ANXIETY

ANXIETY

• A state of tension in response to real or imagined stress or danger situations.
• Anxiety may manifest itself as •Psychic or mental state. •Somatic or physical symptoms.

Physical reactions (autonomic changes):
tachycardia, sweating, fatigue, weakness, agitation, restlessness , and sleep disturbances

TYPES OF ANXIETY

• Obsessive-compulsive disorder (OCD)people cant prevent themselves from dwelling on unwanted thoughts or performing repetitious rituals, such as washing their hands
• Panic disorder: people have sudden,intense attacks of anxiety in certain situations
• Phobia:intense, or illogical fear of something specific, such as heights or open spaces.

TYPES OF ANXIETY

• Post traumatic stress disorder (PTSD):Recurrent nightmares and memories of mental, physical, emotional distress when exposed to situations that remind them of the trauma.
• Generalized anxiety disorder: Patients are usually and constantly worried with no apparent reasons; They may be worried about health, money, work.

CLASSIFICATION:
BENZODIAZEPINES

INDICATIONS

• Reduce the intensity of feelings of anxiety prescribe primarily for short-term relief of anxiety and related symptoms when it is disabling resulting in significant distress or problems in social functioning.
• Other forms of anxiety may be treated by psychological means or pharmacological treatments suitable for long-term use.
• Sedative / hypnotic effect depending on dosage client sensitivity

INDICATIONS ( CON’T)

• Benzodiazepines should not usually be prescribed for longer than one month.
• circumstances in which longer-term prescription of benzodiazepines may be considered desirable because the alternative is considered less beneficial.
• anxiety is complicated by other illnesses and the risk of dependence may be considered acceptable because of severity of the other disorders.

Benzodiazepine drugs are habit forming and can lead to addiction
Long-term use can lead to tolerance, which means that lower doses will become ineffective and patients will need higher doses.
These drugs are abused to get 'high' due to their effects on the brain.

ANXIETY

• The first choice for treatment of anxiety: Xanax (Alprazolam) Ativan (Lorazepam) librium (chlordiazepoxide) Valium(Diazepam ) Klonopin (Clonazepam)
• Mechanism of Action enhance the effect of the neurotransmitter GABA) at the GABAA receptor, resulting in sedative, hypnotic (sleep-inducing), anxiolytic (anti-anxiety), anticonvulsant, and muscle relaxant properties.

SIDE EFFECTS

• sedative
• Drowsiness
• Dizziness
• Trembling
• Impaired coordination
• Vision problems
• Headache
• Feeling of depression

CONTRAINDICATIONS
- KNOWN ALLERGY
- NARROW ANGLE GLAUCOMA
- PREGNANCY

TOXICITY

• Somnolence
• Diminished reflexes
• Confusion
• Respiratory depression
• Hypotension
• Coma
• TX FOR TOXCITIY- FLUMAZENIL: reverses sedative effect

TEACHING

• Instruct client to consult the health care provider before taking this drug if snoring is a problem. Snoring may indicate an obstruction in the upper respiratory tract resulting in hypoxia.
• Instruct client to report extreme lethargy, slurred speech, disorientation, or ataxia
• Avoid driving or performing hazardous activities until effects of drug are known.

TEACHING ( CON’T)

• Avoid consumption of alcohol and other CNS depressants while on benzodiazepines
• Instruct client to report significant mood changes, especially depression
• Instruct client to Take drugs exactly as prescribed