Antianxiety Medications and Patient Education

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Questions and Answers

A patient is struggling to manage their anxiety despite showing improved physical signs. They are unable to participate in group therapy and continue to experience persistent fears. What might this indicate about their anxiety?

  • The patient is not yet ready to address their anxiety.
  • The patient is likely exaggerating their symptoms.
  • The anxiety is not yet manageable. (correct)
  • The anxiety is no longer a significant concern.

Which of the following statements is true regarding psychological drug dependence?

  • It is easily controlled by influencing the patient's perceptions.
  • It is not considered a true addiction.
  • It is easier to treat than physiological dependence.
  • It requires medical intervention to treat. (correct)

A nurse is educating a patient and their significant other about antianxiety medication before discharge. What is the most important information to include in the teaching plan?

  • Provide all instructions verbally, with repetition as needed when requested by the patient.
  • Discuss, review, and validate the behavior monitoring system and intervention flow sheet that the patient and significant other will continue to use following discharge. (correct)
  • Instruct the patient to educate family members about the medication therapy, based on recollection of discussions with the nurse.
  • Discuss the possible dependence associated with the medication at length to make sure the patient does not overuse the drug.

When educating a patient about azaspirone antidepressant medication, what should the nurse caution the patient about?

<p>The possible interaction with other medications. (D)</p> Signup and view all the answers

Why should the nurse not emphasize dependence when educating a patient about antianxiety medications?

<p>It can be discouraging for the patient and undermine their motivation. (A)</p> Signup and view all the answers

What is the primary goal of the nurse's education about antianxiety medication?

<p>To empower the patient and their support system to manage anxiety effectively. (C)</p> Signup and view all the answers

Why is it important for family members or significant others to participate in discussions about antianxiety medication?

<p>To facilitate communication and support for the patient. (B)</p> Signup and view all the answers

A patient is being discharged on antianxiety medication. What should the nurse emphasize regarding written instructions?

<p>They are meant to be reviewed with the patient and their support system. (B)</p> Signup and view all the answers

Which of the following statements about benzodiazepines during pregnancy is true?

<p>Benzodiazepines may increase risk for birth defects. (D)</p> Signup and view all the answers

What should be monitored in infants if their mothers took benzodiazepines during pregnancy?

<p>Signs of withdrawal. (C)</p> Signup and view all the answers

In what condition is the measurement of blood glucose levels relevant in anxiety patients?

<p>Blood glucose levels are not relevant in anxiety evaluation. (A)</p> Signup and view all the answers

Which of the following statements about benzodiazepines and breastfeeding is accurate?

<p>Benzodiazepines may exert pharmacologic effects on breastfed infants. (D)</p> Signup and view all the answers

Which of the following best describes the administration of benzodiazepines during pregnancy?

<p>Benzodiazepines should typically be avoided during the first trimester. (D)</p> Signup and view all the answers

Which of the following substances may cause excessive sedation when taken with benzodiazepines?

<p>Both B and C (D)</p> Signup and view all the answers

What additional therapeutic effect does hydroxyzine provide besides relieving anxiety?

<p>Control of itching in allergic reactions (B)</p> Signup and view all the answers

Which assessment is necessary in the evaluation of a patient with anxiety?

<p>Psychological evaluation (B)</p> Signup and view all the answers

What is true about the use of benzodiazepines during pregnancy?

<p>They should not be administered in the first trimester. (B)</p> Signup and view all the answers

Which of the following is NOT a therapeutic outcome of hydroxyzine?

<p>Elimination of obsessive compulsive thoughts (A)</p> Signup and view all the answers

Which patient history is relevant during an anxiety evaluation?

<p>Substance abuse history (C)</p> Signup and view all the answers

Why should breastfeeding mothers be cautious about taking benzodiazepines?

<p>They can enter breast milk. (B)</p> Signup and view all the answers

Which of the following statements about the evaluation of anxiety is false?

<p>Blood glucose level should be assessed. (C)</p> Signup and view all the answers

Which adverse effects are most commonly associated with azaspirone therapy?

<p>Dizziness and nervousness (D)</p> Signup and view all the answers

Which patient demographic is expected to experience the fastest response to benzodiazepine therapy?

