Psychiatric Drugs and Medications Q 36

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For which of the following medical conditions would the nurse anticipate that an antianxiety agent would not be indicated?

  

     A. Seizure disorders

     B. Alcohol detoxification

     C. Parkinson's disease

     D. Panic disorder

    

    

Correct Answer: C. Parkinson’s disease

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Benzodiazepines may exacerbate the symptoms of Parkinson’s disease. Benzodiazepines are a class of drugs that act upon benzodiazepine receptors (BZ-R) in the central nervous system (CNS). The receptor is a protein composed of five transmembrane subunits that form a chloride channel in the center, i.e., GABA-A receptor. The five subunits consist of two alpha, two beta, and one gamma subunit. The extracellular portions of the alpha and beta subunit proteins form a receptor site for gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter.

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Option A: Benzodiazepines are especially important in the cessation of seizure activity, as 1% to 2% of emergency department visits annually in the United States are for seizures. Indications for benzodiazepine administration include, but are not limited to, anxiety disorders, insomnia, acute status epilepticus, induction of amnesia, spastic disorders, seizure disorders, and agitation.

Option B: Benzodiazepines have the largest and the best evidence base in the treatment of alcohol withdrawal, and are considered the gold standard. Others, such as anticonvulsants, barbiturates, adrenergic drugs, and GABA agonists have been tried and have evidence.

Option D: Benzodiazepines approved by the FDA for the treatment of panic disorder include alprazolam (Xanax) and clonazepam (Klonopin). Benzodiazepines are generally used only on a short-term basis because they can be habit-forming, causing mental or physical dependence.

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