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Tx modalities
- individual psychotherapy
- cognitive therapy
- behavior therapy
- - systematic desensitization
- - implosion/flooding
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cognitive behavorial therapy
- belief that pt make errors in thinking that lead to mistaken negative beliefs about oneself and others
- process of cognitive restructuring
- pt identifies automatic negative beliefs causing anxiety
- explores the basis for these thoughts
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cog/behav therapy 2
- reevaluates the situation realistically
- replaces negative self talk with supportive ideas
- short term- therapy
- requires active participation of the pt and therapist
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systematic desensititization
behavioral therapy for phobias
- gradual intro to feared object or experience
- series of steps with graduated exposre
- uses relaxation techniques at each step to reduce anxiety
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tx modalities
exposure, flooding
- relaxation and breathing technique
- exposure./flooding
- - exposure to feared object/situation
- - does not involve relaxation
- - pt controls the amt of time exposed 1-2 hrs
- eventually stimulating event losses it effect
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psychopharm
- antianxiety agents (anxiolytics)- can help w/anxiety for short term, are addictive and do not chx the cause of the anxiety
- substance abuse pts not good canidates
- withdrawal symptoms- convulsion, delirium, pyschosis, incr anxiety- slowly taper off4
- xanax ativan- do not take with grapefruit juice- can cause toxicity- takes away intrinsic factor
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major meds for anxiety, ocd, and other related
- benzo- sedative hypnotic anxiolytics, diazepam, (valium)
- atypical anxiolytic/nonbarbituate anxiolytics, Busirone (buspar- not addictive takes longer to work)
- selected antidepressants- paroxetine (paxil) and setraline (zoloft), SSRI
- SNRI serotonin- norephine reuptake inhibitors venlafaxine (effexor)- dec anxiety
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more meds for disorders
- antidepressants (TCA) tricyclic antidepressants, amitriptyline (elavil) and clomipramine (anafranil)
- antihistamine- hydroxyzine pamoate (visteral) and hydrozine hydrochloride (atarax)
- beta blocker- propranolol (inderal)
- anti-convulsants- gabapentin (neurotin)
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other meds of anxiety
- beta blocker- inderal
- used to tx hypertension, cardiac conditions, found to be helpful in certain anxiety disorders, especially social phobia and performance anxiety
- when you know a situation is coming up like boarding a plan. take po to help heart from pounding, hands shaking, and other physical symptoms
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panic GAD
- anxiolytics
- antidepressant
- antihyptension agent
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side effects of antianxiety meds
- drowiness, confusion, lethargy,
- tolerance: physical, psychological dependence (does not apply to buspirone)
- doesn't mean it can't cause harm to the body
- potentiates effects of other cns depressants
- orthostatic hypotension
- paradoxical excitement
- dry mouth, n/v
- blood dyscrasis
- 10-14 delay onset actuib0 buspirone
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phobia
- anxiolytics
- antidepressant
- antihtn
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hair pulling
alot psychotic
- chlorpromazine
- amitriptyline
- lithium carbonate
- SSRI and pimozide
- olanzapine
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serotonin syndrome
- averse effect from SSRI
- report symptoms immediately - look in ATI
- occurs from too much serotonin in brain
- usually begines 2-72 hours after initiation of medication or increase in dose
- resolves med discont
- life threaten
- - fever
- - agitated
- - confused
- - diaphoresis
- - coordination /tremors
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