<prompt> hyperventilation may lead to ?tetanyrespiratory alkalosismetabolic acidosismetabolic alkalosis  <response>: 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 