Benzos
True or false: Xanax/Alprazolam and Ativan/Lorazepam are long acting?
false
they are short acting
Alters the levels of neurotransmitter serotonin in the brain by blocking the reabsorption (REUPTAKE) of serotonin into neurons.
This results in more serotonin in the body.
A 13 year old client comes into the clinic telling the nurse that she has been having trouble falling asleep at night and has difficulty relaxing. She is worried about school and making friends and states her constant worrying is interfering with her daily functioning and that her stomach has been more upset than usual.
What type of anxiety is she portraying?
Generalized anxiety disorder (GAD)
-With GAD, someone may be experience excess worrying that is out of proportion with stressors, may interfere with daily functioning, and lasts about 6 months. GAD occurs primarily among children and adolescents and can inlude symptoms such has difficulty relaxing, easily startled, trouble falling asleep, fatigue, headache, tension, GI issues, and irritability.
What are the most common side effects of an SSRI?
-Sexual dysfuntion
-Insomni
-Dry mouth
OTEHRS: jitters, nausea, vomiting, headache, drowsiness, nervousness, dizziness
MULTIPLE QUESTION
NAME THESE NON-ADDICTIVE ANXIETY MEDS
1. This drug is a non-addictive anxiety medication that can also be used as an anticonvulsant and for neuropathic pain
2. Also used as an antihistamine
3. is a beta blocker that slows HR, typically used for social anxiety.
1: Gabapentin
2: hydroxyzine
3: Propranolol
True or false: Valium/Diazepam and Klonopin/Clonazepam are long acting.
True
List the 5 examples of common SSRI (that bree had in her ppt)
Hint:
S
P
E
C
F
Zoloft/Sertraline
Paxil/Paroxetine
Lexapro/Escitalopram
Celexa/Citalopram
Luvox/Fluvoxamine
This drug is an antidepressant that can also be used for smoking cessation
Wellbutrin/Bupropion
Rohypnol is considered what type of drug?
Date rape drug; "roofies"; short acting
How does a drugs half life work?
Short half-life: leaves your body quicker
Longer half-life: leaves your body slower (more symptoms of withdrawal!!!)
What are the leading signs of Benzo Toxicity?
-Altered mental status / drowsiness / slurred speech / ataxia / coma / respiratory depression / decreased reflexes / nystagmus
A patient tells her health care provider that she wishes to discontinue her sertraline. How long over a course of time would the doctor taper her dose?
Slowly, gradually over a few weeks, reduce every few days or weeks depending on the dose/persons symptoms
A patient tells the RN that "nothing feels real, I am not in my own body"
What type of anxiety is the pt experiencing?
Panic
-Panic disorder is a form of anxiety when people experience sudden attacks of terror. Someone may have a sense of unreality, fear of impending death, terror or losing control. It is one of the most treatable anxiety disorders and may involve someone to experience nausea, chest pain, and sense of breathlessness.
A client is experiencing a severe panic attack. Which nursing intervention would meet this client's immediate need?
A. Teach deep breathing relaxation exercises
B. Place the client in a Trendelenburg position
C. Stay with the client and offer reassurance of safety
D. Administer the ordered PRN buspirone (BuSpar)
C
The nurse can meet this client's immediate need by staying with the client and offering reassurance of safety and security. The client may fear for his or her life and the presence of a trusted individual provides assurance of personal safety
What does long/short acting mean in the sense of withdrawal?
Long acting: easier for withdrawal
Short acting: more difficult withdrawal
What is the antidote you administer to a patient with benzo toxicity?
Flumazenil
1. The nurse has a patient taking two or more medications that increase serotonin levels, what should she be on alert for?
2. What does the acronym MAN stand for looking for symptoms?
1: Serotonin Syndrome
2:
Mental status (altered)
Autonomic hyperactivity (diaphoresis, tachycardia, hyperthermia, hypertension, vomiting, diarrhea)
Neuromuscular abnormalities (tremors, bilateral babinski sign, hyperreflexia)
What characterisitic distinguishes moderate anxiety from severe anxiety?
A pt with moderate anxiety can be redirected when instructed to do so
-Moderate anxiety is more focused than mild anxiety. When in a stressful situation, zoning in on the situation, and not much else. Some of the symptoms of moderate anxiety include stomach pains, racing heartbeat, sweating or dry mouth. Exaggerated hand/arm movements, rapid speech or high-pitched voices are also common.
-Severe anxiety has much of the same symptoms as mild, and moderate anxiety. But, can have added symptoms of vomiting, chest pain, pounding heartbeat, diarrhea, scattered thoughts, or erratic behavior. Some people even experience a sense of dread or impending doom.
What is the SSRI antidote?
Cyproheptadine
1. How long does it take for an SSRI to reach its full therapeutic potential?
2. What is important to look for after an SSRI reaches its full potential?
1: Several weeks, 2-4 usually
2: increased risk for suicide/follow through
Benzos are meant to be SHORT TERM MEDS, meaning less than 4 weeks (usually while SSRIs are kicking in)...what are some long term effects of prolonged Benzo use?
-Coma / seizures / muscle weakness / suicidal thoughts / cognitive impairment / cognitive decline (interes with brains processing speed) / slower heart rate / slower breathing rate / liver tissue damage
Flu like symptoms
Insomnia
Nausea/vomiting
Imbalance (esp from sitting to standing)
Sensory disturbance (brain zaps)
Hyperarousal (irritability, jerkiness)
What are some non-pharmacological treatments for anxiety?
-Breathing techniques; deep breathing / Exercise (30 min/day) / tapping / meditation / aromatherapy / yoga / CBT (cognitive behavior therapy) / support groups / sleep
What is the difference between a flat and blunted affect?
A flat affect is a complete and utter LACK of expression in both verbal and non-verbal behaviors while a blunted affect has a LIMITED expression in verbal and non-verbal behaviors
1. This medication is known to be a non addictive anxiolytic to treat anxiety, does NOT depress the CNS and has no abuse potential. This drug MAY be appropriate for someone who abuses drugs or alcohol, and does not intensify the effects of CNS depressants, what is the drug?
2. What should you AVOID drinking while using this drug?
1: Buspar/Buspirone
2: Grapefruit juice