Mental Health Antianxiety/anxiolytic Meds

Front 1

What is the first line treatment for anxiety disorders?

Back 1

SSRIs b/c they have less side effects and more rapid onset of actions

Front 2

What med is reserved for treatment-resistant conditions due to risk of hypertensive crisis?

Back 2

Monoamine oxidase inhibitors (MAOIs)

Front 3

What are the 3 main indications for benzodiazepines (BZs) an antiolytics and hypnotics?

Back 3

-Anxiety
-insomnia
-seizure disorder
*they may also be used for alcohol withdrawl

Front 4

What are the downsides of using BZs?

Back 4

- associated w/impaired psychomotor function, sedation, decreased cognitive function and ataxia.
-may cause depression
- lead to tolerance
- may lead to dependency

Front 5

When/how should BZs be used?

Back 5

- Short term bases to treat anxiety
- High potency BZs considered only due to to side effects or alternatives are unacceptable
- If the pt is unwilling to wait 4-6wk delay response of other antidepressants

Front 6

Which meds are used to treat panic disorders?

Back 6

Xanex
klonopin
ativan

Front 7

Which meds are used to treat Acute mania?

Back 7

klonopin
ativan

Front 8

Which meds are used for short-term hypnotic to induce sleep?

Back 8

Restoril
PeoSom
Dural
Ambien
Sonata

Front 9

Which meds are used to treat muscle spasms?

Back 9

Valium

Front 10

Which meds are used to treat seizure disorders?

Back 10

IV valium
Ativan
Klonopin

Front 11

Which meds are used to treat sedative withdrawl syndromw ?

Back 11

Valium
Librium

Front 12

Which meds are used for preoperative anesthesia?

Back 12

Midazolam (versed)

Front 13

When is klonopin used?

Back 13

Panic disorders
Acute mania
seizure disorders

Front 14

When is Ativan used?

Back 14

Panic disorders
Acute mania
seizure disorders

Front 15

When is valium used?

Back 15

Muscle spasms
Seizure disorders
sedative withdrawl syndrome

Front 16

What is the mechanism of action for BZs?

Back 16

Potentiates and intensify the action of GABA. GABA inhibits and/or reduces aggression, excitation and anxiety

Front 17

Where are BZs metabolized?

Back 17

In the liver; will need periodic liver studies.

Front 18

What are the long acting BZs, what is their half life and what is a nursing consideration pertaining to their metabolism?

Back 18

- Librium
- Transexene
- Valium
- Centrex
Half life is 4 days therefore that can be suddenly d/c WITHOUT causing withdrawl

Front 19

What are the short acting BZs, what is their half life and what is nursing consideration pertaining to their metabolism?

Back 19

-Xanax
-Adivan
- Serax
Rapid elimination therefore sudden d/c WILL cause withdrawl

Front 20

What are the side effects of BZs?

Back 20

2 most important
-Confusion
- Anterograde amnesia (unable to form new memories)

CNS side effects
-Psychomotor impairment, drowsiness
- Muscle weakness, ataxia, vertigo
- Older adults more susceptible to side effects
-Cognitive impairment, sedative effects
*Combined with other CNS depressants may cause resp depression
*NO alcohol; potentates sedation

Front 21

What should you teach a pt about BZs?

Back 21

-Do not increase dosage
- Causes reduced ability to work mechanical equipment
- Avoid caffeine and alcohol
- Avoid pregnancy & breast feeding
-Stopping usage after 3-4mo may cause withdrawl
- Take with food, avoid antacids (delays absorption)

Front 22

What are some contraindications for BZs?

Back 22

-Driving, being around machinery
- pregnancy
- substance abuse
- glaucoma
- alcohol or CNS depressant users

Front 23

What is a non-BZ used to treat anxiety and the advantages and disadvantages?

Back 23

Buspirone (BuSpar)
-does not cause sedation
- no abuse potential
- does not enhance CNS depression
- does not interact with other drugs except MAOIs and Haldol
-takes several weeks to become effective; cannot be used as a PRN

Front 24

What are indications for BuSpar?

Back 24

-Anxiety: general anxiety disorder (GAD) and/or anxiety accompanying depressive symptoms
- Augments response to antidepressants
- Treats OCD
Reduce aggression in pt w/brain damage

Front 25

What are the adverse affects of BuSpar?

Back 25

-dizziness, drowsiness, headache, excitability
- Nausea, dry mouth, diarrhea, constipation

Front 26

What classification/drugs are used to treat ADHD?

Back 26

Stimulants such as Methylphenidate (Ritalin, Concerta, Metadate-ER, Adderall, Dexadrine)

Front 27

What are the contraindications for stimulants?

Back 27

-glaucoma
-motor tics
-severe depression
-use cautiously in pt w/seizure disorders (lowers threshold)

Front 28

What are side effects of methylphenidate?

Back 28

-nervousness
- insomnia (give last dose before 6pm)
-Anorexia (take with food or after eating)
- Nausea
- increased/decreased HR & BP
- Tachycardia
-Use cautiously with other meds

Front 29

What are nursing considerations for pt on long-term methylphenidate?

Back 29

-long term problem is growth/weight suppression
- children must swallow pill whole; don't chew
- Store with cautio; high street value
- Avoid caffeine, chocolate and excessive sugar

Front 30

What are the cholinesterase inhibitors and the mechanism of action?

Back 30

-Aricept
- Reminyl
- Exelon
-Namenda
Prevents break down of ACh causing a delay in cognitive/functional decline in elderly pt w/AZ

Front 31

What phase of AZ will cholinesterase inhibitors work and for how long?

Back 31

Only works in the mild/moderate phase (except Namenda) and improvements peaks at 3 months will slow return to previous functioning in 9-12 months

Front 32

Which drug demonstrated effectiveness in pt with moderate to severe AZ?

Back 32

Namenda

Front 33

What are some side effects of Namenda?

Back 33

-hypertension
- pain
-headache
- constipation
-fatigue