Nursing Learning BD

Anxiolytics (Anti-Anxiety Medications) – NCLEX Notes

Three classes:

Benzodiazepines
Barbiturates
Buspirone

BENZODIAZEPINES

Examples:

Alprazolam
Diazepam
Lorazepam
Temazepam

Ending:

-pam
-lam

Uses:

Anxiety
Seizures
Alcohol withdrawal
Sedation
Medically induced coma

Mechanism:

Increase GABA
Decrease CNS activity
Cause relaxation and sedation

Onset:

Fast (within minutes)

Side Effects:

Sedation
Drowsiness
Low blood pressure
Low heart rate
Respiratory depression
Dizziness

Important NCLEX Points:

Highly addictive
Causes tolerance and dependence
Not safe for long-term use
Never stop suddenly
Taper gradually

Patient Teaching:

Take at bedtime
Avoid alcohol completely
Avoid driving or operating machinery
Take as prescribed
Do not skip doses
Report excessive sleepiness or breathing problems

Antidote:

Flumazenil

BARBITURATES

Example:

Phenobarbital

Uses:

Seizures
Sedation

Characteristics:

Long duration (3–5 days)
High toxicity
Higher overdose risk

Side Effects:

Severe sedation
Hypotension
Respiratory depression
Coma
Death (overdose)

Nursing Priorities:

Monitor blood pressure
Monitor respiratory status
Assess level of consciousness
Watch for excessive sedation

BUSPIRONE

Example:

Buspirone

Uses:

Long-term treatment of anxiety

Characteristics:

Non-sedating
Non-addictive
No dependence
No tolerance
No withdrawal symptoms
Safe for long-term use

Onset:

Slow
Full effect in 2–4 weeks

Patient Teaching:

Take every day
Not for panic attacks
Not PRN
Safe to drive
Continue taking even though it works slowly

Comparison

Benzodiazepines

Fast onset
Sedating
Addictive
Withdrawal present
Short-term use

Barbiturates

Long-lasting
Very sedating
Highly toxic
Respiratory depression
Overdose risk

Buspirone

Slow onset (2–4 weeks)
No sedation
No addiction
No withdrawal
Long-term use

NCLEX Pearls

Benzodiazepines usually end in "-pam" or "-lam."
Benzodiazepines increase GABA.
Benzodiazepines can cause respiratory depression.
Never stop benzodiazepines abruptly.
Avoid alcohol while taking benzodiazepines or barbiturates.
Flumazenil is the antidote for benzodiazepine overdose.
Naloxone is the antidote for opioid overdose.
Phenobarbital is a barbiturate.
Buspirone takes 2–4 weeks to work.
Buspirone is not effective for acute panic attacks.
Buspirone does not cause sedation, dependence, or withdrawal symptoms.