Drugs for Anxiety and Insomnia Ch.14

Prototype Drugs Antidepressants Benzodiazepines Escitalopram (Lexapro) Benzodiazepines Lorazepam (Ativan) Nonbensodiazepine, nonbarbiturate, CNS depressants Zolpidem (Ambien)

2 AREAS OF THE BRAIN AFFECTED Limbic System –middle of brain Emotional expression, learning, memory Recticular Activating System (RAS) Help focus attention on individual task Sleeping and wakefulness

Anxiety State of apprehension, tension, or uneasiness that stems from the anticipation of danger, the source of which is largely unknown or unrecognized

Anxiety Disorders Situational anxiety Generalized anxiety disorder (GAD) Panic disorder Phobias Social anxiety Obsessive-compulsive disorder Post-traumatic stress disorder

Short-term or behavioral insomnia attributed to stress Condition characterized by patient inability to fall asleep or remain asleep Short-term or behavioral insomnia attributed to stress Long-term insomnia often caused by depression, manic disorders, chronic pain Insomnia

Nonpharmacologic Therapies to Cope with Anxiety and Insomina No Medications: May Help To: Cognitive behavioral therapy Counseling Meditation Change the way one thinks Uncover root causes of anxiety

Other Classifications Sedatives –sedate or relax Hypnotics –induce sleep Sedative-hypnotic - Tranquilizer –calm, tranquil feeling

Classes of Medications Used to Treat Anxiety and Sleep Disorders Antidepressants frequently used to treat anxiety (SSRIs, MAOIs, TCAs) Benzodiazepines (LORAZEPAM) Barbiturates (LUMINAL) Nonbarbiturates/Nonbenzodiazepines (ZOLPIDEM)

Other Classes of Medications Used to Treat Anxiety Antidepressants Antiseizure Drugs for Emotional and Mood Disorders Antihypertensives Antidysryhthmics

Assessment Reason for drug Monitoring vital signs Cautions and contraindications Possible drug interactions

Planning Client will Experience therapeutic effects depending on drug Be free of adverse effects Demonstrate understanding of the drug’s activity Accurately describe drug side effects and precautions Demonstrate proper self-administration technique

Interventions and rationales Administration of drug Implementing Evaluating Interventions and rationales Administration of drug Observing for adverse effects Client education and discharge planning Effectiveness of drug therapy Evaluate the achievement of goals and expected outcomes

Prototype Drugs Escitalopram Oxalate (Lexapro) Lorazepam (Ativan) Zolpidem (Ambien)