NUR 2310 PSYCH MEDS UPDATED 2022 | NUR 2310 Study Guide

NUR 2310 PSYCH MEDS UPDATED 2022 | NUR 2310 Study Guide. Benzodiazepine anxiolytics: [Controlled substance IV]  diazepam (Valium)  alprazolam (Xanax)  lorazepam (Ativan)  chlordiazepoxide (Librium)  oxazepam (Serax)  clonazepam (Klonopin)  clorazepate (Tranxene) IV Benzodiazepines are Diazepam and lorazepam For IV toxicity, administer flumazenil (Romazicon) to counteract sedation and reverse side effects Klonopin Wafer disintegrating tablet was discontinued in US. Action: enhances the inhibitory effects of gammaaminobutyric acid in the Central nervous system. Relief from anxiety occurs rapidly after administration. Therapeutic Uses: First-line treatment for generalized anxiety disorder and panic disorder  Quick onset of action  Potential for dependence  Ideally used short term, only until other medication or treatment reduces symptoms.  Important for nurse to monitor side effects  Avoid pregnancy because of risk of congenital anomalies  Do not breast feed  Avoid caffeine because it decreases desired effects of drug  Avoid alcohol and other antianxiety drugs because depressant effect would be potentiated.  Cessation after 3-4 months use may cause withdrawal symptoms: insomnia, irritability, nervousness, dry mouth, tremors, convulsions, and confusion.  Take medicine with or shortly after meal to reduce GI discomfort.  Do not discontinue abruptly  For oral toxicity, gastric lavage is used, followed by administration of activated charcoal or saline cathartics  After taking high doses of benzodiazepines, patient should be tapered off to avoid withdrawal effects  Sedation  Light-headedness  Ataxia  Decreased cognitive function  Paradoxical response: insomnia, excitation, euphoria, anxiety, rage Complications  CNS Depression  Anterograde amnesia - difficulty recalling events that occur after dosing  Acute toxicity - Oral toxicity symptoms are drowsiness, lethargy, confusion. IV toxicity symptoms are respiratory depression, severe hypotension, and cardiac arrest  Withdrawal response – anxiety, insomnia, diaphoresis, tremors, lightheadness, delirium, seizures  Cautions/Contraindications Caution in patients with  Substance abuse  Liver disease Contraindicated in patients with  Glaucoma  Sleep apnea  Respiratory depression Buspirone (BuSpar): Used for treatment of general anxiety disorder (GAD) Action: Binds to serotonin and dopamine receptors. Increases norepinephrine metabolism in brain. Therapeutic Uses: Panic disorder, OCD social anxiety disorder, generalized anxiety disorder OTHER MEDS USED FOR ANXIETY DO: BETA BLOCKERS: Propanolol CENTRALLY ACTING ALPHABLOCKERS: Prazosin ANICONVULSANTS: Gabapentin ANTIHISTAMINES: Nursing Interventions Side Effects  Alternative that does not cause dependence  Takes 2–4 weeks to reach full effect [ATI: 2-6 weeks for full effects] . During this period there is a very high rate of suicidality.  May be used for long-term treatment  Must be taken regularly at same time  Not recommended for nursing mothers  Do not use concurrently with erythromycin, ketoconazole; avoid drinking grapefruit juice.  Teach patient to avoid herbal preparations containing St. John’s Wort  Advise patient to take with food to avoid to prevent gastric irritation  Dizziness, drowsiness, excitement, fatigue, headache, insomnia, nervousness, weakness.  Blurred vision, nasal congestion, sore throat, tinnitus  Nausea, vomiting  Clamminess, sweating Complications/Precautions  Pregnancy category B risk  Not recommended in women who are breastfeeding  Use cautiously in older adults or patients with renal problems  Concurrent use with MA  OI, or for 14 days for after MAO has been discontinued, hypertensive crisis can occur.