buspirone hydrochloride Nursing Considerations & Management

Drug Name

Generic Name : buspirone hydrochloride

Brand Name: BuSpar

Classification: Anxiolytic

Pregnancy Category B

Dosage & Route
  • 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-HT1A 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).
  • 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.
  • Hypersensitivity. Epilepsy; severe renal or hepatic impairment; children <18 yr; pregnancy, lactation.
Nursing considerations
  • 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
  • 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.