A client diagnosed with an Anxiety Disorder tells a nurse that being in crowds creates thoughts of losing control and the need to suddenly leave. What should the nurse recommend as an effective, non-pharmacological therapy for managing the client’s symptoms of anxiety?

Choice A Reason:

Acupuncture.

Acupuncture is a traditional Chinese medicine practice that involves inserting thin needles into specific points on the body to balance energy flow and promote healing. While it is a form of manual therapy, it is not part of chiropractic medicine. Chiropractors focus on the musculoskeletal system, particularly the spine, and do not typically use acupuncture as a primary treatment modality.

Choice B Reason:

Surgical procedures.

Surgical procedures are not part of chiropractic medicine. Chiropractors are not licensed to perform surgeries. Their practice is centered around non-invasive treatments, primarily involving manual adjustments and manipulations of the spine and other joints. Surgery is outside the scope of chiropractic care and is typically handled by medical doctors or surgeons.

Choice C Reason:

Spinal manipulation.

This is the correct response. Spinal manipulation, also known as chiropractic adjustment, is a core component of chiropractic medicine. Chiropractors use their hands or specialized instruments to apply controlled force to spinal joints, aiming to improve spinal alignment, reduce pain, and enhance physical function. This technique is fundamental to chiropractic care and distinguishes it from other forms of manual therapy.

Choice D Reason:

Prescription medications.

Prescription medications are not part of chiropractic medicine. Chiropractors do not prescribe medications; instead, they focus on manual therapies, exercise, and lifestyle counseling to manage and prevent musculoskeletal issues. The use of medications is typically managed by medical doctors or other healthcare providers.

Choice A Reason:

Prevents the breakdown of acetylcholine.

Galantamine is an acetylcholinesterase inhibitor, which means it works by preventing the breakdown of acetylcholine in the brain. Acetylcholine is a neurotransmitter that is important for memory and learning. By inhibiting the enzyme that breaks down acetylcholine, galantamine increases the levels of acetylcholine available in the brain, which can help improve cognitive function in patients with Alzheimer’s disease1. This mechanism of action is crucial because it directly addresses the cholinergic deficit observed in Alzheimer’s disease.

Choice B Reason:

Decreases amyloid plaques in the brain.

This statement is incorrect. Galantamine does not work by decreasing amyloid plaques in the brain. Amyloid plaques are one of the pathological hallmarks of Alzheimer’s disease, but galantamine’s primary mechanism of action is related to acetylcholine metabolism. Other treatments and research efforts focus on targeting amyloid plaques, but this is not the function of galantamine.

Choice C Reason:

Increases acetylcholine levels in the brain.

While this statement is partially correct, it is not as precise as the correct answer. Galantamine increases acetylcholine levels indirectly by preventing its breakdown rather than directly increasing its production. The distinction is important because the therapeutic approach involves inhibiting the enzyme acetylcholinesterase, which breaks down acetylcholine, thereby increasing its availability.

Choice D Reason:

Limits neurotransmitter engagement of NMDA receptors.

This statement is incorrect. Limiting neurotransmitter engagement of NMDA receptors is the mechanism of action for a different class of Alzheimer’s medications, such as memantine. Galantamine does not affect NMDA receptors; instead, it enhances cholinergic function by inhibiting acetylcholinesterase and potentiating nicotinic receptors.