Psychiatric Medications Q 35
Alfred was newly diagnosed with anxiety disorder. The physician prescribed buspirone (BuSpar). The nurse is aware that the teaching instructions for newly prescribed buspirone should include which of the following?
A. A warning about the drug's delayed therapeutic effect, which is from 14 to 30 days.
B. A warning about the incidence of neuroleptic malignant syndrome (NMS).
C. A reminder of the need to schedule blood work in 1 week to check blood levels of the drug.
D. A warning that immediate sedation can occur with a resultant drop in pulse.
Correct Answer: A. A warning about the drug’s delayed therapeutic effect, which is from 14 to 30 days.
The client should be informed that the drug’s therapeutic effect might not be reached for 14 to 30 days. The client must be instructed to continue taking the drug as directed. Unlike benzodiazepines and barbiturates, there is no associated risk of physical dependence or withdrawal with buspirone use due to the lack of effects on GABA receptors. However, buspirone has little efficacy as an acute anxiolytic as clinical effect typically takes 2 to 4 weeks to achieve.[1] Buspirone is FDA approved for the short and long-term treatment of GAD, as well as short-term symptomatic relief of anxiety. It is as effective as benzodiazepine treatment for GAD.
Option B: NMS hasn’t been reported with this drug, but tachycardia is frequently reported. Patients should receive a warning about the possibility of CNS depression. While rarer, patients should also be informed of the potential for akathisia (likely due to central dopamine antagonism) and serotonin syndrome.
Option C: Blood level checks aren’t necessary. Offer frequent follow-up after initiating treatment to assess for therapeutic and adverse effects. Encourage patients to stay consistent with their medication schedule and whether they take it with food. As mentioned before, a therapeutic effect typically takes 2 to 4 weeks to take effect. Often, many of the adverse effects will lessen over time, as well. However, the patient should have close monitoring for signs and symptoms of anaphylaxis, akathisia, and serotonin syndrome.
Option D: Relative to other anxiolytics, buspirone has low toxicity and potential for abuse. There have been no deaths reported from a buspirone overdose alone. In pharmacological trials, healthy male patients were given up to 375 mg per day and developed nausea, vomiting, dizziness, drowsiness, miosis, and gastric distress. While buspirone overdose typically resolves with complete recovery, high suspicion of additional medication overdose should be maintained and investigated.