UNIT 2 - BENZODIAZEPINES AND ANXIETY Worksheet: Benzodiazepines and anxiety Case Study Part A Mary is a 38 year old single mother of two school age children (James 7 and Emma 9). Mary works full time as a secretary. Mary is admitted to the Emergency Department after collapsing at work one morning and she is discharged in the afternoon after investigations show no abnormalities. Mary is told to see her GP for follow up the next day. Mary describes the incident as a sudden onset of severe chest pain. She couldn’t breathe and thought she was going to die. She felt panicked and thought she was having a stroke like her mother did. She is very frightened and says this has happened a number of times but never this bad. On further questioning, she has difficulty getting to sleep as she lies awake worrying about things she needs to get done the following day. She has a poor appetite and recent weight loss which she attributes to being very stressed about work, money and her family. She says she has been taking Valium, Xanax and Normison she obtained from friends and a number of Doctors and Community Pharmacists. They don’t seem to work as well and she needs to take more to relieve the symptoms. Points for Discussion • What are the important issues here? • What are the risks and what assessments might you use? • What is the diagnosis or problem which carries the most risk? • What interventions would be useful at this consultation? • What support could local health services offer at this point? UNIT 2 - BENZODIAZEPINES AND ANXIETY Worksheet: Benzodiazepines and anxiety Case Study Part B Mary presents at the Emergency Department on ten occasions over the following three weeks, with similar symptoms. On her tenth visit, a member of the Mental Health Service is called to see her. She is very distressed and expresses fleeting thoughts of harming herself and feelings of hopelessness about her situation. She is also concerned about her escalating benzodiazepine use. Points for Discussion • What particular challenges might there be with this case? • What additional information would you be seeking from Mary? And how would this change your management? • How could Mary be effectively managed using the services and resources in your local area?
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