Anxiety Disorders 7 Flashcards
Non-barbiturate anxiolytic/atypical anxiolytic Buspar/buspirone
Binds to serotonin and dopamine receptors. Abuse is less likely. Does not cause sedation. It is used for panic disorder, obsessive-compulsive disorder, social anxiety, PTSD.
Side effects include dizziness, nausea, headache, lightheadedness, agitation. Take with food.
Use cautiously in older adults and liver or renal dysfunction. Do not use with MAOI antidepressants or for 14 days after they are discontinued. It could cause a hypertensive crisis.
Avoid grapefruit juice.
May take weeks to notice the full effect. Dependence and withdrawal are not an issue.
Benzodiazepine/
sedative hypnotic anxiolytic
Valium/diazepam
Other medications include Xanax, Ativan, Librium, Clonopin. They enhance GABA in the central nervous system. Used for general anxiety disorder, seizures, insomnia, muscle spasms, alcohol withdrawal, anesthesia
Complications: CNS depression subtest sedation, ataxia. Notify Dr. don’t drive.
Anterograde amnesia difficulty remembering.
Acute oral toxicity which is drowsiness, lethargy, confusion, and can be treated with gastric lavage using activated charcoal or saline.
IV toxicity can cause respiratory depression, hypertension, cardiac arrest. Administer Romazicon to counteract and reverse side effects. Have resuscitation equipment available.
Can cause insomnia, excite Tatian, euphoria, anxiety, rage. Notify the doctor and stop medications. Withdrawal symptoms include anxiety, insomnia, diaphoresis, tremors, lightheadedness. Taper the dose off.
Contraindicated with sleep apnea or respiratory depression. Use with caution with substance abuse and liver disease. Administer with meals to decrease G.I. upset.
Selective serotonin reuptake inhibitors/SSRI antidepressants
Paroxetine
Other meds include Lexapro, Prozac, Luvox
Inhibit serotonin reuptake allowing more serotonin available. Produces CNS stimulation which can cause insomnia. Takes four weeks for therapeutic level. It is used for general anxiety disorder, panic disorder, obsessive-compulsive disorder, social anxiety, PTSD, depression
Side effects include nausea, diaphoresis, tremor, fatigue, drowsiness. These will go away with time.
Later side effects include sexual dysfunction, weight gain, G.I. bleeding, hyponatremia, Serotonin syndrome, bruxism.
Withdrawal syndrome includes nausea, sensory disturbances, anxiety, tremor, unease and should be tapered off.
Do not take with MAOIs or a TCA. Should avoid alcohol. Use with caution in liver and renal dysfunction, seizures disorder, or history of G.I. bleed. Minimize sleep disturbances by taking in the morning.
Serotonin syndrome
Agitation, confusion, disorientation, difficulty concentrating, anxiety, hallucinations, hyperreflexia, incoordination, tremors, fever, diaphoresis. Begins 2 - 72 hours after medication and resolves when discontinued.
Bruxism
Grinding and clenching teeth during sleep
Client may need to use a mouth guard, switch medications, or treat with low-dose buspirone.
