00:01
Let's do another case study.
00:02
A 45-year old
emergency room physician
is complaining of anxiety,
difficulty sleeping,
and an inability to cope
with the stresses of his daily job.
00:14
He gets buspirone prescribed to him.
00:16
The following are true
about this particular medication.
00:21
A. The patient may not notice
improvement for up to 10 days.
00:28
B. Buspirone has
a high addictive potential
and it should not be given
to a person with ready access
to multiple medications.
00:37
C. Buspirone acts through
antagonizing orexin receptors
in the brain.
00:43
Or D. Buspirone will cause sedation
and motor coordination issues.
00:49
It should not be used in a person
like an ER doctor.
00:53
Which one's true?
Right.
A is true.
00:58
In fact, this is a very good
illustration of where buspirone is,
is actually
an advantages drug,
because it doesn't cause a lot of
psychomotor retardation
or coordination issues.
01:08
It doesn't cause a lot of
addictive issues.
01:11
And obviously,
it does not act through
the orexin receptor.
01:16
Let's go on to
a second case study.
01:18
A 21-year old
grocery store clerk
complains of occasional
rapid heart rate,
complaints with sweating,
some anxiety, and nausea.
01:28
Episodes are brought about
when her supervisors present.
01:32
She doesn't complain
of any of these symptoms
when she's on holidays,
or when she's in
social circumstances
not related to work.
01:40
The best medication to use
in this situation
is one of the following.
01:44
A. Propranolol,
B. Eszopiclone,
C. Zopiclone,
D. Tasimelton,
or E. Alprazolam.
01:56
So we have several
good choices here.
01:58
But I think the best answer for this
question is E. Alprazolam.
02:02
Alprazolam is an excellent
anti-anxiety medication
and it's good for
situational anxiety.
02:07
One could suggest A.
02:09
But A, is a little bit different
in the sense that it's purely
a beta blocker.
02:13
If patients come to you
complaining of, you know,
pounding chest and
pounding tachycardia
prior to say doing a speech
in front of a large audience,
you might want to consider
propranolol in that situation.
02:25
But I think
in this particular answer,
where she has multiple symptoms
associated with anxiety,
including the
sweating and nausea,
I think it's reasonable
to go to alprazolam.
02:37
Okay, that's it.
02:38
You did really well.
02:39
Good luck on your exams.