pharmacological treatments. SSRIs, SNRIs, and benzodiazepines are the most commonly used medications for pharmacological treatment.
Pharmacists play a key role in managing pharmacological treatment of anxiety by recommending appropriate medications, reviewing for drug-drug interactions, and identifying potential causative agents which could be contributing to anxiety symptoms. • Muskin, P. R. (2021, June). What are anxiety disorders ? American Psychiatric Association. https://www. psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders • Osler, M., & Jørgensen, M. B. (2020, April 7). Associations of benzodiazepines, Z-drugs, and other anxiolytics with subsequent dementia in patients with affective disorders: A nationwide cohort and nested case-control study. The American Journal of Psychiatry . https://ajp.psychiatryonline.org/doi/10.1176/appi. ajp.2019.19030315 • Perna, G., Daccò, S., Menotti, R., & Caldirola, D. (2011, October). Antianxiety medications for the treatment of complex agoraphobia: pharmacological interventions for a behavioral condition. Neuropsychiatric Disease and Treatment. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3215519/ • Pharmacia & Upjohn Company LLC. (2021, March). Xanax (alprazolam) tablets, for oral use, CIV . AccessFDA. https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/018276s055lbl.pdf • Rose, G. M., & Tadi, P. (2021, September 29). Social anxiety disorder. StatPearls. https://www.ncbi.nlm.nih.gov/ books/NBK555890/ • Samra, C. K., & Abdijadid, S. (2021, May 15). Specific phobia. StatPearls. https://www.ncbi.nlm.nih.gov/books/ NBK499923/ • Sheffler, Z. M., & Abdijadid, S. (2021, November 14). Antidepressants. StatPearls. https://www.ncbi.nlm.nih. gov/books/NBK538182/ • Shin, J., Park, D.-H., Ryu, S.-H., Ha, J. H., Kim, S. M., & Jeon, H. J. (2020, July 24). Clinical implications of agoraphobia in patients with panic disorder . U.S. National Library of Medicine. https://www.ncbi.nlm.nih.gov/ pmc/articles/PMC7387026/ • Shrestha, P., Fariba, K. A., & Abdijadid, S. (2021, December 9). Paroxetine. StatPearls. https://www.ncbi.nlm. nih.gov/books/NBK526022/ • Simon, L. V., & Keenaghan, M. (2022, February 4). Serotonin syndrome. StatPearls. https://www.ncbi.nlm.nih. gov/books/NBK482377/ • Singh, D., & Saadabadi, A. (2021, October 14). Venlafaxine. StatPearls. https://www.ncbi.nlm.nih.gov/books/ NBK535363/ • Singh, H. K., & Saadabadi, A. (2022, February 21). Sertraline. StatPearls. https://www.ncbi.nlm.nih.gov/books/ NBK547689/ • U.S. Department of Health and Human Services. (n.d.). Any anxiety disorder . National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder • Vanderminden, J., & Esala, J. F. (2018, November 14). Beyond symptoms: Race and gender predict anxiety disorder diagnosis . Sage. https://journals.sagepub.com/doi/full/10.1177/2156869318811435 • Wilson, T. K., & Tripp, J. (2021, August 12). Buspirone. StatPearls . https://www.ncbi.nlm.nih.gov/books/ NBK531477/ • World Health Organization (WHO). (2017). Depression and other common mental disorders: Global Health Estimates . World Health Organization. https://apps.who.int/iris/handle/10665/254610
References • Ahwazi, H. H., & Abdijadid, S. (2021, November 14). Chlordiazepoxide. StatPearls. https://www.ncbi.nlm.nih. gov/books/NBK547659/ • Ameer, M. A., & Saadabadi, A. (2021, December 29). Neuroleptic medications. StatPearls. https://www.ncbi. nlm.nih.gov/books/NBK459150/ • Bridgeman, M. B., & Abazia, D. T. (2017, March). Medicinal cannabis: History, pharmacology, and implications for the acute care setting. P & T: A Peer-Reviewed Journal for Formulary Management. https://www.ncbi.nlm. nih.gov/pmc/articles/PMC5312634/ • Cackovic, C., Nazir, S., & Marwaha, R. (2022, February 7). Panic disorder. StatPearls. https://www.ncbi.nlm.nih. gov/books/NBK430973/ • Chu, A., & Wadhwa, R. (2022, January 11). Selective serotonin reuptake inhibitors. StatPearls. https://www. ncbi.nlm.nih.gov/books/NBK554406/ • Curtiss, J., Andrews, L., Davis, M., Smits, J., & Hofmann, S. G. (2017, February 1). A meta- analysis of pharmacotherapy for social anxiety disorder: An examination of efficacy, moderators, and mediators. Expert Opinion on Pharmacotherapy. https://www.tandfonline.com/doi/ abs/10.1080/14656566.2017.1285907?journalCode=ieop20 • Dhaliwal, J. S., Spurling, B. C., & Molla, M. (2021, June 11). Duloxetine. StatPearls. https://www.ncbi.nlm.nih. gov/books/NBK549806/ • Feriante, J., & Bernstein, B. (2021, July 26). Separation anxiety. StatPearls. https://www.ncbi.nlm.nih.gov/ books/NBK560793/ • Garakani, A., Murrough, J. W., Freire, R. C., Thom, R. P., Larkin, K., Buono, F. D., & Iosifescu, D. V. (2020, December 23). Pharmacotherapy of anxiety disorders: Current and emerging treatment options. Frontiers in Psychiatry. https://www.frontiersin.org/articles/10.3389/fpsyt.2020.595584/full • George, T. T., & Tripp, J. (2021, July 19). Alprazolam. StatPearls. https://www.ncbi.nlm.nih.gov/books/ NBK538165/ • Ghiasi, N., Bhansali, R. K., & Marwaha, R. (2022, February 7). Lorazepam. StatPearls. https://www.ncbi.nlm.nih. gov/books/NBK532890/ • Jilani, T. N., Gibbons, J. R., Faizy, R. M., & Saadabadi, A. (2021, August 9). Mirtazapine. StatPearls. https:// www.ncbi.nlm.nih.gov/books/NBK519059/ • Landy, K., Rosani, A., & Estevez, R. (2022, January 19). Escitalopram. StatPearls. https://www.ncbi.nlm.nih.gov/ books/NBK557734/ • Maan, J. S., Rosani, A., & Saadabadi, A. (2022, August 22). Desipramine . National Library of Medicine. https:// www.ncbi.nlm.nih.gov/books/NBK470581/ • Moraczewski, J., & Aedma, K. K. (2021, November 30). Tricyclic antidepressants. StatPearls . https://www.ncbi. nlm.nih.gov/books/NBK557791/ • Munir, S., & Takov, V. (2022, January 9). Generalized anxiety disorder. StatPearls . https://www.ncbi.nlm.nih.gov/ books/NBK441870/
THE PHARMACOLOGIC MANAGEMENT OF ANXIETY IN ADULTS Final Examination Questions Select the best answer for each question and mark your answers on the Final Examination Answer Sheet found on page 123, or complete your test online at EliteLearning.com/Book 86. Which of the following is not a known class adverse effect with selective serotonin reuptake inhibitors (SSRIs)? a. Sexual dysfunction. 91. A meta-analysis analyzing efficacy of different pharmacotherapies for treating social anxiety disorder (SAD) found the largest effect size for which of the following SSRIs? a. Citalopram. b. Escitalopram.
b. Weight changes. c. Blood dyscrasias. d. Headache. 87. What parameters should be monitored in patients prescribed alprazolam? a. Liver function tests (LFTs). b. Cardio-vascular & respiratory function. c. Signs of drug diversion, physical dependence, or misuse/abuse. d. All of the above. 88. In patients prescribed an SSRI who are experiencing sexual side effects, which of the following medications may be effective as an augmentation agent for decreasing SSRI- induced sexual dysfunction? a. Buspirone. b. Mirtazapine. 89. With persons with generalized anxiety disorder (GAD), excessive & persistent worry interferes with daily activities. This worry is often accompanied by which of the following constellation of symptoms? a. Cardiac symptoms, such as chest pain, palpitations, & hypotension. b. Renal symptoms, such as nocturia & urinary retention. c. Physical symptoms, including feeling on edge, fatigue, muscle tension. d. None of the above. 90. Which SSRI listed below is known to inhibit its own metabolism, increasing the likelihood for withdrawal symptoms with abrupt discontinuation? a. Paroxetine. b. Escitalopram. c. Citalopram. d. Sertraline. c. Cannabidiol (CBD). d. Chlordia-zepoxide.
c. Sertraline. d. Fluoxetine. 92. Which patient population is at highest risk for SSRI-induced syndrome of inappropriate antidiuretic hormone (SIADH)? a. Pediatric patients. b. Patients with chronic kidney disease (CKD). c. Geriatric patients. d. Patients with cardio-vascular disease. 93. Symptoms of serotonin syndrome can include: a. Diaphoresis. b. Muscle rigidity. c. Tachycardia. d. All of the above. 94. Which of the following medications is NOT considered a first-line treatment for generalized anxiety disorder?
a. Buspirone. b. Paroxetine. c. Venlafaxine. d. Clomi-pramine.
95. Which of the following medications has utility as an as- needed medication for social anxiety disorder (SAD) & does not carry risk for dependence or tolerance?
a. Propranolol. b. Alprazolam. c. Buspirone. d. Citalopram.
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