pharm

feeling of apprehension, worry, or ineasiness that may or may not be based on reality

symptoms can interfere w/ ADL, feeling jitters, acute pain

• AKA anxiolytics
• TX of anxiety & short-term tx of anxiety symptoms
• they exert their tranquilizing effect by blocking certain neurotransmitters receptor sites

benzodiazepine- pt takin in long-tern can become physically & psychological dependent, excert effect by potentiating effect of GABA, an inhibitory transmiter

nonbenzodiazepine- non depentant , actions depend on drug

• Uses:
• anxiety disorders & panic attacks
• preanesthetic sedation & muscle relaxation
• convulsion or seizures
• alcohol withdrawal

• frequent early reaction:
• mild drowsiness or sedation
• lightheadedness or dizziness
• headache

• other body system reaction:
• lethargy, apathy, fatigue
• disorientation
• anger
• restlessness
• nausea, constipation/diarrhea, dry mouth
• visual disturbance

b/c they excrete slow risk 4 toxicity, so start w/ sm. dose

• withdrawal seen 4-6wk of therapy w/ benzodiazepine, & when drug taken for 3mon./more & d/c fast
• tapering- gradually decreasing drug
• onset of withdrawal w/i 1-10 days after d/c, & duration of withdrawal effects 5days-1mon.

S/S- increased anxiety, concentration difficulty, tremor, & sensory disturbance like paresthesias, photophobia, hyperinsomnia, & metallic taste, fatigue, headache, numbness in extremities, nausea, sweating, muscle tension & cramps, psychoses, hallucination, memory impairment, possible convulsion

• psychoses
• acute narrow angle glucoma
• when in coma, shock, & if v/s of a pt who is in alcoholic toxication

benzodiazepine- preg. & labor b/c of reports of floppy infant syndrome (sucking difficulties, lethargy, hypotonia) & lactating b/c baby can be lethargic & loss wt

• Precautions:
• elders
• pt impaired liver function
• impaired kidney function
• debilitation

• Inter:
• alcohol- increased risk 4 CNS drpression or convulsion
• analgesics- increased risk 4 CNS depression
• antidepression- increased risk 4 sedation & resp. depression
• antipsychotics- increased risk 4 sedation & resp. depression
• digoxin (cardiac)- increased risk 4 digitalis toxicity

Kava- releive stress, anxiety, & tension, promote sleep, gives releif form menstrual discomfort, may cause liver damage, take occasionally

• use:
• anxiety disorders, short-term relief of anxiety, panic attacks

AR:Transient mild drowsiness, lightheadedness, headache, depression, constipation, diarrhea, dry mouth

• use:
• anxiety disorders, short-term relief of anxiety, acute alcohol withdrawal

AR:Transient mild drowsiness, lightheadedness, headache, depression, constipation, diarrhea, dry mouth

• Use:
• anxiety disorders, shot-term relief of anxiety, acute alcohol withdrawal, anticonvulsant, preoperative muscle relaxant

AR:Transient mild drowsiness, lightheadedness, headache, depression, constipation, diarrhea, dry mouth

safe 4 elders

• uses:
• anxiety disorders, short-term relief of anxiety, preanesthetic

• AR:
• Transient mild drowsiness, lightheadedness, headache, depression, constipation, diarrhea, dry mouth

• action: acts on brain serotonin receptors
• safe 4 elders doesnt cause to much sedation so low risk 4 falls

• use:
• anxiety disorder, short term relief of anxiety

• AR:
• dizziness & drowsiness

• Use:
• anxiety & depression

• AR:
• dizziness, drowsiness

action: produce its antianxiety effect by acting on hypothalumus & brain stem reticular formation

• use:
• anxiety, tension from psychneurosis, pruritis, preanesthetic sedative

• AR:
• dry mouth, transitory, drowsiness, involuntary motor activity

• medical hx, either from pt. or family member b/c od level of anxiety
• mental status
• anxiety level
• observe pt behaviors indicating axiety(focus, restlessness, facial grimmaces, tense posture)
• physical assessment (B/P, pulse, resp. rate, wt), eveything increase w/ anxiety incliding muscle tension, may show cool pale skin
• hx of past drug/alcohol use

• check b/p before giving med, if systolic dropped 20mmg, withhold med & notify DR
• monitor pt mental status & anxiety level, improvement/worening
• compare before & after assessments

• monitor AR
• postural hypotension
• drowsiness
• dry mouth
• remember not good 4 long-term use, depedence/tolerance/withdrawal not seen when taken 1-2wks
• monitor signs of dependence like needing higher dose, or complaints of increased anxiety & agitation

• risk 4 injury b/c of dizziness, lightheadedness, ataxia), instuct pt to call 4 help when getting up
• check V/S frequetly
• assist w/ ADL
• tell pt that meds can reduces thier effect when taken reg.
• when given parental give IM (gluteus), monitor pt closely for 3hr, keep pt laying down for 30 min, elders & those w/ limited pulmonary reserves req. care b/c they could get apnea & cardiac arrest, resuscitative equip. should be available
• dry mouth & slower transit could lead to constipation, offer sips of water, increase fluids, hard candy or gum
• give med w/ meals if GI problems
• meals should be high in fiber, vegggies, 4 constipation
• identify ? leads 2 anxiety/panic attacks

anidote(antagonist) 4 benzodiazepine toxicity (sedation, resp. depression, coma) w/i 6-10min after IV admin.

• AR:
• agitation
• confusion
• seizures
• benzodiazepine withdrawal, reversed by giving benazodiazepine

• take rx as directed
• dont d/c med fast b/c of withdrawal symptoms
• dont take nonrx med unless directed
• inform dr, dentist, about taking meds
• no alcohol
• if dizziness occurs when changing position, rise slow, get help if needed
• if dryness of mouth, sips of water, hard candy, gum
• prevent constipation with hifh fiber foods, increasing fluids, exercise
• keeps all appt.
• report unusual changes or physical effects