)
a,
e.
Coges
b
i
v
e
b)
ndocai
n
e
a
v
d
met
a
bol
i
e
:
disease,
i
d
i
a
m.
henst
tulue
Medi
c
al
d'
s
enses
as5oci
a
t
e
d
i
t
R
Anxi
e
ky
o)
cardi
o
vas
uda
g
:
prgi
n
a
axhyt
m
i
a
s,
Prtbohics.
Quindlees
Art
i
c
epversant
s
:
Sel
e
chve
zercorin
zeuptaka
i
n
l
i
b
i
t
o
s
An
Cov
ulsarts
:
Caxbomazepine
anni
l
y
hi
s
ky
e
anicl
vd
depreion.
Indvidua)
wi
t
h
sorial
tssuas
ar
d
those
oi
t
h
a
thore
COmmon
n
Womon.
spdemielegy
ilneses
avd
are
endl
phiddgicad
anei
u
scl
delilithirg
sehelagical
(
c
a
oi
n
y
or
foal
i
g
of
t
a
cat
)
fhvet
y
c
o
n
pr
o
duco
weonort
a
hl
a
ardpot
e
rt
i
a
l
l
y
Ani
e
l
y
ig
an
onohi
o
nal
tate
Conmoal
e
y
Causcd
hy
ushi
n
gs
t
a
t
devel
e
p
betre
nsi
e
h,
disodes
au
a
guoup
eh
heteagncnut
Bsy cliat discnses associoted wik aniehy
Can be a
qoiexad major pychiabse ilhea.
Dag idacad Anxiy
Ahity
sstonten) ilatig daug
Ahwcs cccuss duig
duig
diwcal Maui<estation:
Fox Gereuoliad Anihy tsoreea:.
Pychoicel ord Cognitie yplons
Excesive anxiehy
Woies that are
dificalt toconhrol
Poor Conentation:
distunharees, lsuitabily
Impai zmert :
in a dose-derendot
Restlesness, Tatigue,Muscla. tension,
Secia), Occupational.
o Ponic Atfack
Feoz ef dying
fen ofgoingcvazy
Feoz of Losina Contro.
Falpitcios
Nauusea
Shothess of breatk
Sueating
tachyGeodia
Tapmiiog px stakina
sleer
Tenss
Cutinizsd byortieu
hun l'tated.
Sove feauad huchins
Use of pubictoileh
Taliewithshrgen
TaclyCaudbia
Tpernblirg
Sucating
eluslirg
Risk tato:
Gonpralizod,
.nnllora nfnharmacy
anviehy:
tamty membeas orth an
Ineeas in shess
Dag ahuse
Expobuz tophysical
1-Geremalizad anxiety disorde:
lraenlshe
Pewed aleast bonts
disorle
Oremoional awna.
es sed han an indiiduol
Ganiehy and wog tos a
Hocormaying the au'ehy wony tor 6months oit
3 0Y moYe
5follooing ymptonsteabig tense or
inani
c
h
y
Daric
vdes,
G,
e
D
are
GABA
Receptor
Modal:.
leods
fo
aniehy
in
t
h
e
pres
Cr
c
e.
of
poNcai
ve
d
thcat
ACcodi
n
g
to
t
h
e
novei
n
ephai
n
e
Gat
a
i
n
g
rovad-eragie
t
h
eony
LocLs
CoeLul
e
us
is
t
h
e
net
ß
e
Qreas
of
t
h
e
bah.
prinany
Sydem
f
o
r
ani
o
us
påhanks
is
hepeensi
t
i
e
.
Thi
s
mocl
o
sugest
s
t
h
at
he
aut
o
nomi
e
neuos
brun
stern
Lot
u
s
(oeuleus
wfi
c
h
i
o
s
l
o
Cnt
ed
tn
t
h
a
Novadhosqi
c
Mo
d
e
l
:
Geneal
Pai
e
attacks
MÉ
o
n
at
i
n
di
v
i
d
ual
epouer
t
es
pent
e
el
u
n
o
p
B
p
o
h
e
n
d
ig
di
a
g
ne
s
e
e
l
wt
h
a
to
l
a
st
s
no
ha
n
0
nuns
A
Ta
n
i
c
aHack
usual
l
y
peaks
l
o
g
oi
t
f
a
pni
e
di
s
ord
TSD.
