Ch 19 Meds For Anxiety Disorders Flashcards
What are uses for benzodiazepines
Generalized anxiety disorder and panic disorder
Seizures, insomnia, muscle spasm, alcohol withdrawal
Induction of anesthesia
Amnesic prior to surgery or procedures
What is anterograde amnesia
Difficulty recalling events that occur after dose
What are side effects of benzodiazepines
CNS depression such as sedation, light headedness,ataxia, decreased cognitive function
Anterograde amnesia
Paradoxical response
Withdrawal effects
What are the 2 benzodiazepines approved for IV use
Diazepam
Lorazepam
Diazepam is contraindicated in who
Ppl with sleep apnea, respiratory depression, and or glaucoma
Use cautiously in ppl who have liver disease and or a history of substance use disorder
How long are benzodiazepines recommended
For short term use due to risk for dependence
What drug class does buspirone ( Buspar) belong to
Atypical anxiolytics/ non barbituate anxiolytics
What are the therapuetic uses of atypical anxiolytics buspirone ( Buspar)
Panic disorder
OCD RELATED DISORDERS
Social anxiety disorder
PTSD
What are side effects of buspirone ( Buspar)
CNS effects such as dizziness, nausea, headache, light headedness, agitation
What is pt education regarding atypical anxiolytics such as buspirone ( Buspar)
This med does not interfere with activities, because it DOES NOT CAUSE SEDATION
What are contraindications of the atypical anxiolytic buspirone ( Buspar)
Pregnancy category B
Do not use if breastfeeding
Use cautiously in older adults as well as ppl who have liver and or renal dysfunction
MAOIs may cause hypertensive crisis
What are med/ food interactions of the atypical anxiolytic buspirone ( Buspar)
Erythromycin, ketonazole, St. John’s wort & Grapefruit juice may increase the effects of buspirone
What is nursing education regarding buspirone
Take with meals to avoid gastric irritation
It takes 3-6 weeks to reach therapuetic effect
Tolerance, dependence, and withdrawal manifestations are not a issue
Bruxism
Grinding and clenching of teeth during sleep
What are side effects of SSRIs
Sexual dysfunction Weight gain GI BLEEDING Hyponatremia with older adults Serotonin syndrome, Bruxism, withdrawal syndrome
Paroxetine is contraindicated in who
Concurrent use of MAOI or TCAs can cause serotonin syndrome
Alcohol
Use cautiously in bipolar disorder due to the risk for mania.
What is education for the SSRI paroxetine (Paxil)
Take with food
Take in am to minimize sleep disturbances
Take daily to establish therapeutic plasma levels.
May take up to 4 weeks to reach desired result.
What side effect is an indication of diazepam toxicity
Confusion is a potential indication of toxicity that should be reported to the provider
What symptoms are an indication of serotonin syndrome
Hallucinations Daiphoresis Agitation Fever Muscle tremors
What are the therapeutic uses of the SSRI paroxetine ( Paxil)
Generalized anxiety disorder Panic disorder OCD Social anxiety disorder Trauma and stressor related disorders ( PTSD) Depressive disorders
What is sertraline indicated for
Panic disorder
OCD
Social anxiety disorder
PTSD
What is escitalopram indicated for
GAD
OCD
What is fluoxetine indicated for
Panic disorder
GAD
What is fluvoxamine indicated for
OCD
Social anxiety disorder
What are the major meds to treat anxiety disorder
Benzodiazepines
Atypical anxiolytics such as buspirone ( Buspar)
SSRIs such as paroxetine ( Paxil) sertraline ( Zoloft)
SNRIs such as venlafaxine ( Effexor)
TCAs such as Amitriptyline and clomipramine
Antihistamines, beta blockers, anticonvulsants such as gabapentin
