Anxiolytic & Hypnotic Agents
What is the antidote for benzodiazepine overdose?
Flumazenil
What dietary restriction must patients follow with MAOIs?
Avoid tyramine-containing foods (aged cheese, wine, cured meats)
What life-threatening reaction is associated with antipsychotics, characterized by fever, muscle rigidity, and autonomic instability?
Neuroleptic malignant syndrome
What oral hygiene teaching should be given to patients on phenytoin?
Maintain good oral care due to risk of gingival hyperplasia
What is a major nursing concern with IV phenytoin?
Give slowly; can cause hypotension and arrhythmias if given too fast
Why should benzodiazepines not be stopped abruptly?
Risk of withdrawal symptoms and seizures
What syndrome can occur if SSRIs are combined with MAOIs or St. John’s Wort?
Serotonin syndrome
What are involuntary lip-smacking and tongue movements called?
Tardive dyskinesia
Which antiseizure medication is also used for neuropathic pain?
Gabapentin
What lab must be monitored with clozapine therapy?
: Absolute neutrophil count (risk of agranulocytosis)
Which drug class is the “first-line” treatment for generalized anxiety disorder?
SSRIs
A patient taking tricyclic antidepressants reports dry mouth, blurred vision, and constipation. What is this group of side effects called?
Anticholinergic effects
What are “extrapyramidal symptoms” (EPS)?
Movement disorders (dystonia, akathisia, Parkinsonism, tardive dyskinesia)
A patient taking antiseizure meds stops abruptly. What is the risk?
Rebound seizures or status epilepticus
What is a black box warning for SSRIs and SNRIs?
Increased risk of suicidal ideation in children/young adults
What is the main nursing consideration when administering IV lorazepam
Monitor for respiratory depression and hypotension
How long does it usually take for antidepressants to show therapeutic effects?
2–4 weeks
Why should patients on antipsychotics avoid alcohol?
Increases CNS depression and sedation
What lab levels need to be monitored with valproic acid?
Liver function tests, platelets
What is one safety teaching for a patient prescribed zolpidem (Ambien)?
Take at bedtime, allow 7–8 hours for sleep, risk of sleepwalking
Why are older adults at higher risk for falls when taking hypnotics?
Sedation, confusion, impaired coordination
What nursing consideration is important when starting an SSRI?
Monitor for increased anxiety or suicidal thoughts initially
Which generation of antipsychotics (first or second) generally has fewer EPS but higher metabolic risks?
Second-generation (atypical)
Why must patients be consistent with dosing times for antiseizure medications?
To maintain therapeutic drug levels and prevent breakthrough seizures
What pregnancy category are most antiseizure drugs?
Category D (risk of fetal abnormalities)