The flashcards below were created by user cvillarreal on FreezingBlue Flashcards.

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

    symptoms can interfere w/ ADL, feeling jitters, acute pain
  2. Antianxiety drugs
    • 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
  3. adverse reaction
    • 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
  4. dependance
    • 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
  5. contraidications
    • 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
  6. herbal alert
    Kava- releive stress, anxiety, & tension, promote sleep, gives releif form menstrual discomfort, may cause liver damage, take occasionally
  7. alprazolam (Niravam)
    • use:
    • anxiety disorders, short-term relief of anxiety, panic attacks

    AR:Transient mild drowsiness,
    lightheadedness, headache, depression, constipation, diarrhea, dry mouth
  8. chlordiazepoxide (Librium)
    • use:
    • anxiety disorders, short-term relief of anxiety, acute alcohol withdrawal

    AR:Transient mild drowsiness, lightheadedness, headache, depression, constipation, diarrhea, dry mouth
  9. diazapam (valium)
    • 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
  10. lorazepam (ativan)
    safe 4 elders

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

    • AR:
    • Transient mild drowsiness, lightheadedness, headache, depression, constipation, diarrhea, dry mouth
  11. buspirone (BuSpar)
    • 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
  12. doxepin (Sinequan)
    • Use:
    • anxiety & depression

    • AR:
    • dizziness, drowsiness
  13. hydroxyzine (Atarax)(vistaril)
    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
  14. assessment
    • 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
  15. ongoing assessment
    • 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
  16. immplementaion
    • 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
  17. monitoring pt needs
    • 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
  18. flumazenil (remazicon)
    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
  19. teaching plan
    • 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
Card Set
ch 20
Show Answers