Question

what does the nurse need to know about buspirone? what teaching needs to be done with thw client in regard to buspirone? what medication other than buspirone are being used in the treatment of Generalized Anxiety Diorder, and how effective are they?

Answer 1

Buspirone, sold under the brand name Buspar among others, is a medication primarily used to treat anxiety disorders, particularly generalized anxiety disorder. Benefits support its short term use. It has not been found to be effective in treating psychosis. It is taken care by mouth, and it may up to four weeks for an effect.

The nursing implications while giving buspirone as follows;

• Assess degree and manifestations of anxiety before and periodically during therapy.
• Buspirone does not cause physical or psychological dependence or tolerance. However , patient with a history of substance use disorder should be assessed for tolerance bor impaired control. Restrict amount of drug available to these patients.
• Assess blood pressure and compare to normal values. Report changes in BP, either a problematic decrease in BP(hypotension) or a sustaineDod increase in BP( hypertension)  
• Assess heart rate, ECG, and heart sounds, especially during exercise. Report rapid heart rate or symptoms of other arrhythmias, including palpitations, chest discomfort, shortness of breath, syncope, and fatigue/weakness.
• Monitor any breathing problems, and report shortness of breath, rapid shallow breathing, or abnormal breath sounds that might indicate pulmonary congestion.
• Monitor personality changes, including excitement and nervousness. Notify physician if these changes become problematic.
• Assess any muscle aches or pain to rule out musculoskeletal pathology;thalt is try to determine if pain is drug induced rather than caused by anatomic or biochemical problems.
• Asees signs of paresthesia ( numbness or tingling), tremors, or incoordination .perform objective tests. Including electroneuromyography and sensory testing to document any drug related neuropathic changes.
• Assess dizziness and drowsiness that might affect gait, balance, and other functional activities. Report balance problems and functional limitations to there physician and nursing staff, and caution the patient and family/ caregivers to guard against falls and trauma.
• Do not administer concurrently with MOAI or grape fruit juice.
• Instruct patient to avoid alcohol and other CNS depressants.
• Instruct the patient as to take as directed.

The patient teaching of a cilent taking buspirone as follows;

• Instruct patient to take buspirone exactly as directed. Take missed doses as soon as possible if not just before next dose;do not double doses.
• Do not take more than amount prescribed.
• May cause dizziness or drowsiness. Caution patient to avoid driving or other activities requiring alertness untill response to the medications is known.
• Advise patient to avoid concurrent use of alcohol or other CNS depressants.
• Instruct patient to notify health care professional of all OTC medications, vitamins, or herbal products being taken and to consult healthcare professional before taking any OTC or herbal products.
• Instruct patient to notify healthcare professional if any chronic abnormal movements occur( dystonia, motor restlessness, involuntary movements of facial or cervical muscles) or if pregnancy is suspected.
• Emphasize the importance of follow-up exams to determine effectiveness of medication.
• Instruct patient to avoid grape fruit juice as it interacts with buspirone and lead to unwanted side effects.

Other medications used in the treatment of generalised anxiety disorder includes the following;

• Selective serotonin reuptake inhibiors-These are antidepressants. They can relieve anxiety symptoms and help reduce the symptoms of depression that often accompany anxiety disorders. It usually take 2 to 6 weeks for SSRIs to start reducing the anxiety. Escitalpram and paroxetine are used in generalised anxiety disorders.
• Selective norepinephrine reuptake inhibiors(SNRIs) - This group of drugs includes duloxetine and venlafaxine. They have a similar effect to SSRIs.
• Pregabalin- This drug is mainly used to treat nerve related pain, but it is also approved for the treatment of generalised anxiety disorders. But it often causes dizziness and tiredness.
• Opipramol-Opipramol is an antidepressant whose effectiveness has only been very poorly studied. For this reason, it is rarely used.
• Hydroxyzine-This antihistamine can also probably reduce the symptoms of generalised anxiety disorders. There has been less research on it than on other drugs, though, so it's hardly ever used.
• Benzodiazepines-These are sedatives that also help to relieve anxiety. They have a fast effect, but there is a risk of becoming dependent on them after just a few weeks of use. For this reason. These aren't recommended for the treatment of generalised anxiety disorders.