SJH Nursing Officer - 2019
Pharmacology
Easy
Propranolol can be used to allay anxiety associated with?
Appeared in: SJH Nursing Officer - 2019
Explanation
- Propranolol is a beta-blocker that effectively manages the peripheral somatic (physical) symptoms of anxiety, such as tachycardia, tremors, and sweating.
- Its mechanism involves blocking the effects of adrenaline on the body's beta-receptors, which are activated during the 'fight or flight' response.
- This makes it particularly useful for performance anxiety, a type of anxiety linked to short-term stressful situations like public speaking or exams.
- A typical dose is 10 to 40 mg taken about 20-30 minutes before the stressful event.
Why Other Options Were Wrong
- Option A: Chronic neurotic disorders, such as Generalized Anxiety Disorder (GAD), involve persistent and excessive worry. Propranolol does not treat these core psychological symptoms.
- Option B: Schizophrenia is a psychotic disorder characterized by symptoms like hallucinations, delusions, and disorganized thought. Propranolol has no antipsychotic properties.
- Option D: Endogenous depression is a mood disorder. Propranolol is not an antidepressant and can sometimes cause or worsen depressive symptoms like fatigue.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pharmacological management of anxiety with beta-blockers as background academic context rather than a clinical decision trigger.
- A key nursing responsibility before administering propranolol is to check the patient's heart rate and blood pressure. Hold the dose if the heart rate is below 60 bpm or if the patient is hypotensive.
- Propranolol is contraindicated in patients with asthma or severe COPD because its non-selective action can block beta-2 receptors in the lungs, leading to bronchospasm.
- It can mask the signs of hypoglycemia (like tachycardia) in diabetic patients, requiring careful monitoring of blood glucose levels.
How to Approach the Question
- First, identify the drug mentioned: Propranolol. Recall its drug class: a non-selective beta-adrenergic antagonist (beta-blocker).
- Next, recall the primary mechanism of beta-blockers in psychiatry. They work by blocking the peripheral effects of adrenaline, thus controlling physical symptoms like a racing heart, sweating, and tremors.
- Analyze the options in the context of this mechanism. Which type of anxiety is primarily characterized by acute physical symptoms that need to be controlled for a short period?
- Evaluate the options: Chronic disorders (neurosis, depression) and psychosis (schizophrenia) require long-term treatment targeting brain chemistry, not just peripheral symptoms.
- Conclude that propranolol's effect on physical symptoms makes it most suitable for short-term stressful situations or performance anxiety.
Concept Tested & Keywords
- Concept Tested: Pharmacological management of anxiety with beta-blockers.
- Stem keywords: Propranolol, anxiety
- Lead-in keywords: used to allay
- Negative lead-in flag: false
Question ID
QpZPLdTiRApLzHhgtVmLVq
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 10480-10482, 10481-10483
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 2126-2128
Practise the full SJH Nursing Officer - 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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