New User Special Price Expires in

Let's log you in.

Sign in with Facebook


Don't have a StudySoup account? Create one here!


Create a StudySoup account

Be part of our community, it's free to join!

Sign up with Facebook


Create your account
By creating an account you agree to StudySoup's terms and conditions and privacy policy

Already have a StudySoup account? Login here

Anxiety Pathophysiology & Medications to treat it

by: Katerina Korunovski

Anxiety Pathophysiology & Medications to treat it

Marketplace > Ramapo College of New Jersey > NURSING > > Anxiety Pathophysiology Medications to treat it
Katerina Korunovski

GPA 3.7

Preview These Notes for FREE

Get a free preview of these Notes, just enter your email below.

Unlock Preview
Unlock Preview

Preview these materials now for free

Why put in your email? Get access to more of this material and other relevant free materials for your school

View Preview

About this Document

This study guide is from my class powerpoint and my own notes added into the mix. It describes nursing concepts that relate to anxiety.
Class Notes
25 ?




Popular in Pathophysiology/Pharmacology

Popular in NURSING

This 8 page Class Notes was uploaded by Katerina Korunovski on Monday September 26, 2016. The Class Notes belongs to at Ramapo College of New Jersey taught by in Fall 2016. Since its upload, it has received 2 views. For similar materials see Pathophysiology/Pharmacology in NURSING at Ramapo College of New Jersey.


Reviews for Anxiety Pathophysiology & Medications to treat it


Report this Material


What is Karma?


Karma is the currency of StudySoup.

You can buy or earn more Karma at anytime and redeem it for class notes, study guides, flashcards, and more!

Date Created: 09/26/16
Monday, September 26, y PathoPhysiology Anxiety • A state of apprehension, tension or uneasiness that stems from the  anticipation of danger, the source of which is largely unknown or  unrecognized” ­ International Classification of Diseases, 10th ed (ICD­10) Comorbidity  • Psychiatric; often treated similarly • Initiated by physical illness  • Physiologic response ­ fight or flight  • Comorbidity: with a lot of psychiatric and physiologic disorders  Anxiety: Types • Situational: during an event (death, or loss) • Panic disorder:  – Attacks:  • Phobias: focused, irrational fear about one thing; can lead to OCD  – Social anxiety: biggest fear ; Germaphobia: fear of germs  • Post­traumatic Stress Disorder (PTSD): rational anxious response tied to a  traumatic event; subconscious response • daily type of medication to control the response to stress; generalized anxiety  (vital signs will show this); long term pathophysiologic cycle  • Obsessive­compulsive Disorder (OCD): need to go through the behavior to  feel better about the obsession; neurotransmitters are released when the task is finished.  1 Monday, September 26, y Pathophysiology • Limbic system: Emotional expression, learning and memory – Amygdala  – Thermostat for stress: low, medium, high  • Activates hypothalamus – Unconscious responses to stress: S/S  • Stimulates reticular formation (RAS) – Increased alertness and wakefulness, perception of fear/stress permitted •Limbic system: pain receptors end in the limbic system; remembering pain because the  memory center is there/ experiences form memories  •Amygdala: close to the hypothalamus­ thermostat for stress levels •Neurotransmitters released between neurons (activate hypothalamus)­ glands and  neurons will produce chemicals of stress: cortisol is a steroid hormone produced by the  adrenal gland •Cortisol produced at a high level for a long time­ can cause changes in the body like the  response of a steroid drug ­ will stay in the system a lot longer than epi/norepi •RAS: located underneath the hypothalamus­ produces excitatory neurotransmitter  (glutamate) when stimulated, travels from the RF into the higher centers of the brain  and wakes you up 2 Monday, September 26, y Pathophysiology • Various theories to explain anxiety • kindling theory  • Change in amygdala  – Chemical imbalances, genetics, drugs, traumatic events • Genetic research – Correlation between anxiety disorders and mutations in human serotonin transporter genes; missing genes that transport serotonin  – Serotonin: cognitive, excitatory neurotransmitter­ provides the ability to  focus – SSRI: allows for more serotonin to dwell in synapses  3 Monday, September 26, y – Prozac, Zoloft, Lexopril ­ antidepressants prescribed for generalized  anxiety  Treatments • Therapies • Pharmacotherapeutic Classes:  • Anxiolytics: short term use of benzos – Benzodiazepines  – Non­benzodiazepines • Non­barbitual meds for sleep  Benzodiazepines • Lorazepam (Ativan), Alprazolam (Xanax), Midozolam (Versed), Diazepam (Valium) • ­ pam or ­lam  • prototype is Diazepam (Valium)  • Xanax 0.5 mg will do more than 10 mg of Valium *  • Antiemetic for cancer patients  •GABA is a relaxatory neurotransmitter; GABA inhibition­ means it does it jobs by  inhibiting the other neurotransmitters  Action • Act on the limbic, thalamic, and hypothalamic level of CNS • Inhibits GABA neurotransmission by binding to specific receptors • Makes GABA stay in its place at neuron  • Produce rapid calming effect by inhibiting excitatory  neurotransmitters Use • Anxiolytic, anticonvulsant, sedative­hypnotic, preoperative drug  Side effects • Drowsiness, dizziness, confusion • Blurred vision • Weakness, restlessness • Sleep disturbance, hallucinations  4 Monday, September 26, y • GI distress: absorbed quickly (snack before taking it)  Interactions • Increases CNS depression with alcohol, & other CNS depressants  (including herbs) • Increases phenytoin levels • Decreases levodopa effects • Nicotine counter­effects •Alcohol: slows down GABA transmission like a benzo; effects are synergistic when  taken together •Phenytoin (Dilantin) : increased levels with Benzos  • Decreases Levodopa effects (Parkinson's med)  • Nicotine is a stimulant; counteracts the effects of Benzos  Withdrawal – Develops slowly, in 2 to 10 days, and may last several weeks – Withdrawal symptoms • Tremor, agitation, nervousness • Sweating • Insomnia • Anorexia, muscle cramps • NT= neurotransmitters • Neuron 1: communicates with Neuron 2 to decrease the amount of the excitatory medication • Benzo: attach to the receptors to capture more GABA 5 Monday, September 26, y • Impulse of an exchange of electrolytes- especially chloride, the impulse will be inhibited to enhance the effect of the GABA • Benzo: enhances the effect of GABA- decreased neurotransmission of excitatory NT • Short half life (the holding) lasts 2-4 hours Nursing interventions – Monitor vital signs. – Encourage client to rise slowly to avoid dizziness. – Advise client not to drive a motor vehicle or operate dangerous  equipment.  – Client should not use for more than 2 to 4 months as tolerance develops  and effectiveness decreases. Typical Benzo dosage • Adults 2­6mg/day, 10 mg max/day • Peds: 0.05mg/kg, max 2mg per dose  • Older adult: 0.5 to 1 mg/day, 2 mg max/day • What characteristic makes dosing so strict?  • Who is at risk for benzo toxicity?  • *Dosages based on Ativan • Is this effective for long­term use?  Non­Benzo Anti­Anxiety Med • buspirone/Bu­Spar  • Action: Binds to serotonin and dopamine receptors • Balances out neurotransmitters  6 Monday, September 26, y • Must establish blood level for efficacy • Not for PRN use like benzos  • GAD and OCS, phobias  • works similarly as a SSRI ­ balances serotonin and dopamine  • Dopamine plays a role in behavior  • PO med for daily use to establish blood levels  • teaching point: be patient bc it will take a few weeks to be effective  Buspirone Side/Adverse effects:  • Dizziness, nausea, headache, lightheadedness, agitation • Constipation • Suicidal ideation  • Risk of Serotonin Syndrome Treating Insomnia • Benzodiazepines (short­term) – Temazepam (Restoril) • Non­benzo/barbiturates  – Zolpidem (Ambien) – Zoplicone (Lunesta) Zolpidem (Ambien) • 5­10mg PO HS • Inhibition of excitatory neurotransmitters by increasing GABA  • High PB; dose MUST be reduced in elderly • Monitor for tolerance and dependence  7 Monday, September 26, y • Rapid onset ~ 20 min  • Daytime sedation, confusion, dizziness • Teach non­pharmacologic methods for sleep • renal function needs to be adequate bc highly PB • need to know the dose for Ambien 5­10 mg  • increases GABA ** benzos do not  8


