Week 1: Anti-anxiety Drugs: Anxiolytics Flashcards
Anti-anxiety drugs are used to treat what?
to treat anxiety and anxiety disorders, insomnia, obsessive-compulsive disorder (OCD), depression, posttraumatic stress disorder, and alcohol withdrawal
Different Classifications
- Benzodiazepines
- Non-benzodiazepines
What Classification of drugs are proved to be most effective in relieving anxiety and are most frequently prescribed?
benzodiazepines
-may be also prescribed for their anticonvulsant and muscle relaxant effects
Mechanism of Action of Benzodiazepines
mediate the actions of the amino acid GABA, the major inhibitory neurotransmitter in the brain (anti-anxiety reliefer in the brain)
- because GABA receptor channels selectively admit the anion chloride into neurons, activation of GABA receptors hyperpolarizes neurons and thus is inhibitory
- Benzodiazepines produce their effects by binding to a specific site on the GABA receptor
- depresses the CNS
Long Vs short Half-life
- drugs with a longer half life require less frequent dosing and produce fewer rebound effects between doses; but they can accumulate in the body and produce “next day sedation”
- drugs with a shorter half life do not accumulate in the body or cause next day sedation; but do have a rebound effect and require more frequent dosing
Examples of Anxiolytics: Benzodiazepines
- Alprazolam (Xanax)
- Lorazepam (Ativan)
- Chlordiazepoxide
- Clonazepam
- Diazepam (Valium)
- Clorazepate
- Oxazepam
Example of Non-benzodiazepines
Buspirone
Side Effects of Benzodiazepines
- tendency to cause physical dependence; clients fear the return of anxiety symptoms or believe they can not handle anxiety without the drug; lead to over use and abuse of the drug
- associated with CNS depression: drowsiness, sedation, poor coordination, and impaired memory or clouded sensorium
- when used for sleep, may complain of next day sedation or a hangover effect
- dizziness, clumsiness, sedation, headache, fatigue, sexual dysfunction, blurred vision, dry throat and mouth, constipation, high potential for abuse and dependence
Non-benzodiazepine; Buspirone side effects
dizziness, sedation, nausea, headache
-dizziness, restlessness, agitation, drowsiness, headache, weakness, nausea, vomiting, paradoxical excitement, or euphoria
Client education on the use of anti-anxiety medications
clients need to understand that anti-anxiety agents are aimed at relieving symptoms such as anxiety and insomnia but do not treat the underlying problems that cause the anxiety
Precautions with Benzodiazepines
- strongly potentiate the effects of alcohol; one drink while on a benzodiazepine may have the effect of 3 drinks; clients should not drink alcohol while on benzodiazepines
- clients should be aware of decreased response time, slower reflexes, and possible sedative effects of these drugs when attempting activities such as driving or going to work
- avoid other CNS depressants like antihistamines
Benzodiazepine withdrawal
can be fatal
-after starting a course of therapy with these drugs, he/she should never discontinue abruptly or without the supervision of the physician
Who can you not give a Benzodiazepine to?
someone with a history of addiction and drug abuse because Benzodiazepines are addicting
Nursing Implications for Benzodiazepines
- avoid other CNS depressants such as antihistamines and alcohol
- avoid caffeine
- take care with potentially hazardous activities, such as driving
- rise slowly from lying or sitting position
- use sugar-free beverages or hard candy for dry mouth
- drink adequate fluids
- take only as prescribed
- do not stop taking the drug abruptly
Nursing Implications for Non-benzodiazepines (Buspirone)
- rise slowly from sitting position
- take care with potentially hazardous activities such as driving
- take with food (nausea + vomiting)
- report persistent restlessness, agitation, excitement, or euphoria to physician