ucseTI
O
potenhial
zol
e
has
baon
plicahng
Th
e
vol
e
cf
GoBn-b
erzniaxpine
acapiv
Covpl
e
x
disorders
ha
s
n
o
t
bcon
ully
choactoai
le Ga> Aoducad termçoral lobe benzodzapie
elucoel
Ce obsexved
TsD,(otical benediozepine e epkor
ln bANIC, docxcased GDBA bindirg
Argignie agnts haurigthe piopaty alteirg
the bindig f benzodiazepincs to tegamna
ocid z0coploy
Jleadsto
newe cell excitabilty
extorin ysiam
5-HTisinvolved in the
isnedl
anxiety disovdes-
* As abnomalzgathios ohsexotorin xelooue
ard zugtaka Crabroymal 1esporsvenes
arnino
to s-HT
* Arggdalo i xole includles dekechina
emotions
Cocordinating andmointing tetl
*-the anugdala integrates ingmako
tom atiple geron
thacats witf Corsideration of input cgaela
he Context Paes ertira stimulus, Onxa a theat
hasbaen detect ed y the Cunygdala el aapi d
Aesperse t loodinated,
aTeasto acass
on
Tacatrent:.
fhamacological tronhart
O sonsalizad anxiey
fisl ine: Venlatoae
Poaoxefine
Escitalp
Second line,Benxodiazcpie ,inipvonsdy
Panic dlsordl er:
Secondlirelprozolam,citalopau
*ooialanxichy disoede
tist line Panorohina
sexhaline
Secondline Citalopn
Esoalopan
clorozapam
Benxodiaxepine ~heoH
Most
Giencalizad anxiet disoder
slrazla Phasaco kineht
Timeto peak plasma ledlCh) 1-ak
Fliminction ball ie lQ-15ha.
Metabolie pothoa is oxidahn,
Protein bining
80
Ve
40
MO
M
P
So
DYeUsines, csedation, teion, Contion
piapam:.
phamacokinehe:
o5-&h.
Ada:
Mo9:
Eiminahion haly eig ao-coh.
Metabolie path
Gongrti-depeansdg
Venttaxine
tirve topeak plasa leuel ie
pisoventation,depexion.
cHneuvonal 4gna transduchionpathwas
tothe
neuotru%mitte
Busiprne
Adz:
Antidepvesants moddates 30capbor artivch'on
MOA:
Nausen,somnolere,cytout.
ts DKadah'on
Protial agpnist:
H
is a nn-benzodiazasihe ahxiouhe that lacks
OnhiConvelsant,wuscla elcxant, hypnctie
H
exent itsanxiolyh'eetbect teugh
dizziness, ausea
Sorial Anxiehy isoder
Ben~adio zene,
Connert ed
hendache
tis reoted wit% selecthve perotonin
Neuptake inibito. MOnoaninÍ 0xidaseinhibito
Bblocken.
rap
sign
ear
r
n
ing
to
el
ns
)
sSRT
S
block
he
take
t
h
e
electve
gerotorun
Reuptak
e
-)Monoamine
oxocdase
inhibitors:
phenolxi
ne
-Naocil-Isg.
8e0
t
o
r
Diazzpom
clonazepam
DTncycic
antidaesante
-02S
-0S-)
Alpraxolam
-0smg
Fox
ehne
Escitalarm
taloprom
-
(Omg
5mg
es
olective
kerotoni'
n
aeuptake
inhibtos
Daugs
Usad
in
t
h
e
treaterd
o
Pani
c
disoes
Qannes,
visty
norepiephire
MOB:
Theu
inhibit
t
h
e
aeuptake
4he
bi
g
oe
Ada:
av'
c
hy,
lrornia,
j
teurcsa
Anbidepesort
theo
Thicylie
outidepasats
&houl
d
be
uscdin
poiond
w
i
t
h
ShD
ist
ire
vonbnad
a
clomipaminc
-sg
ne
bSmg
Cognt
i
v
e
Behaut
o
oal
heany
EA
ercises
Me
d
t
a
h
'
o
n
Pe
s
c
i
p
hi
o
n
Shmul
o
nt
i
r
c
l
a
udi
n
g
cat
e
i
n
e
,
c
rgs
f
abuze
a
r
d
n
o
n
Su
b
st
e
unces
Ra
t
Ca
n
rocipitat
e
pani
e
attacka,
Patient
shoul
d
N
o
n
be
cclucaf
ed
to
auoi
d
Phamacdagjial
rcot
m
ent
Insomnia,
isxeessible
i
n
aci
vat
i
o
n.
oxidasetnhibitors-
l
e
dech
Umov
,
Nauscn,
V
ormhi
n
g
20
Assignment
apalayE
Mo
n
o
Q
mu
n
a

Anxiety disorder.pdf