Pharm Final Exam Chapter 15: Antianxiety Medications

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Questions and Answers

What is a common adverse effect associated with azaspirone therapy?

  • Increased Appetite
  • Dizziness (correct)
  • Addiction
  • Nausea and Vomiting

Why is it recommended to avoid combining azaspirones with alcohol?

  • Alcohol can enhance the CNS depressant effects of azaspirones. (correct)
  • Alcohol can increase the risk of addiction to azaspirones.
  • Alcohol can cause a severe allergic reaction when combined with azaspirones.
  • Alcohol can decrease the effectiveness of azaspirones.

Which patient is most likely to benefit from benzodiazepine therapy for anxiety?

  • A patient experiencing auditory hallucinations.
  • A patient with severe depression.
  • A patient experiencing recent anxiety reactions. (correct)
  • A patient with a history of long-term anxiety.

What instruction is most important for a nurse to give a patient newly prescribed alprazolam (Xanax)?

<p>You may experience dizziness when standing up. (A)</p> Signup and view all the answers

What is a key characteristic of buspirone (BuSpar) regarding its potential for abuse?

<p>It has a low potential for abuse. (A)</p> Signup and view all the answers

When should a patient expect to see signs of improvement after starting buspirone?

<p>Within 2-3 weeks. (A)</p> Signup and view all the answers

What is a common side effect of benzodiazepines?

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

Why is smoking a concern for patients taking benzodiazepines?

<p>Smoking can increase the metabolism of benzodiazepines. (C)</p> Signup and view all the answers

What is the typical duration for safely tapering off antianxiety medications?

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

Which benzodiazepine is most commonly chosen for treating anxiety associated with alcohol withdrawal?

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

Which medication is the primary choice for treating obsessive-compulsive disorder (OCD)?

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

A patient reports experiencing increased anxiety and panic attacks after discontinuing their antianxiety medication. What is the likely reason for this?

<p>The patient did not taper off the medication gradually enough. (B)</p> Signup and view all the answers

Which of the following statements is TRUE about the use of benzodiazepines for anxiety?

<p>Benzodiazepines are often used as short-term solutions for anxiety and require monitoring for potential dependence. (C)</p> Signup and view all the answers

Which of the following assessment findings would indicate that a patient's anxiety level has improved after starting alprazolam (Xanax)?

<p>Patient reports feeling calmer and able to participate in everyday activities more easily. (D)</p> Signup and view all the answers

A patient being treated for panic disorder with alprazolam (Xanax) reports feeling drowsy and having difficulty concentrating. What would be the appropriate nursing action?

<p>Inform the healthcare provider about the patient's experience and potential need for dosage adjustment. (B)</p> Signup and view all the answers

Which medication is commonly used as a non-benzodiazepine option for managing anxiety disorders?

<p>Buspirone (BuSpar) (B)</p> Signup and view all the answers

A patient experiencing alcohol withdrawal is experiencing nausea and vomiting. Which route of administration is most appropriate for lorazepam in this situation?

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

Which of the following is a therapeutic outcome that can be observed in a patient with generalized anxiety disorder who is receiving anxiolytic medication and group therapy?

<p>The patient's tremors and pacing have decreased significantly. (B)</p> Signup and view all the answers

Which of the following medication is NOT an anxiolytic?

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

Which of the following statements about Buspirone is TRUE?

<p>Buspirone does not affect GABA receptors. (A)</p> Signup and view all the answers

Which of the following actions should be the priority when caring for a patient who is expressing suicidal thoughts?

<p>Ensure the patient's safety by implementing appropriate interventions. (A)</p> Signup and view all the answers

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

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

Which of the following is a potential side effect of benzodiazepine use?

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

Which of the following is true about therapeutic outcomes specific for a patient with Generalized Anxiety Disorder?

<p>The patient can sleep 5 hours a night, not exhibit tremors or pacing, and attend and actively participate in group sessions. (D)</p> Signup and view all the answers

What is a potential risk associated with benzodiazepine use during pregnancy?

<p>Increased risk of birth defects (C)</p> Signup and view all the answers

Which of the following is a reason why benzodiazepines are not recommended for breastfeeding mothers?

<p>Benzodiazepines can readily cross into breast milk and affect the infant. (B)</p> Signup and view all the answers

What is a common symptom of benzodiazepine withdrawal in newborns?

<p>Increased muscle tone (B)</p> Signup and view all the answers

Which statement about benzodiazepine use during pregnancy is TRUE?

<p>Benzodiazepine use is generally discouraged, especially in the first trimester. (A)</p> Signup and view all the answers

What is a key aspect of benzodiazepine pharmacokinetics during pregnancy?

<p>Benzodiazepines readily cross the placenta and enter fetal circulation. (D)</p> Signup and view all the answers

What are potential signs that an anti-anxiety therapy is working effectively for a patient with generalized anxiety disorder?

