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Buspirone (Buspar)
Antianxiety agent
Action: binds to the serotonine and dopamine receptors in the brain, increases metabolism of norepinephrine
Side effects (most common): dizziness, drowsiness, excitement, fatigue, headache, insomnia, nervousness, weakness, blurred vision, nasal congestion, sore throat, tinnitus, chest pain, palpitations, tachycardia, nausea, rash, myalgia, incoordination, numbness, paresthesia, clamminess, sweating
Nursing Implications: Grapefruit juice will increase serum levels and effects of medication, assess anxiety levels before and throughout therapy
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Diazepam (Valium)
Adjunct in the management of anxiety and alcohol withdrawl symptoms, amnesiac
Action: depresses the CNS most likely by potentiating GABA
Side effects (most common): dizziness, drowsiness, lethargy
Nursing Implications: monitor vitals before and periodically throughout therapy, assess IV site as phlebitis and venous thrombosis may occur, dependancy may occur in prolonged therapy, assess anxiety levels before and during therapy, assess renal and hepatic and CBC functions periodically
Overdose: adjunct is Flumazenil
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Alprazolam (Xanax)
Treatment of GAD and panic disorder, used as an adjunct with acute mania and acute psychosis
Action: effects may be mediated by GABA
Common side effects: dizziness, drowsiness, lethargy
Nursing Implications: Grapefruit juice increases blood levels, smoking decreases effectiveness, assess anxiety level and mental status before administration, assess for fall risk, prolonged therapy at >4mg/day can lead to dependancy, monitor renal and hepatic functions and CBC periodically, may cause decreased hematocrit and neutropenia
Overdose: Flumazenil is the antidote
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