A nurse is providing education to a client with panic disorder about the pharmacological treatment options. Which statement by the client indicates understanding of the teaching?
"I should avoid medications that increase serotonin levels in the brain.”
"Antihypertensives can help reduce physical symptoms of panic attacks.”
"Antiepileptics can enhance the effects of gamma-aminobutyric acid (GABA) in the brain.”
"Tricyclic antidepressants inhibit the reuptake of norepinephrine in the brain.”
The Correct Answer is C
Choice A rationale:
"I should avoid medications that increase serotonin levels in the brain." While avoiding medications that increase serotonin levels is relevant in some cases, it's not a comprehensive understanding of pharmacological treatment for panic disorder. Serotonin-related medications like selective serotonin reuptake inhibitors (SSRIs) are commonly used for panic disorder treatment.
Choice B rationale:
"Antihypertensives can help reduce physical symptoms of panic attacks." This statement is not accurate. Antihypertensives are not commonly used to treat panic disorder. Medications like beta-blockers may be prescribed to manage some physical symptoms of anxiety, but they are not a primary treatment for panic disorder.
Choice C rationale:
"Antiepileptics can enhance the effects of gamma-aminobutyric acid (GABA) in the brain." This is the correct choice. Antiepileptic medications like pregabalin and gabapentin can indeed enhance the effects of GABA, an inhibitory neurotransmitter that helps reduce anxiety and panic. These medications are sometimes used to manage panic disorder symptoms.
Choice D rationale:
"Tricyclic antidepressants inhibit the reuptake of norepinephrine in the brain." While tricyclic antidepressants have been used historically to treat panic disorder, they are not considered first-line treatments due to their potential side effects and the availability of newer, safer options. The statement in Choice D is accurate but not as relevant to current treatment approaches.
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Correct Answer is D
Explanation
Choice A rationale:
Taking benzodiazepines as needed for panic attacks is an incorrect statement. Benzodiazepines are generally not intended for "as-needed" use due to the risk of dependence and withdrawal. They are typically prescribed on a scheduled basis to provide consistent anxiety relief.
Choice B rationale:
Avoiding alcohol while taking benzodiazepines is important due to potential interactions between alcohol and the medication. Both substances can have central nervous system depressant effects, which can lead to increased drowsiness, impaired coordination, and cognitive deficits.
Choice C rationale:
Experiencing drowsiness and dizziness are common side effects of benzodiazepines. Educating the client about these potential side effects is necessary to promote safety and to avoid engaging in activities that require alertness while taking the medication.
Choice D rationale:
This statement indicates a need for further education. Abruptly stopping benzodiazepines can lead to withdrawal symptoms, which may include increased anxiety, irritability, insomnia, and even seizures. Benzodiazepines should be tapered off gradually under medical supervision.
Correct Answer is B
Explanation
Choice A rationale:
The statement "I'm not worried about having another panic attack" indicates a lack of understanding of anticipatory anxiety. Anticipatory anxiety is characterized by the fear of experiencing future panic attacks, so this statement contradicts that concept.
Choice B rationale:
This choice is correct because it reflects an accurate understanding of anticipatory anxiety. Anticipatory anxiety is the fear of being in situations or places where escape might be challenging or embarrassing in the event of a panic attack. This fear often leads to avoidance behavior and can worsen the overall anxiety.
Choice C rationale:
The statement "I don't think my panic attacks are related to my thought patterns" suggests a misunderstanding of the connection between thoughts and panic attacks. In reality, panic attacks are often triggered by anxious thoughts and thought patterns.
Choice D rationale:
The statement "I believe my panic attacks are caused by a substance I'm using" indicates a different perspective on the origin of panic attacks. While substance use can contribute to anxiety or trigger panic attacks in some cases, anticipatory anxiety specifically refers to the fear of future panic attacks, not their immediate causes.
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