chapter 29: Anxiety & Depression Flashcards
1
Q
- Common mistakes practitioners make in treating anxiety disorders include:
- Switching medications after an 8- to 12-week trial
- Maximizing dosing of antianxiety medications
- Encouraging exercise and relaxation therapy before starting medication
- Thinking a partial response to medication is acceptable
A
- Thinking a partial response to medication is acceptable
2
Q
- An appropriate first-line drug to try for mild to moderate generalized anxiety disorder would be:
- Alprazolam (Xanax)
- Diazepam (Valium)
- Buspirone (Buspar)
- Amitriptyline (Elavil)
A
- Buspirone (Buspar)
3
Q
- An appropriate drug to initially treat panic disorder is:
- Alprazolam (Xanax)
- Diazepam (Valium)
- Buspirone (Buspar)
- Amitriptyline (Elavil)
A
- Diazepam (Valium)
4
Q
- Prior to starting antidepressants, patients should have laboratory testing to rule out:
- Hypothyroidism
- Anemia
- Diabetes mellitus
- Low estrogen levels
A
- Hypothyroidism
5
Q
- David is a 34-year-old patient who is starting on paroxetine (Paxil) for depression. David’s education regarding his medication would include:
- Paroxetine may cause intermittent diarrhea.
- He may experience sexual dysfunction beginning a month after he starts therapy.
- He may have constipation and he should increase fluids and fiber.
- Paroxetine has a long half-life so he may occasionally skip a dose.
A
- He may experience sexual dysfunction beginning a month after he starts therapy.
6
Q
- Jamison has been prescribed citalopram (Celexa) to treat his depression. Education regarding how quickly selective serotonin reuptake inhibitor (SSRI) antidepressants work would be:
- Appetite and concentration improve in the first 1 to 2 weeks.
- Sleep should improve almost immediately upon starting citalopram.
- Full response to the SSRI may take 2 to 4 months after he reaches the full therapeutic dose.
- His dysphoric mood will improve in 1 to 2 weeks.
A
- Appetite and concentration improve in the first 1 to 2 weeks.
7
Q
- An appropriate drug for the treatment of depression with anxiety would be:
- Alprazolam (Xanax)
- Escitalopram (Lexapro)
- Buspirone (Buspar)
- Amitriptyline (Elavil)
A
- Escitalopram (Lexapro)
8
Q
- An appropriate first-line drug for the treatment of depression with fatigue and low energy would be:
- Venlafaxine (Effexor)
- Escitalopram (Lexapro)
- Buspirone (Buspar)
- Amitriptyline (Elavil)
A
- Venlafaxine (Effexor)
9
Q
- The laboratory monitoring required when a patient is on a selective serotonin reuptake inhibitor is:
- Complete blood count every 3 to 4 months
- Therapeutic blood levels every 6 months after a steady state is achieved
- Blood glucose every 3 to 4 months
- There is no laboratory monitoring required
A
- There is no laboratory monitoring required
10
Q
- 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?
- Change dose to every other day dosing for a week
- Reduce dose by 50% for 3 to 4 days
- Reduce dose by 50% every other day
- Escitalopram (Lexapro) can be stopped abruptly due to its long half-life
A
- Reduce dose by 50% for 3 to 4 days
11
Q
- 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?
- They have become tolerant of the medication, which is characterized by the need for higher and higher doses.
- They are a drug seeker.
- They are suicidal.
- They only need additional counseling on lifestyle modification.
A
- They have become tolerant of the medication, which is characterized by the need for higher and higher doses.
12
Q
- What “onset of action” symptoms should be reviewed with patients who have been newly prescribed a selective serotonin reuptake inhibitor?
- They will have insomnia for a week.
- They can feel a bit of nausea, but this resolves in a week.
- They will have an “onset seizure” but this is considered normal.
- They will no longer dream.
A
- They can feel a bit of nausea, but this resolves in a week.
13
Q
- Which of the following should not be taken with a selective serotonin reuptake inhibitor?
- Aged blue cheese
- Grapefruit
- Alcohol
- Green leafy vegetables
A
- Alcohol
14
Q
- 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)?
- It has a shorter half-life and withdrawal syndrome has a faster onset without taper.
- It has the longest half-life and the withdrawal syndrome has a faster onset.
- It is quasi-addictive in the dopaminergic reward system.
- It is the most activating of SSRI medications and will cause the person to have sudden deep sadness.
A
- It has a shorter half-life and withdrawal syndrome has a faster onset without taper.
15
Q
- The patient shares with the provider that he is taking his Prozac at night before going to bed. What is the best response?
- This is a good idea because this class of medications generally makes people sleepy.
- Have you noticed that you are having more sleep issues since you started that?
- This a good way to remember to take your daily medications because it is near your toothbrush.
- This is a good plan because you can eat grapefruit if there is 8–12 hours difference in the time each are ingested.
A
- Have you noticed that you are having more sleep issues since you started that?