<p>All of the above. (D)</p> Signup and view all the answers

Which of the following substances can potentially increase the toxic effects of benzodiazepines?

<p>Analgesics (B), Antihistamines (C)</p> Signup and view all the answers

Which of the following is NOT a therapeutic outcome of hydroxyzine (Vistaril)?

<p>Prevention of extrapyramidal adverse effects and tardive dyskinesia (A)</p> Signup and view all the answers

What is a key assessment to include when evaluating a patient with anxiety?

<p>History of precipitation stressors (D)</p> Signup and view all the answers

Which of the following would NOT be considered a primary therapeutic outcome of antianxiety medication?

<p>Elimination of all symptoms of anxiety. (B)</p> Signup and view all the answers

Which of the following substances would be most likely to interact negatively with benzodiazepines?

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

Hydroxyzine (Vistaril) is primarily used for which of the following therapeutic purposes?

<p>Relief of anxiety, allergic reactions, and nausea (A)</p> Signup and view all the answers

Which of the following assessments would be LEAST relevant for a patient diagnosed with generalized anxiety disorder?

<p>Assessment of cognitive function (D)</p> Signup and view all the answers

What is the most important nursing action when a patient states, "I wish I were dead. I just want to kill myself."?

<p>Provide for patient safety. (C)</p> Signup and view all the answers

Which of the following is TRUE regarding psychological drug dependence?

<p>It is an irresistible craving for a drug, even if it is harmful. (C)</p> Signup and view all the answers

What is the MOST important instruction for a nurse to teach a patient who has recently been prescribed buspirone (BuSpar)?

<p>Avoid alcohol while taking this medication. (D)</p> Signup and view all the answers

Which of these is NOT a typical sign of benzodiazepine withdrawal in an infant?

<p>Increased appetite (D)</p> Signup and view all the answers

Which of these is the most appropriate route of administration for lorazepam in a patient experiencing nausea and vomiting due to alcohol withdrawal?

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

Which is the drug of choice to treat a patient with obsessive-compulsive disorder (OCD)?

<p>All of the above (D)</p> Signup and view all the answers

What is the typical outcome statement for a patient suffering from anxiety disorder?

<p>Patient will report decreased anxiety levels after 1 week of treatment. (B)</p> Signup and view all the answers

Flashcards

CNS Depression with Alcohol

Combining alcohol with CNS depressants may enhance drowsiness and dizziness.

Azaspirones Adverse Effects

Common side effects include dizziness, nervousness, and drowsiness, without addiction risk.

Anxiety Treatment Response

Recent anxiety reactions respond better to benzodiazepines than long-term anxiety.

Benzodiazepine Usage

Long-term anxiety is better treated by medications like Zoloft and Prozac, not benzodiazepines.

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Alprazolam (Xanax) Instruction

Patients should be warned about possible dizziness upon standing.

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Smoking and Benzodiazepines

Smoking increases the metabolism of benzodiazepines, potentially requiring higher doses.

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Buspirone (BuSpar) Potential for Abuse

Buspirone has minimal potential for abuse compared to other anxiolytics.

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Duration for Buspirone Effect

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

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Benzodiazepines in breastfeeding

Benzodiazepines can enter breast milk and affect infants.

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Withdrawal signs in infants

Infants may show withdrawal signs like hypotonia if benzodiazepines were used by the mother during pregnancy.

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Obsessive-Compulsive Disorder (OCD) treatment

SSRIs are often the first-line treatment for OCD.

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Buspirone (BuSpar) properties

Buspirone has minimal potential for abuse and may take longer than 3 days for effects.

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Suicidal thoughts patient care

Safety is the priority when caring for suicidal patients.

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Lorazepam administration in withdrawal

Lorazepam is best given intramuscularly for patients with nausea and vomiting from alcohol withdrawal.

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Psychological drug dependence

Psychological drug dependence is characterized by emotional and mental reliance on a drug.

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Buspirone onset of action

Buspirone shows signs of improvement typically after more than 3 days of use.

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Tapering antianxiety medications

Medications should be gradually reduced over 4 weeks before discontinuation.

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Oxazepam (Serax)

Preferred benzodiazepine for anxiety related to alcohol withdrawal.

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Fluvoxamine (Luvox)

First-line treatment for obsessive-compulsive disorder (OCD).

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Primary outcome of benzodiazepines

Expected to decrease anxiety to a manageable level.

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Withdrawal supervision

Withdrawal from antianxiety medication must be supervised by a healthcare provider.

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Active metabolites in benzodiazepines

Benzodiazepines without active metabolites are safer, especially in liver impairment.

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Assessment finding for Alprazolam therapy

Patient reports sleeping better and increased interest in activities indicates success after 1 week.

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Lorazepam (Ativan) in OCD

Not effective for treating obsessive-compulsive disorder (OCD).

