Medication for Anxiety Disorders Diazepam (Valium) Sedative Hypnotic AnxiolyticBenzodiazepine Mechanism of Action This medication enhances the inhibitory effects of gamma aminobutyric acid (GABA) in the CNS. Therapeutic use Used for anxiety disorderspanic disorders, social phobia, OCD, PTSD Seizure disorders Insomnia Muscle spasms Alcohol withdrawal Induction of anesthesia Adverse effects CNS depression Ataxia Antergrade amnesiadifficulty recalling events that occur after dosing Paradoxical response insomnia, excitation, euphoria, anxiety, rage Withdrawal symptoms diaphoresis, tremors, light-headedness Acute toxicity/overdose o Oral toxicity oral toxicity (drowsiness, lethargy, confusion) o IV toxicity respiratory depression, stupor, coma Contraindications/ precautions Contraindicated in clients w/ sleep apnea and/or respiratory depression Use cautiously with pt with substance abuse and liver disease Med/ food interactionsCNS depressants—alcohol, barbiturates, opioids High risk of respiratory depression when two CNS depressants are use and concurrently
Therapeutic nursing interventions and client education Avoid abrupt discontinuation of tx Taper dose off over several wks Admin w/ meals Inform client about possible development of dependency during and after tx and notify primary care provider if sx occur Buspirone (BuSpar): Nonbarbiturate Mechanism of Action Exact mechanism unknown, but it does bind to serotonin and dopamine receptors. NO POTENTIAL FOR ABUSE and use of buspirone does not result in sedation or potentiate the effects of other CNS Depressants. Therapeutic uses Long-term management of anxiety disorders Tx of general anxiety disorder (GAD) Adverse Effects CNS effects dizziness, nausea, headache, lightheadness- agitation Contraindications/precautions Contraindicated for concurrent use with MAOI antidepressants or for 14 days after MAOIs are discontinued Hypertensive crisis may result Medication/Food interactions Increase in the effects of buspirone with concurrent use of erythromycin, ketoconazole, grapefruit Therapeutic nursing interventions and client education Take meds with meals to prevent GI upset Med effect may take up to a week to start
Should not be use for rapid result or a PRN basis Paroxetine (Paxil): Nonbarbitruate Anxiolytic—SSRI Mechanism of Action Inhibits serotonin reuptake, allowing more serotonin to stay at the junction of the neurons It does not block uptake of dopamine or norepinephrine Produces CNS excitation rather than sedation Has long effective half-life, about 4 weeks is necessary to produce therapeutic medication levels Therapeutic uses GAD Panic disorder OCD Social phobia PTSD Depressive disorder Adverse Effects Early symptomsnausea, diaphorsis, tremor, fatigue, drowsiness Later symptoms sexual dysfunction, weight gain, headache
You've reached the end of your free preview.
Want to read all 16 pages?
- Fall '14
- Selective serotonin reuptake inhibitor, Major depressive disorder, Antidepressant, Tricyclic antidepressant