<s>[INST] context: Hyperventilation syndrome * Hyperventilation syndrome (HVS) represents a relatively common emergency depament (ED) presentation that is readily recognized by most clinicians. * The underlying patho-physiology has not been clearly elucidated. * HVS is a condition in which minute ventilation exceeds metabolic demands, resulting in hemodynamic and chemical changes that produce characteristic dysphoric symptoms * Inducing a drop in PaCO, through voluntary hyperventilation reproduces these symptoms. * Many patients with HVS do not manifest low PaCO, during attacks. Pharmacologic Therapy * Benzodiazepines are useful in the treatment of hyperventilation resulting from anxiety and panic attacks. * By binding to specific receptor sites, these agents appear to potentiate the effects of gamma-aminobutyric acid (GABA) and to facilitate inhibitory GABA neurotransmission and the actions of other inhibitory transmitters. * Alprazolam (xanax) is indicated for treatment of anxiety and management of panic attacks. * Lorazepam (ativan) is a sedative-hypnotic of the benzodiazepine class that has a sho time to onset of effect and a relatively long half-life. ref : harrisons 21st ed [/INST] question: hyperventilation may lead to ? | options: A: tetany B: respiratory alkalosis C: metabolic acidosis D: metabolic alkalosis | answer: A </s>