Anxiety & Anxiolytic Medication – Pharmacology for Nurses

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Chapter 16: Psychotherapeutic Drugs Test, Anxiety, Pharmacology for Nurses

The key terms in this Pharmacology course include Psychotherapeutic Drugs, Anxiety, Anxiolytic Medication, Lorazepam (Ativan), Patient, Adverse, Nurse, Drug, Pharmacology, Bipolar Disorder, Buspirone (BuSpar), Schizophrenia, Antipsychotic Medication, Extrapyramidal Symptoms, Phenothiazine (Thorazine) Drug Therapy

A patient prescribed lorazepam (Ativan) for the treatment of anxiety states, “I feel drowsy all the time, and it’s interfering with every aspect of my life.” The nurse knows that a better drug therapy option for this patient is which anxiolytic medication?

Hydroxyzine hydrochloride salt (Vistaril)

Chlordiazepoxide (Librium)

Buspirone (BuSpar)

Alprazolam (Xanax)

Buspirone (BuSpar) has the advantage of having fewer adverse effects such as sedation and lack of dependency potential. All of the other options are sedatives as well as anxiolytics.

The nurse is monitoring a patient taking an antipsychotic medication for extrapyramidal symptoms. Which clinical finding indicates the patient is having an adverse effect from this drug?

Presence of myoglobin in the blood

Blood pressure of 80/50 mm Hg

Dry mouth and constipation

Muscle cramps of the head and neck

Dystonia, or sudden and painful muscle spasms, is the only extrapyramidal adverse effect listed. The other adverse effects also occur but are not extrapyramidal effects.

Which statement by the patient indicates the need for additional teaching on phenothiazine (Thorazine) drug therapy?

“I will call my health care provider for abnormal tongue movements”

“I need to change positions slowly to prevent dizziness.”

“It is okay to take this drug with a small glass of wine to help relax me.”

“I will need to wear sunscreen and protective clothing when outdoors.”

Drinking alcohol with phenothiazines puts the patient at risk for increased central nervous system depression.

When doing an admission drug history, the nurse notes that the patient has a prescription for lithium. The nurse suspects that this patient has been diagnosed with which condition?

Paranoid schizophrenia

Bipolar disorder

Absence seizures

Obsessive-compulsive disorder

Lithium is a mood-stabilizing drug for the treatment of manic episodes associated with bipolar disorders.

Which laboratory test would be monitored closely to assess for a potential life-threatening adverse effect to clozapine (Clozaril)?

Liver function studies

Glomerular filtration rate

Complete blood count

Immunoglobulin levels

Patients taking clozapine must be monitored for the life-threatening adverse effect of agranulocytosis, evidenced by a severe reduction in the number of white blood cells.

What atypical antipsychotic medication would the nurse anticipate the health care provider prescribing for treatment of refractory schizophrenia?

Trazodone (Desyrel)

Risperidone (Risperdal)

Amoxapine (Asendin)

Phenelzine (Nardil)

Risperidone is effective for schizophrenia, including negative symptoms. The other medications listed are antidepressants.

A patient with a diagnosis of depression is being discharged with a prescription for an monoamine oxidase inhibitors (MAOI). Which instruction would the nurse include for this medication?

Encourage use of fiber supplements.

Emphasize that tremors are a common adverse effect.

Explain the symptoms of tardive dyskinesia.

Avoid eating aged cheese.

Eating foods high in tyramine, including aged cheese, can cause a hypertensive crisis in patients taking MAOIs.