A nurse is educating a group of nursing students about the pharmacological management of anxiety disorders. The nurse explains that benzodiazepines are often used as second-line agents or as adjuncts to antidepressants for the treatment of anxiety disorders. The nurse further explains that benzodiazepines:
Enhance the activity of gamma-aminobutyric acid (GABA) in the brain.
Block beta-adrenergic receptors in the heart and blood vessels.
Partially agonize serotonin 5-HT1A receptors and antagonize dopamine D2 receptors.
Modulate the activity of various neurotransmitters and ion channels in the brain.
The Correct Answer is A
Choice A rationale:
Enhance the activity of gamma-aminobutyric acid (GABA) in the brain. Benzodiazepines are known to enhance the inhibitory effects of GABA, the major inhibitory neurotransmitter in the central nervous system. This results in reduced neuronal excitability, leading to the anxiolytic (anxiety-reducing) effects of benzodiazepines.
Choice B rationale:
Block beta-adrenergic receptors in the heart and blood vessels. This statement is incorrect. While beta-blockers can be used to manage certain physical symptoms of anxiety (such as rapid heartbeat), benzodiazepines do not directly block beta-adrenergic receptors.
Choice C rationale:
Partially agonize serotonin 5-HT1A receptors and antagonize dopamine D2 receptors. This statement is inaccurate. Benzodiazepines primarily interact with GABA receptors, not serotonin or dopamine receptors.
Choice D rationale:
Modulate the activity of various neurotransmitters and ion channels in the brain. This statement is overly broad and doesn't accurately describe the specific mechanism of benzodiazepines. Their primary mode of action is through enhancing GABAergic inhibition.
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Correct Answer is ["B","D"]
Explanation
Choice A rationale:
Enhance the activity of gamma-aminobutyric acid (GABA) in the brain - This choice is not accurate. Beta-blockers do not enhance GABA activity; instead, they affect adrenergic pathways in the body.
Choice B rationale:
Block beta-adrenergic receptors in the heart and blood vessels - This is correct. Beta-blockers primarily work by blocking beta-adrenergic receptors, leading to reduced heart rate, decreased blood pressure, and decreased cardiac output. In the context of social anxiety disorder, beta-blockers can help manage physical symptoms of anxiety, such as tremors and rapid heartbeat.
Choice C rationale:
Partially agonize serotonin 5-HT1A receptors and antagonize dopamine D2 receptors - This choice is not accurate. Beta-blockers do not significantly interact with serotonin or dopamine receptors in this manner.
Choice D rationale:
Modulate the activity of various neurotransmitters and ion channels in the brain - This is also correct. While beta-blockers are primarily known for their effects on adrenergic pathways, they can also have indirect effects on various neurotransmitters and ion channels in the brain, contributing to their anxiolytic properties.
Correct Answer is C
Explanation
Choice A rationale:
Benzodiazepines are central nervous system (CNS) depressants, and alcohol also has a depressant effect on the CNS. When combined, they can potentiate each other's effects, leading to excessive sedation, dizziness, and impaired coordination. This can result in increased risks of accidents and injuries.
Choice B rationale:
While alcohol can indeed enhance the sedative effects of benzodiazepines, this is not the primary reason for instructing the patient to avoid alcohol. The main concern is the potential for adverse interactions, as mentioned in choice C.
Choice C rationale:
(Correct Choice) Alcohol can cause adverse interactions with benzodiazepines. Both substances act as depressants on the CNS, and their combined use can lead to severe sedation, respiratory depression, and even coma or death. In addition, the combination can impair cognitive and motor functions, making it unsafe to engage in activities such as driving.
Choice D rationale:
Alcohol's potential to increase the risk of dependence on benzodiazepines is a valid concern, but it is not the primary reason for advising the patient to avoid alcohol. The immediate risk of adverse interactions takes precedence.
Choice E rationale:
While alcohol can worsen the symptoms of anxiety disorder, this is not the primary reason for instructing the patient to avoid alcohol. The focus here is on the potential dangerous interactions between alcohol and benzodiazepine medications.
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