Question

This week, begin selecting a Peer Reviewed Evidence Based Practice article on a specific drug. Write a three page paper discussing the drug article in APA that will be due in wk 10. Anxiolytic drug. Your paper should include an: Introduction of selected drug Discuss therapeutic uses of the drug Ways nurses can enhance effectiveness of the drug Conclusion

Answer 1

Anxiolytics are a group of drugs that are prescribed for the treatment of anxiety disorders. Antidepressants, antihistamines, benzodiazepines are examples of drugs coming under this group. Anxiolytics are used to treat symptoms of anxiety disorders including social phobias. Some are also used as sedatives before anesthesia for medical procedures.

Anxiolytics work by targeting key chemical messengers in the brain. This is thought to help decrease abnormal excitability. Anxiolytics drugs increase the concentration of neurotransmitters such as serotonin, norepinephrine, and dopamine and thus help to reduce the anxiety response originated in the sympathetic nervous system. When the sympathetic nervous system is stimulated, there will be anxiety symptoms like increased heart rate and blood pressure, pupillary dilation and bronchodilation. Anxiolytics helps to reduce all these symptoms.

The more frequently prescribed anxiolytics are benzodiazepines which include Diazepam, Lorazepam, Clonazepam, Alprazolam, Librium etc.

Diazepam or Valium:

Diazepam is coming under benzodiazepines which is available as 2 mg, 5 mg, and 10 mg tablets. Injections also available, but, small doses of oral tablets are effective as an antianxiety drug.

Therapeutic Uses:

1. Generalized anxiety disorder like extreme worry or fear

2. Social phobia. (Deep fear of social situations, such as meeting new people or speaking and performing in public.) Social phobia may lead to social isolation.

3. Relief of acute withdrawal symptoms like agitation, tremors, hallucinations etc.

4. Used adjunctively in convulsive disorders.

5. Used adjunctively in skeletal muscle spasms

Side Effects:

Drowsiness, fatigue, muscle weakness, confusion, depression, headache, constipation, nausea, blurred vision, dizziness, hypotension, dry mouth, urinary retention, restlessness, aggressiveness, irritability etc. are the common side effects of diazepam.

Nursing measures to enhance effectiveness:

Abuse and dependence of benzodiazepines have been reported. Always take a complete history of the patient in order to know any history of addiction in the past. Addiction-prone patients should be under careful observation when taking diazepam. Such patients may develop habituation or dependence. Education regarding strict adherence to the prescribed dose is very essential. An overdose of the diazepam can be fatal. Educate family members also regarding the side effects, chances of dependency and potential hazard of overdose.

Should be vigilant about drug interactions if taking along with other centrally acting agents such as antipsychotics, phenothiazines etc. If the patient is taking antacids, the time required to achieve peak concentrations is 20 - 25 minutes more. So, better to avoid concurrent administration of antacids.

Drugs like cimetidine, omeprazole (compounds inhibiting hepatic enzymes) etc. influence the pharmacokinetics of diazepam and may lead to increased and prolonged sedation. The metabolic elimination of phenytoin is decreased by diazepam. The nurse should be vigilant about all these drug interactions.

The dose of the drug should be tapered gradually before stopping if prescribed for a longer duration to avoid any withdrawal symptoms.

Conclusion:

Treating patients with chronic anxiety disorders may be challenging. As soon as treatment is started, the patient must be told how long the treatment will last and how to stop it gradually. If the indication is no longer valid, it is necessary to propose a strategy of stopping the medicine, especially if given for more than 30 days. Always use correct judgment if the patient is requesting a refill.