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Psychiatric Meds.
Medications for Anxiety Disorders
Question | Answer |
---|---|
What are the Benzodiazepine Sedative Hypnotic Anxiolytics? | Diazepam (Valium); Alprazolam (Xanax); Lorazepam (Ativan); Chlordiazepoxide (Librium); Clorazepate (Tranxene); Oxazepam (Serax); and Clonazepam (Klonopin) |
What's the expected action time of benzodiazepine sedative hypnotic anxiolytics? | Relief from anxiety occurs rapidly following administration. |
What are the therapeutic uses for benzodiazepine sedative hypnotic anxiolytics? | GAD, PANIC DISORDER, seizure disorders, insomnia, muscle spasm, alcohol withdrawal, induction of anesthesia |
What are the side/adverse effects of benzodiazepine sedative hypnotic anxiolytics? | CNS depression, anterograde amnesia, acute toxicity, paradoxical response (insomnia, excitation, euphoria, anxiety, rage), and withdrawal symptoms |
What medication can be administered to counteract sedation and reverse the side effects of benzodiazepine sedative hypnotic anxiolytics? | Flumazenil (Romazicon) |
Contraindications of benzodiazepine sedative hypnotic anxiolytics | Contraindicated in clients with sleep apnea and/or respiratory depression. Use cautiously in clients who have liver disease and/or a history of substance abuse |
Interactions with benzodiazepine sedative hypnotic anxiolytics | CNS depressants: ETOH, barbiturates, opioids--can all cause respiratory depression |
What are the Atypical Anxiolytic/Nonbarbiturate Anxiolytics? | Buspirone (BuSpar) |
What's the expected action time of BuSpar? | It may take a week to notice first therapeutic effects, and several more weeks to reach full therapeutic effect. |
What are the therapeutic uses of BuSpar? | Panic disorder, OCD, social anxiety disorder, and PTSD |
What are the side/adverse effects of BuSpar? | CNS effects: dizziness, nausea, headache, light-headedness, agitation |
Contraindications of BuSpar | Use cautiously in older adults. Contraindicated for concurrent use with MAOI antidepressants, or for 14 days after MAOI's are discontinued. HYPERTENSIVE CRISIS MAY RESULT. |
Interactions with BuSpar | Erythromycin, ketoconazole, and grapefruit juice |
What are the SSRI's? | Paroxetine (Paxil); Sertraline (Zoloft); Escitalopram (Lexapro); Fluoxetine (Prozac); Fluvoxamine (Luvox); and Duloxetine (Cymbalta) |
What's the expected action time for SSRI's? | Takes about 4 weeks to produce therapeutic medication levels. SSRI's cause CNS stimulation. |
What are the therapeutic uses for SSRI's? | GAD, Panic Disorder, OCD, Social Anxiety Disorder, PTSD, Depressive Disorders |
What are the side/adverse effects of SSRI's? | Early adverse effects (nausea, diaphoresis, tremor, fatigue, drowsiness); Later adverse effects (sexual dysfunction, weight gain, headache) Weight gain GI bleeding Hyponatremia--obtain baseline serum sodium |
Side/adverse effects of SSRI's continued... | SEROTONIN SYNDROME: agitation, confusion, disorientation, difficulty concentrating, anxiety, hallucinations, hyperreflexia, fever, diaphoresis, incoordination, tremors (2-72 hours after start of treatment) |
Side/adverse effects of SSRI's continued... | Bruxism: grinding and clenching of teeth Withdrawal Syndrome: nausea, sensory disturbances, anxiety, tremor, malaise, unease |
Contraindications for SSRI's | Contraindicated in clients taking MAOIs Avoid alcohol Use cautiously in clients with liver and renal dysfunction, seizure disorders, or a history of GI bleeding |
Interactions with SSRI's | Concurrent use of MAOIs or tricyclic antidepressants can cause serotonin syndrome |
Nursing administration with SSRI's | Take the medication in the morning. Therapeutic effects may not be experienced for 1-3 weeks |