Pharm Ch. 30 (5th ed) Anxiety and questions and answers.docx

  Common mistakes practitioners make in treating anxiety disorders include: 1.Switching medications after an 8-to 12-week trial 2.Maximizing dosing of antianxiety medications 3.Encouraging exercise and relaxation therapy before starting medication 4.Thinking a partial response to medication is acceptable - Correct Answers: 4.Thinking a partial response to medication is acceptable An appropriate first-line drug to try for mild to moderate generalized anxiety disorder would be: 1.Alprazolam (Xanax) 2.Diazepam (Valium) 3.Buspirone (Buspar) 4.Amitriptyline (Elavil) - Correct Answers: 3.Buspirone (Buspar) An appropriate drug to initially treat panic disorder is: 1.Alprazolam (Xanax) 2.Diazepam (Valium) 3.Buspirone (Buspar) 4.Amitriptyline (Elavil) - Correct Answers: 2.Diazepam (Valium) Prior to starting antidepressants, patients should have laboratory testing to ruleout: 1.Hypothyroidism 2.Anemia 3.Diabetes mellitus 4.Low estrogen levels - Correct Answers: 1.Hypothyroidism David is a 34-year-old patient who is starting on paroxetine (Paxil) for depression. David's education regarding his medication would include: 1.Paroxetine may cause intermittent diarrhea. 2.He may experience sexual dysfunction beginning a month after he starts therapy. 3.He may have constipation and he should increase fluids and fiber. 4.Paroxetine has a long half-life so he may occasionally skip a dose - Correct Answers: 2.He may experience sexual dysfunction beginning a month after he starts therapy. Jamison has been prescribed citalopram (Celexa) to treat his depression. Education regarding how quickly selective serotonin reuptake inhibitor (SSRI) antidepressants work would be: 1.Appetite and concentration improve in the first 1 to 2 weeks. 2.Sleep should improve almost immediately upon starting citalopram. 3.Full response to the SSRI may take 2 to 4 months after he reaches the fulltherapeutic dose. 4.His dysphoric mood will improve in 1 to 2 weeks - Correct Answers: 1.Appetite and concentration improve in the first 1 to 2 weeks. An appropriate drug for the treatment of depression with anxiety would be: 1.Alprazolam (Xanax) 2.Escitalopram (Lexapro) 3.Buspirone (Buspar) 4. Amitriptyline (Elavil) - Correct Answers: 2.Escitalopram (Lexapro) An appropriate first-line drug for the treatment of depression with fatigue and low energy would be: 1.Venlafaxine (Effexor) 2.Escitalopram (Lexapro) 3.Buspirone (Buspar) 4.Amitriptyline (Elavil) - Correct Answers: 1.Venlafaxine (Effexor) The laboratory monitoring required when a patient is on a selective serotonin reuptake inhibitoris: 1.Complete blood count every 3 to 4 months 2.Therapeutic blood levels every 6 months after a steady state is achieved 3.Blood glucose every 3 to 4 months 4.There is no laboratory monitoring required - Correct Answers: 4.There is no laboratory monitoring required Jaycee has been on escitalopram (Lexapro) for a year and is willing to try tapering off of the selective serotonin reuptake inhibitor. What is the initial dosage adjustment when starting a taper off antidepressants? 1.Change dose to every other day dosing for a week 2.Reduce dose by 50% for 3 to 4 days 3.Reduce dose by 50% every other day 4.Escitalopram (Lexapro) can be stopped abruptly due to its long half-life - Correct Answers: 2.Reduce dose by 50% for 3 to 4 days The longer-term Xanax patient comes in and states they need a higher dose of the medication. They deny any additional, new, or accelerating triggers of their anxiety. What is the probable reason? 1.They have become tolerant of the medication, which is characterized by the need for higher and higher doses. 2.They are a drug seeker. 3.They are suicidal. 4.They only need additional counseling on lifestyle modification - Correct Answers: 1.They have become tolerant of the medication, which is characterized by the need for higher and higher doses. What "onset of action" symptoms should be reviewed with patients who have been newly prescribed a selective serotonin reuptake inhibitor? 1.They will have insomnia for a week. 2.They can feel a bit of nausea, but this resolves in a week. 3.They will have an "onset seizure" but this is considered normal. 4.They will no longer dream - Correct Answers: 2.They can feel a bit of nausea, but this resolves in a week. Which of the following should not be taken with a selective serotonin reuptake inhibitor? 1.Aged blue cheese 2.Grapefruit 3.Alcohol 4.Green leafy vegetables - Correct Answers: 3.Alcohol Why is the consistency of taking paroxetine (Paxil) and never running out of medication more important than with most other selective serotonin reuptake inhibitors(SSRIs)? 1.It has a shorter half-life and withdrawal syndrome has a faster onset without taper. 2.It has the longest half-life and the withdrawal syndrome has a faster onset. 3.It is quasi-addictive in the dopaminergic reward system. 4.It is the most activating of SSRI medications and will cause the person to have sudden deep sadness - Correct Answers: 1.It has a shorter half-life and withdrawal syndrome has a faster onset without taper. The patient shares with the provider that he is taking his Prozac at night before going to bed. What is the best response? 1.This is a good idea because this class of medications generally makes people sleepy. 2.Have you noticed that you are having more sleep issues since you started that? 3.This a good way to remember to take your daily medications because it is near your toothbrush. 4.This is a good plan because you can eat grapefruit if there is 8-12 hours difference in the time each are ingested - Correct Answers: 2.Have you noticed that you are having more sleep issues since you started that?