MINOR TRANQUILIZERS (ANTIANXIETY)

MEDICATION

NURSING
IMPLICATIONS

SIDE EFFECTS

PATIENT TEACHING

Xanax (Alprazolam)
Ther. class: antianxiety
Pharm class:
Benzodiazepines
Action: relief of anxiety

-assess degree &

manifestations of
anxiety & mental
status (orientation,
mood, behavior)
prior to &
periodically during
therapy
-assess for
drowsiness, lightheadedness, &
dizziness symptoms disappear
as therapy
progresses
-Geri: assess CNS
effects & risk of falls
- institute falls
prevention
strategies

-dizziness
-drowsiness
-lethargy
-confusion
-headache
-mental depression
-paradoxical
excitation
-blurred vision
-constipation
-diarrhea
-nausea
-vomiting
-weight gain
-physical
dependence
-psychological
dependence
-tolerance

-do not skip or

double up on missed
doses - abrupt
withdrawal may
cause sweating,
vomiting, muscle
cramps, tremors &
seizures
-avoid driving &
other activities
requiring alertness
until response to
medication is known
-avoid alcohol or
other CNS
depressants while
taking drug
-prescribed for shortterm use ONLY
-administer with
food if GI upset
occurs
-administer greatest
dose at bedtime to
avoid daytime
sedation
-avoid grapefruit
juice during therapy

MEDICATION

NURSING
IMPLICATIONS

SIDE EFFECTS

PATIENT TEACHING

Librium
(Chlordiazepoxide)
Ther. class: antianxiety
Pharm class:
Benzodiazepines
Action: relief of
anxiety; sedation

-assess for anxiety &

level of sedation
(ataxia, dizziness,
slurred speech)
periodically during
therapy
-assess degree &
manifestations of
anxiety & mental
status (orientation,
mood, behavior)
prior to &
periodically during
therapy
-Geri: assess risk of
falls & institute fall
prevention
strategies

-dizziness
-drowsiness
-headache
-mental depression
-paradoxical
excitation
-sedation
-blurred vision
-constipation
-diarrhea
-nausea
-vomiting
-weight gain
-physical
dependence
-psychological
dependence

-sudden cessation
may lead to
withdrawal
(insomnia,
irritability,
nervousness,
tremors)
-do not share with
others
-avoid driving or
other activities
requiring alertness
until response to
medication is known
-avoid alcohol or
other CNS
depressants while
taking drug
-notify health care
professional if
pregnancy is
planned or
suspected or if
breastfeeding

MEDICATION

NURSING
IMPLICATIONS

SIDE EFFECTS

PATIENT TEACHING

Valium (Diazepam)
Ther. class: antianxiety
Pharm. class:
Benzodiazepines
Action: relief of
anxiety; sedation

-monitor BP, pulse, &

respiratory rate prior
to & periodically
throughout &
frequently during IV
therapy
-assess IV site
frequently during
admin - may cause
phlebitis &
thrombosis
-observe depressed
patients closely for
suicidal tendencies
-assess mental
status (orientation,
mood, behavior) &
degree of anxiety
-assess level of
sedation (ataxia,
dizziness, slurred
speech) prior to &
periodically during
therapy
-keep patient on
bedrest & observe
for 3hrs following
parenteral admin
-given IV push

-dizziness
-drowsiness
-lethargy
-depression
-ataxia
-slurred speech
-headache
-paradoxical
excitation
-blurred vision
-respiratory
depression
-hypotension (IV
only)
-constipation
-diarrhea
-nausea
-vomiting
-weight gain
-rashes
-pain (IM)
-phlebitis (IV)
-venous thrombosis
-physical
dependence
-psychological
dependence

-abrupt withdrawal
may cause insomnia,
unusual irritability or
nervousness, &
seizures
-do not share
medication
-avoid driving or
other activities
requiring alertness
until response to
medication is known
-advise geri patients
of increased risk of
CNS effects &
potential for falls
-avoid alcohol or
other CNS
depressants while
taking drug
-advise patient to
notify health care
professional if
pregnancy is
planned or
suspected
-important to followup with health care
provider

MEDICATION

NURSING
IMPLICATIONS

SIDE EFFECTS

PATIENT TEACHING

Ativan (Lorazepam)
Ther. class: antianxiety
Pharm. class:
Benzodiazepines
Action: decreased
anxiety; sedation

-pedi: assess
neonates for
prolonged CNS
depression related
to inability to
metabolize med
-geri: more sensitive
to CNS reactions assess falls risk
-assess degree &
manifestations of
anxiety & mental
status (orientation,
mood, behavior)
prior to &
periodically
throughout therapy

-dizziness
-drowsiness
-lethargy
-headache
-ataxia
-slurred speech
-mental depression
-paradoxical
excitation
-blurred vision
-respiratory
depression
-rapid IV use only:
APNEA, CARDIAC
ARREST,
bradycardia,
hypotension
-constipation
-diarrhea
-nausea
-vomiting
-weight gain
(unusual)
-physical
dependence
-psychological
dependence
-tolerance

-for short-term used

ONLY
-do not increase or
skip dose
-decrease dose
gradually - abrupt
withdrawal may
cause tremors,
nausea, vomiting, &
abdominal & muscle
cramps
-teach other
methods to decrease
anxiety, such as
increased exercise,
support groups,
relaxation
techniques
-avoid driving or
other activities
requiring alertness
until response to
medication is known
-avoid or other CNS
depressants while
taking drug
-contact health care
professional
immediately if
pregnancy is
planned or
suspected
-important to followup with health care
provider

MEDICATION

NURSING
IMPLICATIONS

SIDE EFFECTS

PATIENT TEACHING

Klonopin (Clonazepam)
Ther. class:
anticonvulsants
Pharm. class:
Benzodiazepines
Action: prevention of
seizures; decreased
manifestations of
panic disorder

-observe and record

intensity, duration, &
location, and
location of seizure
activity
-assess degree &
manifestations of
anxiety & mental
status (orientation,
mood, behavior)
prior to &
periodically during
therapy
-monitor closely for
notable changes in
behavior that could
indicate the
emergence or
worsening of suicidal
thoughts or behavior
or depression

-SUICIDAL
THOUGHTS
-behavioral changes
-drowsiness
-fatigue
-slurred speech
-ataxia
-sedation
-abnormal eye
movements
-increased resp.
secretions
-palpitations
-constipation
-diarrhea
-hepatitis
-weight gain
-dysuria
-nocturia
-urinary retention
-anemia
-eosinophilia
-leukopenia
-thrombocytopenia
-ataxia
-fever
-physical
dependence
-psychological
dependence
-tolerance

-take with food to

minimize gastric
irritation
-take missed doses
within 1hr or omit do not double doses
-abrupt withdrawal
of drug may cause
status epilepticus,
tremors, nausea,
vomiting, &
abdominal & muscle
cramps
-for short-term use
ONLY
-avoid driving or
other activities
requiring alertness
until response to
drug is known
-avoid alcohol or
other CNS
depressants while
taking drug
-notify health care
professional of
medication regimen
prior to treatment or
surgery
-notify health care
professional of
unusual tiredness,
bleeding, sore
throat, fever, claycolored stools,
yellowing of skin, or
behavioral changes
-notify health care
professional if
thoughts about
suicide or dying,
attempts to commit
suicide, new or
worse depression,
new or worse
anxiety or other
changes in behavior
-notify if pregnancy
is planned or
suspected or if
breastfeedinig