Anxiety Pharmaceutical Care Flashcards
What is General Anxiety Disorder (GAD)?
Disproportionate, persuasive, uncontrollable + widespread worry
What are other anxiety disorders?
Acute stress disorder
OCD
Panic disorder
PTSD
Social phobia
Specific phobias
What are complications if untreated?
QoL
Social + occupational functioning
Comorbidities
Suicidal ideation + attempts
What are the risk factors?
Family situations/duties
Lack of support
Problems with housing/finance
Medical conditions
How is it diagnosed?
International diagnostic criteria
Physical physiological + psychological symptoms
Risk factors
GAD-7
What is the 1st step after GAD is confirmed?
Assess severity
Ask about comorbid factors
Consider mental health history
Educate about GAD + treatment options
Active monitoring
What is the 2nd step after GAD is confirmed?
Low intensity psychological intervention: CBT
= individual guided self-help
= psychoeducational groups
What is the 3rd step after GAD is confirmed?
1st line SSRI - eg. Sertraline
Discuss adverse effects + withdrawal
Review every 2-4 weeks for 1st 3 months THEN every 3 months
What is the 4th step after GAD is confirmed?
Refer for specialist treatment
What is the most commonly prescribed SSRI?
Sertraline
Why is sertraline preferred?
Minimal drug interactions
Lack of ECG changes
Low risk of discontinuation symptoms
What are the adverse effects of SSRIs?
GI
CNS
Sexual dysfunction
Increased risk of bleeding
Increased risk of fractures
Hyponatraemia
Increased risk of suicide
What happens if the patient gets sexual dysfunction?
CHANGE medication
What are the SNRI licensed for GAD?
Duloxetine + Venlafaxine
When are SNRI contraindicated?
Patients with cardiac disorders + liver + renal impairment