<p>A patient experiencing recent anxiety reactions (A)</p> Signup and view all the answers

What is a crucial instruction for a patient starting alprazolam (Xanax)?

<p>Expect potential dizziness upon standing. (A)</p> Signup and view all the answers

What key point should be included in education about buspirone (BuSpar)?

<p>It has minimal potential for abuse. (B)</p> Signup and view all the answers

How does smoking affect the dosage of benzodiazepines?

<p>It can enhance the effects requiring a larger dose. (A)</p> Signup and view all the answers

Why should azaspirones not be combined with alcohol or sedatives?

<p>They do not have CNS depression effects, but the combination remains risky. (A)</p> Signup and view all the answers

What are the characteristics of long-term anxiety treatment compared to benzodiazepines?

<p>Long-term anxiety often requires a different class of medications. (A)</p> Signup and view all the answers

What is the expected time before a patient notices signs of improvement while taking buspirone?

<p>Typically within 1-2 weeks (C)</p> Signup and view all the answers

Which of the following assessment(s) would be helpful in evaluating a patient with anxiety?

<p>History of precipitation stressors (A), Psychological evaluation (B), Medication history (C), Physical examination (D)</p> Signup and view all the answers

Which of these symptoms is NOT a sign of decreased anxiety in a patient with generalized anxiety disorder?

<p>Complaining of chest pain before group therapy (D)</p> Signup and view all the answers

Which of the following substances can potentiate the toxic effects of benzodiazepines?

<p>Alcohol (A), Hypnotics (D)</p> Signup and view all the answers

Which of the following is a therapeutic outcome associated with hydroxyzine (Vistaril) apart from its antianxiety effects?

<p>Control of itching in allergic reactions (C)</p> Signup and view all the answers

Which of the following would indicate a positive therapeutic outcome for a patient with generalized anxiety disorder receiving antianxiety medication and group therapy?

<p>The patient is able to engage in group therapy and experiences a decrease in somatic symptoms (B)</p> Signup and view all the answers

What is the primary goal of antianxiety medication in treating generalized anxiety disorder?

<p>To reduce anxiety to a manageable level (B)</p> Signup and view all the answers

Hydroxyzine (Vistaril) is used in pre-operative care to achieve which of the following effects?

<p>Reduce anxiety and the need for postoperative analgesia (B)</p> Signup and view all the answers

Which of the following is NOT a potential side effect associated with the use of benzodiazepines?

<p>Increased alertness and focus (B)</p> Signup and view all the answers

What is the recommended duration for gradually tapering antianxiety medications before discontinuation?

<p>1 month (D)</p> Signup and view all the answers

Which benzodiazepine is the preferred choice for managing anxiety associated with alcohol withdrawal?

<p>Oxazepam (Serax) (A)</p> Signup and view all the answers

Which medication is the first-line treatment for obsessive-compulsive disorder (OCD)?

<p>Fluvoxamine (Luvox) (B)</p> Signup and view all the answers

A patient reports that they experience heightened anxiety and excessive drinking during family reunions. This information suggests which of the following?

<p>The patient's anxiety is exacerbated by family gatherings. (C)</p> Signup and view all the answers

Which of the following statements about the benzodiazepine antianxiety agents is TRUE?

<p>They primarily work by reducing anxiety to a manageable level. (D)</p> Signup and view all the answers

Which of the following benzodiazepines is NOT considered ideal for treating anxiety associated with alcohol withdrawal due to the presence of active metabolites?

<p>Chlordiazepoxide (Librium) (B), Clorazepate (Tranxene) (D)</p> Signup and view all the answers

Which of the following assessment findings suggests that a patient's anxiety is NOT at a manageable level?

<p>Patient is unable to participate in group therapy conversations. (C)</p> Signup and view all the answers

Which of the following medications is LEAST likely to be effective in treating obsessive-compulsive disorder (OCD)?

<p>Hydroxyzine (Vistaril) (A), Lorazepam (Ativan) (B), Buspirone (BuSpar) (D)</p> Signup and view all the answers

Flashcards

Coping with Anxiety

Improving strategies to manage anxiety symptoms effectively.

