Module 3.Anxiety: Medications

Summary

This video discusses the use of anxiolytics, particularly benzodiazepines, in the treatment of anxiety disorders and other conditions. It highlights the potential benefits, such as anxiety reduction and muscle relaxation, as well as the risks, including addiction, side effects, and paradoxical reactions like rebound anxiety. The video explains the importance of monitoring patients, especially when used alongside other medications like alcohol or antidepressants. It also touches on non-benzodiazepine hypnotics, which may offer fewer side effects but still carry the risk of dependence. Overall, the script emphasizes the careful consideration needed when prescribing these medications.

Takeaways

• 😀 Anxiolytics, commonly used for anxiety disorders, may also be prescribed for symptoms of other conditions, such as schizophrenia.
• 😀 Medications for anxiety can increase the risk of polypharmacy and side effects, especially when used alongside other drugs.
• 😀 Benzodiazepines (benzos), like Valium, are commonly prescribed anxiolytics, but they are addictive and should be used for no longer than two weeks.
• 😀 Benzos are divided into categories based on their half-life: long, intermediate, short, and ultra-short acting.
• 😀 Ultra-short acting benzos are used in acute situations, often administered through injections, and require careful monitoring after use.
• 😀 The therapeutic actions of benzodiazepines include inducing sleep, reducing anxiety, acting as anticonvulsants, impacting memory, and relaxing muscles.
• 😀 Nursing considerations are important when administering benzos due to potential side effects such as altered gait and sedation.
• 😀 Common side effects of benzodiazepines include sedation, dizziness, rebound anxiety, and paradoxical effects (e.g., increased anxiety despite medication).
• 😀 Benzodiazepines should not be combined with other central nervous system depressants, especially alcohol, due to dangerous interactions.
• 😀 Addiction is a significant concern with benzodiazepines, and careful management is needed to avoid dependence.
• 😀 Non-benzodiazepine hypnotics, newer drugs used for sleep, have fewer side effects but still carry risks such as tolerance, rebound insomnia, and dependence.

Q & A

What are anxiolytics, and why are they prescribed?

Anxiolytics are medications used primarily for treating anxiety disorders. However, they may also be prescribed for symptoms associated with other disorders, such as schizophrenia, where anxiety is a secondary symptom due to delusions.

Why might health professionals prescribe medications for symptoms rather than a specific diagnosis?

Medications may be prescribed to alleviate symptoms rather than to treat a specific diagnosis. For example, a person with schizophrenia who experiences anxiety due to delusions may be prescribed both antipsychotics and anxiolytics to manage the symptoms.

What is polypharmacy, and how is it relevant to the prescription of anxiolytics?

Polypharmacy refers to the use of multiple medications, which can increase the risk of side effects. In the context of anxiolytics, combining these with other medications for different disorders can lead to complications.

What are the potential issues with long-term use of benzodiazepines?

Benzodiazepines can be highly addictive, and guidelines recommend limiting their use to no more than two weeks due to the risk of dependency and other adverse effects.

What are some common examples of benzodiazepines used in clinical practice?

Valium is one of the most common examples of a benzodiazepine prescribed for anxiety. These medications interact with the GABA receptors in the brain to have a calming effect.

How are benzodiazepines classified based on their half-life?

Benzodiazepines are classified into different categories based on their half-life: long, intermediate, short, and ultra-short. Ultra-short and short-acting benzodiazepines are often used in acute situations.

What are some of the therapeutic uses of benzodiazepines?

Benzodiazepines are used for multiple therapeutic purposes, including as hypnotics (sleep aids), anti-anxiety agents, anticonvulsants, memory impact agents, and muscle relaxants.

What are some common side effects of benzodiazepines?

Common side effects of benzodiazepines include sedation, drowsiness, dizziness, rebound anxiety (a paradoxical effect), and feelings of detachment from the world or the body.

Why is it important to monitor patients after administering short-acting or ultra-short-acting benzodiazepines?

Monitoring is crucial to ensure that the person remains safe after receiving short-acting or ultra-short-acting benzodiazepines, especially if administered through intramuscular injection. This helps prevent adverse reactions and ensures that the patient is not compromised.

What are the risks associated with combining benzodiazepines with alcohol or other medications?

Benzodiazepines and alcohol both bind to similar receptors in the brain, making their combination dangerous due to the potential for severe sedation and respiratory depression. Other medications, such as certain antidepressants and anticonvulsants, can also interact negatively with benzodiazepines.

What are non-benzodiazepine hypnotics, and how do they compare to traditional benzodiazepines?

Non-benzodiazepine hypnotics are a class of sleep aids that tend to have fewer side effects than traditional benzodiazepines. However, they still carry a risk of dependence and should only be used for short durations.

What side effects are associated with hypnotic medications?

Side effects of hypnotic medications include tolerance (where the medication becomes less effective after a few weeks), rebound insomnia, paradoxical insomnia (where the medication causes more wakefulness), inappropriate sedation, and dependence.