1. Copyright © 2008 Lippincott Williams & Wilkins. Introductory Clinical Pharmacology Chapter 22 Antianxiety Drugs

2. Copyright © 2008 Lippincott Williams & Wilkins. Introduction to Antianxiety Drugs Antianxiety drugs or anxiolytics –Long-term use of benzodiazepines can result in physical dependence or psychological addiction –Nonbenzodiazapines: Useful antianxiety drugs

3. Copyright © 2008 Lippincott Williams & Wilkins. Medications to Recognize: Antianxiety Drug Benzodiazepines – alprozolam (Xanax) – chlordiazepozide (Librium) – clonazepam (Klonopin) – diazepam (Valium) – lorazepam (Ativan) Non-benzodiazapines – buspirone (Buspar) – doxepin (Sinequan) – hydroxyzine (Atarax,Vistaril)

4. Copyright © 2008 Lippincott Williams & Wilkins. Antianxiety Drugs: Uses Anxiety disorders, panic attacks Preanesthetic sedatives, muscle relaxants Alcohol withdrawal

5. Copyright © 2008 Lippincott Williams & Wilkins. Antianxiety Drugs: Adverse Reactions Early reactions: Mild drowsiness or sedation, lightheadedness or dizziness, headache Other adverse body system reactions –Lethargy, apathy, fatigue –Disorientation –Nausea, constipation or diarrhea, dry mouth –Visual disturbances

6. Copyright © 2008 Lippincott Williams & Wilkins. Antianxiety Drugs: Dependence Long-term use results in physical drug dependence and tolerance Withdrawal symptoms may occur with as few as 4-6 weeks of therapy with benzodiazapine Nursing alert –Symptoms of benzodiazepine withdrawal: Increased anxiety, concentration difficulties, tremor and sensory disturbances

7. Copyright © 2008 Lippincott Williams & Wilkins. Antianxiety Drugs: Interactions Interactant DrugEffect of Interaction with Penicillin AlcoholIncreased risk for central nervous system (CNS) depression or convulsions AnalgesicsIncreased risk for CNS depression Tricyclic antidepressants, antipsychotics Increased risk for sedation and respiratory depression DigoxinIncreased risk for digitalis toxicity

8. Copyright © 2008 Lippincott Williams & Wilkins. Nursing Process: Assessment Preadministration assessment –Nurse obtains medical history, mental status, anxiety level before initiating therapy –Physical assessment, physiologic manifestations of anxiety –Mental status and anxiety level

9. Copyright © 2008 Lippincott Williams & Wilkins. Nursing Process: Implementation Evaluation –Therapeutic effect achieved –Patient reports decrease in feelings of anxiety –Adverse reactions: Identified, reported to health care provider –Verbalize importance of complying with prescribed therapeutic regimen

10. Copyright © 2008 Lippincott Williams & Wilkins. End of Presentation