Psychological Drug Dependence

Need for a substance due to psychological factors, often harder to treat.

Medical Intervention

Professional treatment is necessary for managing psychological drug dependence.

Patient Education on Medications

Essential guidance provided about medication usage and monitoring.

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Behavior Monitoring

A system for tracking patient's behaviors related to medication effects.

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Family Involvement

Engaging family members in discussions about a patient's treatment plan.

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Written Instructions

Documentation given to patients for reference after discharge.

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Azaspirone Antidepressant Caution

Warnings about possible side effects or risks associated with azaspirone medications.

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CNS Depression with Alcohol

Combining alcohol with CNS depressants can enhance drowsiness and dizziness.

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Common Adverse Effects of Azaspirones

Patients may experience dizziness, nervousness, drowsiness, and lightheadedness.

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Azaspirone Abuse Potential

Azaspirones have minimal potential for abuse or addiction.

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Benzodiazepine Effectiveness

Patients with recent anxiety reactions respond quickly to benzodiazepines.

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Long-term Anxiety Treatment

Long-term anxiety is better treated with SSRIs like Zoloft, not benzodiazepines.

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Important Instruction for Alprazolam

Patients should be warned about dizziness when rising to stand after taking alprazolam.

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Buspirone Abuse Potential

Buspirone has minimal abuse potential compared to other anxiety medications.

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Onset of Buspirone Effect

Signs of improvement with buspirone typically take longer than 3 days.

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Tapering Antianxiety Medications

Antianxiety medications should be gradually tapered over 1 month before discontinuation.

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Oxazepam in Alcohol Withdrawal

Oxazepam is the benzodiazepine of choice for anxiety during alcohol withdrawal.

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Fluvoxamine for OCD

Fluvoxamine is the drug of choice for treating obsessive compulsive disorder (OCD).

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Therapeutic Outcome for Alprazolam

After 1 week on alprazolam, patients should report decreased anxiety and improved functioning.

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Active Metabolites

Oxazepam and lorazepam have no active metabolites, making them safer for liver issues.

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Benzodiazepines Usage

Benzodiazepines are used to manage anxiety disorders effectively.

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Assessment Validating Therapy

A validating outcome for anxiety therapy is improved sleep and activity interest.

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Antihistamines

Medications that counteract allergic reactions and have sedative effects.

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Withdrawal Supervision

Withdrawal from antianxiety medications should always be supervised by a health care provider.

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Hydroxyzine Effects

Hydroxyzine reduces anxiety, controls itching, and prevents vomiting.

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Benzodiazepines Risks

Benzodiazepines can cross into breast milk and fetal circulation, posing risks.

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Evaluation of Anxiety

Assessment includes physical exam, psychological evaluation, and substance abuse history.

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Excessive Sedation Causes

Alcohol, antihistamines, and sedatives can cause increased sedation with benzodiazepines.

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Vitamins and Anxiety Meds

Vitamins do not impair psychomotor function when taken with benzodiazepines.

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Clinical Effects of Hydroxyzine

Hydroxyzine alleviates pre-surgery anxiety while minimizing the need for other sedatives.

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Benzodiazepine Transfer Risks

Benzodiazepines readily cross into fetal circulation and breast milk.

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Therapeutic Outcomes in Anxiety

Measures indicating improvement in anxiety management such as improved sleep and participation in therapy.

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Primary Expected Outcome of Anxiolytics

Decreased anxiety levels allowing for adequate rest, nourishment, and participation in therapy.

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Substances Increasing Benzodiazepine Toxicity

Alcohol, antihistamines, analgesics, sedatives, and hypnotics can amplify the effects of benzodiazepines.

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Effects of Hydroxyzine

Along with anxiety relief, hydroxyzine helps reduce the need for sedation and controls itching and vomiting.

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Assessment for Anxiety Evaluation

Evaluative approaches including physical examination, psychological evaluation, and history of stressors.

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Somatic Complaints in Anxiety

Physical symptoms, such as chest pain, that arise from emotional stress.