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Buspirone

An anxiolytic with low sedative effects; does not affect GABA receptors.

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Suicidal ideation intervention

Providing patient safety is the priority nursing action with suicidal statements.

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Lorazepam administration

Intramuscular is preferred for patients unable to take medication orally due to nausea.

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Measures of therapeutic outcomes

Therapeutic outcomes include improved sleep, reduced anxiety signs, and participation in therapy.

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Somatic complaints

Physical symptoms that arise without a clear medical cause, often linked to stress.

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Toxic effects of benzodiazepines

Substances like alcohol can increase the toxicity of benzodiazepines.

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Generalized anxiety disorder (GAD)

A mental health disorder characterized by excessive worry about various aspects of life.

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Nonstimulating environment

An environment that minimizes stressors to help stabilize patients with anxiety.

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Blood glucose level in anxiety diagnosis

Blood glucose levels are not assessed in evaluating anxiety.

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Benzodiazepines and pregnancy

Benzodiazepines should be avoided during the first trimester.

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Effects of benzodiazepines on infants

Infants exposed to benzodiazepines may show signs of withdrawal.

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Benzodiazepines and fetal circulation

Benzodiazepines readily cross the placenta into fetal circulation.

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Therapeutic outcomes of anxiety treatment

Measures of effectiveness such as improved sleep, reduced anxiety symptoms, and participation in therapy.

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Signs of improved medication effect

Includes symptoms like decreased tremors, better sleep quality, and active engagement in group therapy.

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Substances increasing benzodiazepine toxicity

Alcohol, antihistamines, analgesics, sedatives, and hypnotics can enhance sedative effects of benzodiazepines.

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Therapeutic uses of hydroxyzine

Relieves anxiety while also controlling itching, vomiting, and reducing need for sedation pre- and post-surgery.

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Effect of benzodiazepines with alcohol

Concurrent use can lead to excessive sedation and decreased motor function.

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Evaluating anxiety patients

Includes physical examination, psychological evaluation, and history of stressors.

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Hydroxyzine in preoperative care

Decreases the need for sedatives and pain relievers before surgery as an anxiolytic.

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Somatic complaints in anxiety

Physical symptoms like chest pain that may arise from anxiety, especially in stressful situations.

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Study Notes

Pharm Final Exam Chapter 15: Antianxiety Medications

  • Tapering Antianxiety Medications: Withdrawal should be gradual, over 1 month, under a healthcare provider's supervision. A week is insufficient, while 6 months to 1 year is excessive.

  • Benzodiazepine for Alcohol Withdrawal: Oxazepam is the preferred benzodiazepine for anxiety associated with alcohol withdrawal. It has no active metabolites.

  • Obsessive Compulsive Disorder (OCD) Treatment: Fluvoxamine is the drug of choice for treating OCD. It prolongs serotonin activity.

  • Anxiety Disorder Outcome: A patient exhibiting manageable anxiety after one week of alprazolam treatment signifies that the outcome has been met. Indicators include improved sleep, increased interest in activities, and ability to participate in activities, but lack of these indicators shows the outcome hasn't been met.

  • Psychological Drug Dependence: Psychological dependence is a difficult condition to treat, requiring professional medical intervention, and is not easy to control by influencing the patient's perceptions. It's not as easily treated as physiological dependence.

Patient Education and Discharge Planning

  • Anti-anxiety Medication Teaching: Information about the medication, including the monitoring system, possible dependence, and instructions of usage should be discussed with patients and their families.

  • Azaspirone Antidepressant Caution: Caution patients about the potential for dizziness, nervousness, drowsiness, and lightheadedness, and advise against combining with alcohol.

  • Benzodiazepine Therapy: Patients experiencing recent anxiety reactions are better candidates for benzodiazepines. Patients with long-term anxiety, severe depression, or auditory hallucinations may not respond as well.

  • Lorazepam Dosage: Intramuscular administration is the preferred method for lorazepam in patients with alcohol withdrawal and nausea or vomiting.

Psychiatric Patient Safety

  • Patient Safety Priority: In a psychiatric patient experiencing suicidal ideation, the priority intervention is ensuring patient safety. This addresses their immediate safety risk and helps the nursing team establish a trusting relationship. Establishing this relationship is critical to help the patient.

Anxiety Disorder Evaluation

  • Comprehensive Evaluation: Medical evaluation, psychological assessment, history of triggering events, medication history, and substance use should be included in the examination of a patient with anxiety. Blood glucose level is not typically part of a routine anxiety assessment.

Prenatal Benzodiazepines

  • Benzodiazepine Use in Pregnancy: Benzodiazepines are not safe during pregnancy. They readily cross the placenta and can potentially cause harm to the developing fetus.

  • Lactation: Benzodiazepines can be present in breast milk and have a potential impact on the infant's health.

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