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Major Medications to tx anxiety-1. Benzodiazepine anxiolytics
2. Buspirone (BuSpar) 3. Antidepressants like Paxil–ssri, Elavil–
tca, Nardil–maoi, Effexor–snri 4. Others like antihistamines,
beta blockers, anticonvulsants.
Examples of benzodiazepines-Valium (diazepam), Xanax
(alprzolam), Ativan (lorazepam), Librium (chlordiazepoxide),
Serax (oxazepam), Klonopin (clonazepam)
Action of Valium– sedative hypnotic anxiolytic–
benzodiazepine-enhances effects of GABA in the CNS
Therapeutic uses of Valium– benzo-for 1. anxiety disorders,
social phobias, panic, compulsive, posttraumatic stress 2.
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,Seizures 3. Insomnia 4. Muscle spasm 5. Alcohol withdrawal
(for acute symptoms) 6. Induction of anesthesia
For IV toxicity of Valium-give flumazenil (Romazicon)
For oral toxicity of Valium-gastric lavage followed by charcoal
or saline cathartics.
s/e & intervention Valium – benzo-1. CNS depression–
sedation, light–headiness, ataxia, decreased cognitive
function 2. Anterograde amnesia (stop meds if report this
sym) 3. Paradoxical response=insomnia, excitation, euphoria,
anxiety, rage 4. Withdrawal symptoms= taper the dose over
weeks 5. Acute toxicity/OD= 1. oral toxicity, lethargy,
confusion 2. IV toxicity– respiratory depression, stupor, coma
Valium is contraindicated with…-pt with sleep apnea,
respiratory depression. Preg risk Cat D, schedule 1V, use
cautiously with pts with substance abuse, liver disease.
Food interactions with Valium–benzo-CNS depressants lke
alcohol, barbiturates, opiods= will have very high risk for
respiratory depression
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, Nursing interventions with Valium–benzo-1. Avoid disrupt DC
2. DC slowly over weeks 3. Give with meals 4. Do not chew
sustained released tabs 5. Inform pt about possible
development of dependency.
Buspirone (Buspar)= nonbarbiturate anxiolytic, action-
unknown, binds to serotonin and dopamine receptors. No risk
for abuse! No sedation, no potentiate effects of other CNS
depressants.
Buspar therapeutic use-1. long term management of anxiety 2.
Tx GAD
s/e buspar-CNS effects= dizziness, nausea, headache,
lightheadness, agitation. Does not interfere with activities
because it does not cause sedation!
Contraindications of Buspar-1.Do not use with MAOI or 14
days after MAOI DC= can cause hypertensive crisis. 2. Caution
with older adults with renal and liver dysfunction 3. Not for
nursing mothers
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