Anxiety disorders in children and adolescents: clinical and related issues in pharmacological treatment

Children's fears

The purpose of this article is to provide nurses with a comprehensive literature review of children's fears and to offer interventions that help children cope with fear. Children's normal fear development and the importance of developmental considerations in the assessment, diagnosis, and treatment of fear are also explored. A preventive model based on the work of Robinson and colleagues highlights several approaches to assist children in dealing with fear. This model provides consultation and counseling strategies that the nurse may use to help children develop control, self-worth, and security. This model may also be used to explore areas of normative developmental fears.

Therapeutic drug monitoring of alprazolam in adolescents with asthma

Children and adolescents with severe asthma frequently experience anxiety or depression with anxiety, which can undermine their response to treatment. In addition, these patients often receive theophylline and a variety of adrenergic stimulants, which can exacerbate or worsen anxiety. Such children occasionally are candidates for treatment with anxiolytic therapy. There is a paucity of drug disposition data in adolescents for benzodiazepines, the most frequently used antianxiety drugs. The authors monitored the steady state alprazolam plasma concentration in six children with severe asthma who were administered standard doses of alprazolam. In one patient administered concurrent therapy with troleandomycin, a recognized cytochrome 3A4 inhibitor, alprazolam plasma concentration was markedly elevated. Overall, the disposition data of alprazolam was consistent with data previously reported in adults. Alprazolam appeared to be safe and effective for use in adolescents with asthma.