (long)
    • Diazepam-Valium (long)
    • Lorezapam-ativan(mid-duration)
    • Oxazepam-serax (short)
  13. Reason of failure of anxiety therapy
    • Failure to make diagnosis
    • Inadequate treatment
  14. Associated compliaction of anxiety disorder
    • OCD-ritual
    • Panic-agorapobia
    • PTSD-sleep distrubance=functional impairment
    • GAD-sleep distrubance=functional impairment
    • Social-isolation

    consider quality of life if anxiety is not regulated

    Anxiety are at risk for depression, sub abuse, and suicide
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2013-01-28 22:32:25

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