NSG 552 WILKES UNIVERSITY EXAM 2 WITH
DETAILED SOLUTIONS
What effects does GABA lead to? - answer-
Potentiate effects of GABA (GABA is inhibitory and
lead to drowsiness, cognitive impairments,
dampening of fear and anxiety, impaired balance,
motor control, muscle tone, and coordination, and
anterograde amnesia
What is agoraphobia and how can it be treated? -
answer-intense fear of being in public pleases
where escape or obtaining help may be difficult
Treat with CBT and SSRI
What treatment is used for generalized anxiety
disorder - answer-First line - SSRI
Second line - Buspar (anxiolytic), SNRI
Can consider short term course of benzos or
augmentation with buspirone (Buspar)
SSRI - escitalopram (Lexapro), paroxetine (Paxil),
,SNRI - duloxetine (Cymbalta), venlafaxine (Effexor)
What is used to treat panic attacks? - answer-
initially use benzos short term
What is used to treat panic disorder? - answer-First
line- SSRI, SRNA
Second line- TCAs, though limited use
Adjunct - benzo with caution, short-term until
SSRIs reach therapeutic efficacy
Alprazolam (Xanax) is FDA approved
SSRI - Fluoxetine (Prozac), Paxil (paroxetine),
Zoloft (sertraline),
SNRI - Effexor (venlafaxine)
TCA - clomipramine (Anafranil), imipramine
(Tofranil)
What is social phobia and how is it treated? -
answer-fear of scrutiny by others or fear of acting
in humiliating or embarrassing way
CBT
,First line - SSRI or SNRI
Benzos can be used as scheduled or PRN
Beta blockers such as atenolol (50-100 mg) and
propranolol (20-40 mg) 1 hour before performance
or public speaking
What is used to great specific phobias? - answer-
CBT with exposure
SSRI - fluvoxamine (Luvox), Paxil (paroxetine),
Zoloft (sertraline),
SNRI - Effexor (venlafaxine)
What is obsessive compulsive disorder (OCD) and
how is it treated? - answer-obsessions and/or
compulsions that are time consuming, distressing,
and impairing
MEDS + CBT
Fist line- SSRI (often high doses of Zoloft
(sertraline). Prozac (Fluoxetine), Luvox - FDA
approved (fluvoxamine) 50-300 mg
2nd line - SNRI Effexor (venlafaxine)
, TCA Anafranil (clomipramine) FDA approved
Can augment with atypical antipsychotic in severe
cases
ECT in debilitating resistant cases
What is a common side effect of SSRI Luvox
(fluvoxamine)? - answer-nausea and vomiting
What are commonly prescribed benzodiazepines? -
answer-Alprazolam (Xanax) and lorazepam (Ativan)
Who is at greater risk of fall risk and hip fracture on
benzodiazepines? - answer-Elderly patients
What is the mechanism of action for
benzodiazepines? - answer-enhance activity of
GABA at GABA-A receptors
Why are benzodiazepines not always the best
choice of medicatioon - answer-potential for abuse
and addition
DETAILED SOLUTIONS
What effects does GABA lead to? - answer-
Potentiate effects of GABA (GABA is inhibitory and
lead to drowsiness, cognitive impairments,
dampening of fear and anxiety, impaired balance,
motor control, muscle tone, and coordination, and
anterograde amnesia
What is agoraphobia and how can it be treated? -
answer-intense fear of being in public pleases
where escape or obtaining help may be difficult
Treat with CBT and SSRI
What treatment is used for generalized anxiety
disorder - answer-First line - SSRI
Second line - Buspar (anxiolytic), SNRI
Can consider short term course of benzos or
augmentation with buspirone (Buspar)
SSRI - escitalopram (Lexapro), paroxetine (Paxil),
,SNRI - duloxetine (Cymbalta), venlafaxine (Effexor)
What is used to treat panic attacks? - answer-
initially use benzos short term
What is used to treat panic disorder? - answer-First
line- SSRI, SRNA
Second line- TCAs, though limited use
Adjunct - benzo with caution, short-term until
SSRIs reach therapeutic efficacy
Alprazolam (Xanax) is FDA approved
SSRI - Fluoxetine (Prozac), Paxil (paroxetine),
Zoloft (sertraline),
SNRI - Effexor (venlafaxine)
TCA - clomipramine (Anafranil), imipramine
(Tofranil)
What is social phobia and how is it treated? -
answer-fear of scrutiny by others or fear of acting
in humiliating or embarrassing way
CBT
,First line - SSRI or SNRI
Benzos can be used as scheduled or PRN
Beta blockers such as atenolol (50-100 mg) and
propranolol (20-40 mg) 1 hour before performance
or public speaking
What is used to great specific phobias? - answer-
CBT with exposure
SSRI - fluvoxamine (Luvox), Paxil (paroxetine),
Zoloft (sertraline),
SNRI - Effexor (venlafaxine)
What is obsessive compulsive disorder (OCD) and
how is it treated? - answer-obsessions and/or
compulsions that are time consuming, distressing,
and impairing
MEDS + CBT
Fist line- SSRI (often high doses of Zoloft
(sertraline). Prozac (Fluoxetine), Luvox - FDA
approved (fluvoxamine) 50-300 mg
2nd line - SNRI Effexor (venlafaxine)
, TCA Anafranil (clomipramine) FDA approved
Can augment with atypical antipsychotic in severe
cases
ECT in debilitating resistant cases
What is a common side effect of SSRI Luvox
(fluvoxamine)? - answer-nausea and vomiting
What are commonly prescribed benzodiazepines? -
answer-Alprazolam (Xanax) and lorazepam (Ativan)
Who is at greater risk of fall risk and hip fracture on
benzodiazepines? - answer-Elderly patients
What is the mechanism of action for
benzodiazepines? - answer-enhance activity of
GABA at GABA-A receptors
Why are benzodiazepines not always the best
choice of medicatioon - answer-potential for abuse
and addition
