anxiety Flashcards
what is anxiety
- a very common disorder that can occur with everyday events
- an intense, excessive, and persistent worry and fear about everyday situations
- most ommon of the mental disorders
- a common emotion
name some different types of anxiety
- generalized anxiety disorder
- social anxiety disorder
- panic disorder
- obsessive compulsive disorder
describe the pathophysiology of anxiety
- exact cause is unknown
- environmental stressors
- possible imbalances among neurotransmitters (excess norepi or GABA)
- general medical conditions
what are the clinical manifestations of anxiety
physical: motor tension, muscle tension, restlessness, trembling, palpitations, tachycardia, seating, dry mouth
psychological: excessive worry, hypervigilance, racing thoughts, impaired concentration
behavioral: avoidance, obsessive or compulsive, distress in social situations
these differ slightly between the different disorders
what drugs are used for anxiety
- antidepressants
- benzos
describe antidepressants
- SSRIs and SNRIs
- first line treatment
- effective and safer
- 4-6 weeks for full effect
describe benzos
- immediate relief
- used for short term treatment of anxiety
- habit forming
- increase effects of neurotransmitters
give examples of benzodiazepines
diazepam
clonazepam, lorazepam, alprazolam, etc
describe the action of benzodiazepines
facilitating the binding of the inhibitory neurotransmitter GABA at various GABA receptors throughout the CNS
what are benzodiazepines used for
short term treatment for anxiety disorders
whats the IV onset of benzodiazepines
1-5 minutes
start with low dose and use caution in older adults
what are some adverse effects of benzodiazepines
- CNS depression
black box warning: resp failure if used in combo with opioid analgesics or other CNS depressants and risk for abuse and dependence
what are some contraindications of benzodiazepines
- resp compromise
- liver/kidney disease
- history of alcohol or other drug abuse
describe administration of benzodiazepines
- reversal agent: flumazenil
- PO can be given with/without food
- IV: undiluted and push slow (5mg/5min)
- pre/post assessment (based on route and onset)
- closely monitor resp status
what are some nursing implications of benzodiazepines
- use caution with combo of opioids and other CNS depressants (antidepressants, antpscyhotics, sedatives, antihistamines, alchol)
- use caution with long acting vs short acting oncet (maintenance vs breakthrough)
- utilize nonpharmacologic options (counseling)
- wean to oral medication
describe patient education for benzodiazepines
- take only as prescribed
- do not share drugs with others
- take with a glass of water and food if GI upset occurs
- do not stop abruptly
- do not crush or chew pills
- dispose of drug properly
- dont drive
a woman is receiving treatment for acute short term anxiety with some benzos. the nurse should teach which of the following?
- monitor serum glucose
- avoid alcohol
- take with food
- expect a delay in therapeutic effects of several weeks
- avoid alcohol
combining alcohol can lead to excessive drowsiness, difficulty breathing, and potentially serious adverse drug effects
flumazenil is the treatment of choice for patients who have which of the following conditions?
- severe agitation
- schizophrenia
- benzo OD
- opioid dependence
- benzo OD
flumazenil is a benzo antagonist that interacts with GABA receptors to reverse overdose
