Overview

1. Anti-anxiety meds (anxiolytics) depress CNS which increases GABA, therefore producing a relaxation effect.  
   1. Most common = Benzodiazepines

Nursing Points

General

1. Benzodiazepines
   1. Reduce anxiety
   2. Anticonvulsant
   3. Sedative effect

Nursing Considerations

1. General interventions
   1. Caution:
      1. Elderly
      2. Avoid ETOH – enhances sedative effect
      3. Glaucoma
      4. Increases fall risk
   2. Safety first – sedative effects
   3. Drug-drug Interactions
      1. Notify MD before starting OTC meds
   4. Do NOT abruptly stop
      1. Taper down over weeks
2. Watch for signs of withdrawal and toxicity
3. Withdrawal
   1. Irritability
   2. Sleep disturbances
   3. Tremors, usually hand
   4. Nausea, vomiting
   5. Cramping
   6. Restlessness
   7. Seizures

Toxicity

1. Toxicity
   1. Antidote: Flumazenil (Romazicon) IV
   2. Symptoms:
      1. Confusion and ↓ LOC
      2. Impaired balance and motor function
      3. CNS depression
   3. Possible paradoxical (opposite) reaction:
      1. Hallucinations
      2. Aggression
   4. Can progress to coma, death