Buy Material

Are you sure you want to buy this material for

25 Karma

Buy Material

BOOM! Enjoy Your Free Notes!

We've added these Notes to your profile, click here to view them now.


You're already Subscribed!

Looks like you've already subscribed to StudySoup, you won't need to purchase another subscription to get this material. To access this material simply click 'View Full Document'

Why people love StudySoup

Jim McGreen Ohio University

"Knowing I can count on the Elite Notetaker in my class allows me to focus on what the professor is saying instead of just scribbling notes the whole time and falling behind."

Amaris Trozzo George Washington University

"I made $350 in just two days after posting my first study guide."

Steve Martinelli UC Los Angeles

"There's no way I would have passed my Organic Chemistry class this semester without the notes and study guides I got from StudySoup."


"Their 'Elite Notetakers' are making over $1,200/month in sales by creating high quality content that helps their classmates in a time of need."

Become an Elite Notetaker and start selling your notes online!

Refund Policy


All subscriptions to StudySoup are paid in full at the time of subscribing. To change your credit card information or to cancel your subscription, go to "Edit Settings". All credit card information will be available there. If you should decide to cancel your subscription, it will continue to be valid until the next payment period, as all payments for the current period were made in advance. For special circumstances, please email


StudySoup has more than 1 million course-specific study resources to help students study smarter. If you’re having trouble finding what you’re looking for, our customer support team can help you find what you need! Feel free to contact them here:

Recurring Subscriptions: If you have canceled your recurring subscription on the day of renewal and have not downloaded any documents, you may request a refund by submitting an email to

Satisfaction Guarantee: If you’re not satisfied with your subscription, you can contact us for further help. Contact must be made within 3 business days of your subscription purchase and your refund request will be subject for review.

Please Note: Refunds can never be provided more than 30 days after the initial purchase date regardless of your activity on the site.