busPIRone (Rx)

Assessment - Assess anxiety reaction: inability to sleep, apprehension, dread, foreboding, or uneasiness related to unidentified source of danger - Assess for previous product dependence or tolerance; if patient is product dependent or tolerant, amount of medication should be restricted - Monitor B/P (lying, standing), pulse; if systolic B/P drops 20 mm Hg, hold product, notify prescriber; check I&O; may indicate renal dysfunction - Monitor mental status: mood, sensorium, affect, sleeping patterns, drowsiness, dizziness, suicidal tendencies; withdrawal symptoms when dose is reduced or product discontinued - Assess for CNS reaction, some reactions may be unpredictable

Patient/family education - Teach patient that product may be taken consistently with or without food; if dose is missed take as soon as remembered; do not double doses - Caution patient to avoid OTC preparations unless approved by the prescriber; to avoid alcohol ingestion and other psychotropic medications unless prescribed; that 1- 2 wk of therapy may be required before therapeutic effects occur; to avoid large amounts of grapefruit juice - Caution patient to avoid driving and activities requiring alertness since drowsiness may occur; until medication response is known, tell patient that drowsiness may worsen at beginning of treatment - Instruct patient not to discontinue medication abruptly after long- term use; if dose is missed, do not double - Advise patient to rise slowly or fainting may occur, especially in geriatric Serotonin syndrome: Teach patient to report immediately (fever, tremor, sweating, diarrhea, delirium)

Evaluation

Positive therapeutic outcome: Increased well- being, Decreased anxiety, restlessness, sleeplessness, dread