anxiety- treatment

  1. Tx modalities
    • individual psychotherapy
    • cognitive therapy
    • behavior therapy
    • - systematic desensitization
    • - implosion/flooding
  2. 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
  3. 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
  4. 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
  5. 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
  6. 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
  7. 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
  8. 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)
  9. 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
  10. panic GAD
    • anxiolytics
    • antidepressant
    • antihyptension agent
  11. 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
  12. phobia
    • anxiolytics
    • antidepressant
    • antihtn
  13. OCD
  14. hair pulling
    alot psychotic
    • chlorpromazine
    • amitriptyline
    • lithium carbonate
    • SSRI and pimozide
    • olanzapine
  15. 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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anxiety- treatment
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