Home Drug Guide Buspirone Hydrochloride

Drug Guide

Generic Name

Buspirone Hydrochloride

Brand Names Buspar

Classification

Therapeutic: Anxiolytic

Pharmacological: Serotonergic agent

FDA Approved Indications

  • Generalized Anxiety Disorder (GAD)

Mechanism of Action

Buspirone acts as a partial agonist at 5-HT1A serotonergic receptors, leading to anxiolytic effects without significant sedation or dependence.

Dosage and Administration

Adult: Start with 15 mg per day in two or three divided doses. Dose may be increased by 5 mg at intervals of 2 or more days, up to a maximum of 60 mg/day. Adjustments should be made based on clinical response and tolerability.

Pediatric: Safety and effectiveness in pediatric patients have not been established.

Geriatric: Start with lower doses (e.g., 7.5 mg twice daily). Monitor closely due to potential for increased sensitivity.

Renal Impairment: Adjust dosage as needed; no specific guidelines established. Evaluate renal function regularly.

Hepatic Impairment: Use with caution; start with lower doses and titrate carefully.

Pharmacokinetics

Absorption: Rapidly absorbed with peak plasma concentrations in about 1 hour.

Distribution: Widely distributed; low protein binding (~7%).

Metabolism: Primarily hepatic via CYP3A4 to inactive metabolites.

Excretion: Renal excretion of unchanged drug and metabolites.

Half Life: Approximately 2-3 hours.

Contraindications

  • Hypersensitivity to buspirone
  • Use with monoamine oxidase inhibitors (MAOIs) within 14 days.

Precautions

  • Use with caution in patients with hepatic or renal impairment. Monitor for serotonin syndrome, especially if used with other serotonergic agents. Avoid grapefruit juice, which can increase buspirone levels.

Adverse Reactions - Common

  • Dizziness (Common)
  • Nausea (Common)
  • Headache (Common)
  • Nervousness (Common)

Adverse Reactions - Serious

  • Serotonin syndrome (including agitation, hallucinations, coma) (Rare)
  • Extrapyramidal symptoms (Rare)
  • Priapism (Very rare)

Drug-Drug Interactions

  • Concomitant use with SSRIs, MAOIs, or other serotonergic agents increases risk of serotonin syndrome.
  • CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin) can increase buspirone levels.

Drug-Food Interactions

  • Grapefruit juice may increase plasma concentrations of buspirone.

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for effectiveness in reducing anxiety symptoms and for adverse effects.

Diagnoses:

  • Risk for falls due to dizziness
  • Anxiety related to underlying condition or medication side effects.

Implementation: Administer consistently, avoid sudden discontinuation, and educate patients on limitations of use, including that it may take several weeks for full therapeutic effect.

Evaluation: Assess reduction in anxiety symptoms and monitor for adverse reactions.

Patient/Family Teaching

  • Take medication regularly as prescribed.
  • Do not suddenly stop medication without consulting a healthcare provider.
  • Report any signs of serotonin syndrome, unusual mood changes, or worsening symptoms.
  • Limit grapefruit juice during treatment.

Special Considerations

Black Box Warnings: N/A

Genetic Factors: No specific genetic considerations noted.

Lab Test Interference: No significant interference reported.

Overdose Management

Signs/Symptoms: Dizziness, drowsiness, confusion, agitation.

Treatment: Supportive care; no specific antagonist. Activated charcoal may be considered if ingestion is recent. Cite medical attention immediately.

Storage and Handling

Storage: Store at room temperature, away from moisture, heat, and light.

Stability: Stable for at least 2 years when properly stored.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.