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Role of Antihistamines with Benzodiazepines

Antihistamines can enhance sedation effects when taken with benzodiazepines.

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Food and Mood

Improved appetite signifies decreased anxiety in patients.

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Benzodiazepine Risks in Pregnancy

Benzodiazepines may cause birth defects and withdrawal symptoms in infants.

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Benzodiazepine and Breast Milk

Benzodiazepines readily cross into breast milk, affecting infants.

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Fetal Circulation

Benzodiazepines can enter fetal circulation, impacting development.

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Anxiety Patient Evaluation

Evaluate anxiety patients through physical, psychological assessments, and histories.

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Withdrawal Symptoms in Infants

Infants exposed to benzodiazepines may show withdrawal signs after birth.

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Study Notes

Antianxiety Medication Withdrawal

  • Antianxiety medications should be tapered gradually under supervision.
  • A 1-week taper is insufficient; 1 month is recommended.
  • 6 months to 1 year is unnecessarily long.

Benzodiazepines for Alcohol Withdrawal

  • Oxazepam is the preferred benzodiazepine for treating anxiety associated with alcohol withdrawal.
  • Lorazepam is another suitable choice.
  • Chlordiazepoxide and clorazepate are not the first-line treatments for alcohol withdrawal anxiety.

Obsessive-Compulsive Disorder (OCD) Treatment

  • Fluvoxamine is the drug of choice for OCD.
  • It prolongs serotonin activity at nerve endings.
  • It's used to manage obsessions and compulsions.

Anxiety Disorder Outcome Assessment

  • A patient exhibiting manageable anxiety levels after 1 week of alprazolam therapy demonstrates a positive outcome.
  • Validating assessment findings include sleeping better, increased interest in activities, and not reporting persistent fear or excessive/inappropriate coping mechanisms

Psychological Drug Dependence

  • Psychological dependence requires medical intervention to treat.
  • It's often more challenging to overcome than physical dependence.
  • It is not an easy condition to control through influencing the patient's perceptions.

Patient Teaching for Anti-anxiety Medications

  • Include validated behavior monitoring and intervention flow sheets for the patient and significant other to continue post-discharge.
  • Educate about the possible risk of dependence associated with medication use.
  • Verbal instructions must include supplementary written instructions for the patient to refer to after discharge.

Azaspirone Antidepressant Cautions

  • Patients should be cautioned about the risk of dizziness, nervousness, drowsiness, and lightheadedness.
  • Azaspirones do not carry the risk of abuse or addiction.
  • Azaspirone should not be combined with alcohol or sedatives.

Benzodiazepine Therapy Response

  • Patients with recent anxiety reactions will likely respond best to benzodiazepines compared to those with long-term, chronic, or severe anxiety or co-morbidities such as depression or psychosis.

Lorazepam Route for Alcohol Withdrawal

  • Intramuscular administration is the preferable route of administration for lorazepam if the condition causes nausea, vomiting, or if the patient can not tolerate oral medications.

Generalized Anxiety Disorder Evaluation

  • Evaluating therapeutic effectiveness should assess factors such as improved sleep, decreased anxiety symptoms (tremors, pacing etc.), and increased involvement in group sessions to demonstrate positive therapeutic outcomes.

Benzodiazepine Side Effects

  • Possible side effects of benzodiazepine medication include dizziness, lightheadedness, and issues with hypotension on rising
  • Benzodiazepines may be affected by the use of other drugs such as antihistamines, other sedatives, analgesics, or hypnotics.
  • Smoking may necessitate dosage adjustments.

Substance Use Assessment in Anxiety Disorders

  • Comprehensive assessment must include physical examination, psychological evaluation, history of previous stressors, substance abuse history and medication history to create a complete patient history.

Benzodiazepines during Pregnancy and Lactation

  • Benzodiazepines should be avoided during the first trimester of pregnancy due to possible birth defects
  • They cross the placental barrier and enter fetal circulation.
  • Benzodiazepines should be used cautiously, if at all during lactation
  • Breastfed infants may show signs of withdrawal from exposure to the drug in the mother's breastmilk.
  • Infants whose mothers used the medications while pregnant require careful monitoring after delivery.

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