Anxiety

Question 1

What are the symptoms of anxiety?

Answer 1

• Autonomic hyperactivity - Muscle tension
• Panic attacks - Exaggerated startle response
• Excessive worry

Hint: APE ME

Question 2

Name non-pharmaceutical differential diagnoses for anxiety (diseases/conditions).

Answer 2

Cardiac: Pulmonary:
- Angina - Asthma
- Arrhythmias - COPD
- MI - PE

• Anemias
• Hyperthyroidism
• Essential tremor
• Hypoglycemia
• Carcinoid syndrome

Question 3

Name pharmaceutical differential diagnoses for anxiety (drug-related).

Answer 3

• Drug withdrawal (benzo’s, ETOH) - Caffeine
• Cocaine - Pseudophedrine
• Theophylline - Benadryl
• TCA’s - Dopaminergics

Question 4

What is the first-line pharmacological management of anxiety?

Answer 4

SSRI’s

Question 5

What are alternative pharmacological treatments for anxiety (non-first-line)?

Answer 5

• SNRI’s:
  
  • venlafaxine
  • duloxetine
• Propanolol:
  
  • 10 mg - 40 mg qD or BID
• Buspirone (Buspar):
  
  • slow onset
• Benzodiazepines

Question 6

Which anti-anxiety drug class is on the BEERS list?

Answer 6

Benzodiazepines