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Drug Name buspirone hydrochloride (byoo spye' rone) BuSpar Pregnancy Category B Drug class Anxiolytic Oral

Dosages

Therapeutic Actions Buspirone exerts anxiolytic activity through high affinity for serotonin 5-HT1A and 5-HT2 receptors. It has moderate affinity for dopamine D2receptors but no affinity for GABA receptors. Absorption: Rapidly absorbed from the GI tract (oral); peak plasma concentrations after 40-90 minutes. Distribution: Protein-binding: 95%. Metabolism: Extensively hepatic via hydroxylation and oxidative dealkylation. Excretion: Urine and feces (as metabolites); 2-4 hr (elimination half-life).

Indications Management of anxiety disorders or short-term relief of symptoms of anxiety Unlabeled use: Decreasing the symptoms (aches, pains, fatigue, cramps, irritability) of PMS

Adverse effects Dizziness, nausea, headache, nervousness, lightheadednes s, excitement, paresthesia, sleep disturbances, chest pain, tinnitus, nasal congestion, sore throat. Less sedation and lower potential for dependence compared to other anxiolytics.

Short-term management of anxiety Adult: Initially, 5 mg bid/tid increased by 5mg increments at intervals of 2-3 days. Max: 45 mg daily in divided doses. Max Dosage: 45 mg daily in divided doses.

Contraindicatio ns Hypersensitivity . Epilepsy; severe renal or hepatic impairment; children <18 yr; pregnancy, lactation.

Nursing considerations Assessment History: Hypersensitivity to buspirone, marked liver or renal impairment, lactation Physical: Weight; T; skin color, lesions; mucous membranes, throat color, lesions, orientation, affect, reflexes, vision examination; P, BP; R, adventitious sounds; bowel sounds, normal GI output, liver evaluation; normal urinary output, voiding pattern; LFTs, renal function tests, urinalysis, CBC and differential Interventions Provide sugarless lozenges or ice chips if dry mouth or altered taste occurs. Arrange for analgesic for headache or musculoskeletal aches. Teaching points Take this drug exactly as prescribed. Avoid the use of alcohol, sleep-inducing, or over-thecounter drugs and grapefruit juice; these could cause dangerous effects. You may experience these side effects: Drowsiness, dizziness, light-headedness

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Nursing Notes and Community

(avoid driving or operating complex machinery); GI upset (eat frequent small meals); dry mouth (suck ice chips or sugarless candies); dreams, nightmares, difficulty concentrating or sleeping, confusion, excitement (reversible; will stop when the drug is discontinued). Report abnormal involuntary movements of facial or neck muscles, motor restlessness; sore or cramped muscles; abnormal posture; yellowing of the skin or eyes.

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