Psychopharmacology - Wilkes
Actual Questions and Answers
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,### 1. What medical conditions may precipitate anxiety?
Answer:
- Endocrine: Diabetes Mellitus, Thyroid Disorders
- Neurological: Seizures
- Respiratory: COPD/Asthma
- Cardiac Disease
Explanation: Various medical conditions can mimic or exacerbate anxiety
symptoms. Hormonal imbalances in endocrine disorders, neurological events
like seizures, pulmonary limitations in respiratory diseases, and cardiac-
related issues can all contribute to heightened anxiety.
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### 2. What is the mechanism of action (MOA) of benzodiazepines?
Answer: Benzodiazepines enhance the activity of GABA at the GABA-A
receptor, act as positive allosteric modulators, bind to specific receptor sites,
and increase the receptor's affinity for GABA.
Explanation: This results in increased chloride ion influx leading to
hyperpolarization of the neuron, thus reducing neuronal excitability and
producing anxiolytic, sedative, muscle relaxant, and anticonvulsant effects.
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### 3. What are the effects of benzodiazepines in the elderly population?
, Answer: Increased fall risk and hip fracture risk.
Explanation: Due to age-related pharmacokinetic and pharmacodynamic
changes, elderly patients are more susceptible to the sedative effects of
benzodiazepines, resulting in impaired coordination and balance, significantly
increasing the risk of falls and related injuries.
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### 4. What are the clinical concerns when prescribing benzodiazepines?
Answer: Potential for abuse and addiction; physical dependence and
tolerance; known limitations include rebound insomnia.
Explanation: Benzodiazepines carry a risk of dependency, particularly when
used for prolonged periods. Tolerance can develop, necessitating higher
doses for the same effect, and abrupt cessation leads to rebound symptoms,
including anxiety and insomnia.
### 5. What is the first line of treatment for anxiety disorder?
Answer: SSRIs (Selective Serotonin Reuptake Inhibitors) are the first-line
treatment for chronic anxiety, Generalized Anxiety Disorder (GAD), and
panic disorder.
Explanation: SSRIs, such as escitalopram and paroxetine, are preferred
due to their favorable safety and tolerability profile, as well as their efficacy