Exam 2- Nsg 552 Wilkes University

Acute anxiety First line for acute panic may be short term benzo use. short acting benzos cause rebound anxiety and are the most abused Benzodiazepines Withdrawal can be dangerous, even deadly. Stopping abruptly is not advised. Symptoms of agitation, tension, irritability, and sz. may occur Previous Play Next Rewind 10 seconds Move forward 10 seconds Unmute 0:00 / 0:15 Full screen Brainpower Read More anxiety disorders psychological disorders characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety anxiety disorders treatment -non-activating antidepressants area good place to start. for this disorder first line treatment anxiety disorders SSRI- Fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil) TCAs often effective but with riskier SE may interfere with psychotherapy in TX of AD Benzodiazepines- short acting Alprazolam are most abusable Rapid onset BZD used for acute panic disorder BZD with long half- life (20-80 hours) Diazepam (avoid in elderly) BEERS criteria A list of medications that are generally considered inappropriate when given to elderly people BEERS criteria Identifies High Risk Meds to Generate Wide List of Meds That Should be Avoided The "Beers Criteria for Potentially Inappropriate Medication Use in Older Adults", commonly called the Beers List, are guidelines for healthcare professionals to help improve the safety of prescribing medications for older adults. concomitant with pharmacological tx in AD Psychotherapy First line for specific phobias like clowns, blood, animals Psychotherapy medications not all that helpful for specific phobias OCD treatment SSRI and CBT BZD in treatment of OCD Xanax, Valium, Klonipin Trauma and Dissociative Disorders Consider and treat and comorbid disorders as well Trauma and Dissociative Disorders first line pharmocology Antidepressants Psychotherapy are treatment of choice Dissociative disorders the degree of insight the patient has is crucial to the outcome of psychotherapy DID- Dissociative identity disorder may consider multi pronged approach to treatment but strongly linked to childhood trauma so treating underlying PTSD s/s is often helpful DID discourage use of BZD DID beta blockers and alpha blockers useful for reducing sympathetic nervous system activation Prazosin alpha 1 blocker helpful for nightmares and flashbacks anorexia nervosa An eating disorder characterized by an obstinate and willful refusal to eat, a distorted body image, and an intense fear of being fat Meds for anorexia Prozac Anafranil Pariactin Thorazine Zyprexa Used in anorexia nervosA atypical antipyschotics binge eating disorder significant binge-eating episodes, followed by distress, disgust, or guilt, but without the compensatory purging, fasting, or excessive exercise that marks bulimia nervosa treatment of binge eating disorder Antidepressants and other medication, cognitive behavioral and interpersonal therapy. psychosomatic goal reduce discomfort, improve depression, improve anxieties or obsessive thoughts SSRI indications Major depression, OCD, GAD, panic disorder, social anxiety disorder and premenstrual dysphoric disorder SSRI side effects BAD SSRI B - Body weight increase; A - Anxiety/Agitation; D - Dizziness; Dry mouth S - Serotonin syndrome; S - Stimulated CNS; R - Reproductive/Sexual dysfunction I - Insomnia; antidepressants used in eating disorders SSRIs (high doses), TCAs TCAs tricyclic antidepressants