buspirone hydrochloride

Drug Name

Generic Name : buspirone hydrochloride
Brand Name: BuSpar
Classification: Anxiolytic
Pregnancy Category B

Dosage & Route

Oral

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

Therapeutic actions

• Buspirone exerts anxiolytic activity through high affinity for serotonin 5-HT_1A and 5-HT₂ receptors. It has moderate affinity for dopamine D₂-receptors 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, lightheadedness, excitement, paresthesia, sleep disturbances, chest pain, tinnitus, nasal congestion, sore throat. Less sedation and lower potential for dependence compared to other anxiolytics.

Contraindications

• 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-the-counter drugs and grapefruit juice; these could cause dangerous effects.
• You may experience these side effects: Drowsiness, dizziness, light-headedness (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.

Posted in: Pharmacology