Anti-anxiety Agents

Drugs that treat excessive anxiety, uneasiness, tension, or for temporary relief from social phobia or other phobias are known as antianxiety medications. Drugs used to treat anxiety are also known as anxiolytics and mild tranquilizers. Anti-anxiety medications reduce moderate to severe tension and anxiety.

Classification of Antianxiety Drugs

• Benzodiazepines: Benzodiazepines are currently the medications of first preference for treating anxiety and sleeplessness..
  These drugs following:
  • Very short acting (eg Triazolam, Midazolam)
  • Short-acting (eg Lorazepam: active, trapex, larpose, Alprazolam:Atzolan, Anxit, Trika)
  • Long acting: Chlordiazepoxide (Librium), diazepam (Valium, calmpose) clonazepam (Lonazep), Flerazepam (Nindral), Nitrazepam (Dormin)
• Barbiturates (eg. Phenobarbital, pentobarbital, thiopentone) : Barbiturates are no longer frequently used as anti-anxiety medications. They cause a variety of negative side effects, such as excessive sedation, respiratory and circulatory depression, dependence, etc.
• Non-barbiturate, nob benzodiazepine antianxiety agents: These can be further broken down into the following groups: Beta (B) blockers, Carbamates (meprobamate), and Antihistaminics (hydroxyzine).

Commonly used Antianxiety Agents and its Daily Dose

• Alprazolam= 0.75-4 mg PO
• Chlordiazepoxide= 15-100 mg PO
• Diazepam= 2-10 PO/ slow iv
• Lorazepam= 2-9 mg PO/IM/IV
• Oxazepam= 30-120 mg PO
• Hydroxyzine= 100-400 mg
• Chlormezanone= 100-800 mg
• Meprobate= 200-2400 mg

Indications

• Disorder of generalized anxiety
• Adjustment issues with a nervous attitude
• Panic attack
• School phobia and agoraphobia
• Issues with sleep (e.g. insomnia, nightmares)
• Treatment of the withdrawal symptoms from drugs and alcohol
• Psychological illness
• Acute psychosis management in an emergency

Mechanism of Action

Uncertainty surrounds the precise mode of action of benzodiazepines. It is thought that these medications enhance GABA levels by binding to specific locations on GABA receptors. The inhibitory neurotransmitter GABA (gamma-amino-butyric acid) has a calming effect on the central nervous system, which lowers anxiety.

Contraindication and Precaution

• Hypersensitivity to any type of anxiety medication.
• Other CNS depressants should not be taken along with them.
• May make using some machinery or driving risky.
• Breastfeeding and pregnancy.
• Spectral-band glaucoma
• Coma and shock

Caution

When administering these medications to:

• Senior client
• Customer with renal or hepatic dysfunction
• Previous drug usage or addiction
• An unhappy client

Nursing intervention

Side effect

• Drowsiness
• Confusion
• CNS tranquilizers
• Orthostatic tachycardia
• Contradictory enthusiasm
• Nausea and diarrhoea
• Drug use
• Blood disorders
• Tolerance, dependency on one's bodily and mental well

Nursing implication

• Drugs should be taken before bed.
• Daily mood evaluation
• Precautions should be taken in case of potential suicide.
• Track vital signs
• To prevent a sharp drop in blood pressure, instruct the patient to get up gently from a sitting or reclining position.
• Don't use drugs
• Notify the doctor
• Encourage patients to often sip water, eat hard candies or ice chips, or chew sugarless gum.
• Drugs may be taken with meals or milk.
• Reported right away to the doctor.
• Inform the patient receiving long-term therapy not to stop taking the medication suddenly. A sudden withdrawal could endanger your life.
• To avoid a sharp drop in blood pressure, carefully get up from a sitting or laying position.
• Inform a doctor right away about any sore throat, fever, lethargy, easy bruising, unusual bleeding, or restlessness.
• Be mindful of the dangers of using this medication while pregnant. If pregnancy is anticipated or suspected, inform your doctor and request to stop taking the medication.