WorksheetsSedative Hypnotics
Total questions: 20
Worksheet time: 10mins
Downregulation of receptors is most likely to occur with the long-term administration of which type of drug?
Receptor antagonist
Enzyme inhibitor
reuptake inhibitor
Neurotransmitter precursor
The mechanism of action of barbiturates differs from that of benzodiazepines in that they:
Do not affect the GABA-benzodiazepine receptor-chloride channel complex
Act as inverse agonists at the benzodiazepine receptor
Increase the frequency of chloride channel opening without affecting its life time
Have both GABA-facilitatory as well as GABA-mimetic actions
Currently barbiturates are primarily used as:
Hypnotic
Sedative
Antiepileptic
Preanaesthetic medicant
Which of the following molecular processes best describes the mechanism of action of benzodiazepines?
potentiating the effect of GABA at chloride ion channels by binding to its alpha-1 subunit
potentiating the effect of GABA at chloride ion channels by binding to its alpha-2 subunit
potentiating the effect of GABA at chloride ion channels by binding to its beta subunit
potentiating the effect of GABA at chloride ion channels by binding to both alpha-1 and alpha-2 subunit
Which one of the following statements best describes flumazenil?
does not produce withdrawal seizures
has the longest elimination half-life
is also used for the treatment of epilepsy
is a selective benzodiazepine antagonist
Zaleplon differs from zolpidem in which one of the following ways?
produces withdrawal seizures
has a shorter elimination half-life
shows less tolerance to sedative effects
produces greater morning sedation
Which one of the following anxiolytic drugs is noted for its lack of sedation?
Buproprion
diazepam
oxazepam
alprazolam
buspirone
Increased tendency to fall asleep at night naturally without causing central nervous system depression is a property
exhibited by:
Buspirone
Pyridoxine
Diphenhydramine
Melatonin
Ethanol
Which statement concerning the barbiturates is accurate?
Respiratory depression caused by barbiturate overdosage can be reversed by flumazenil
Barbiturates may increase the half-lives of drugs metabolized by the liver
Alkalinization of the urine accelerates the elimination of phenobarbital
Compared with barbiturates, the benzodiazepines exhibit a steeper dose-response relationship
A 24-year-old stockbroker has developed a "nervous disposition." He is easily startled, worries about inconsequential matters, and sometimes complains of stomach cramps. At night he grinds his teeth in his sleep. There is no history of drug abuse. Diagnosed as suffering from generalized anxiety disorder, he is prescribed buspirone. His physician should inform the patient to anticipate
A need to continually increase drug dosage because of tolerance
A significant effect of the drug on memory
Additive CNS depression with alcoholic beverages
That the drug is likely to take a week or more to begin working
That if he stops taking the drug abruptly, he will experience withdrawal signs
Which of the following best describes the mechanism of action of benzodiazepines?
Increase duration of opening of chloride ion channels coupled to GABAA receptors
Block glutamate receptors in hierarchical neuronal pathways in the brain
Increase frequency of opening of chloride ion channels coupled to GABAA receptors
Inhibit GABA transaminase to increase brain levels of GABA
Stimulate release of GABA from nerve endings in the brain
An 82-year-old woman, otherwise healthy for her age, has difficulty sleeping. Triazolam is prescribed for her at one half of the conventional adult dose. Which statement about the use of triazolam in this elderly patient is accurate?
Ambulatory dysfunction does not occur in elderly patients taking one half of the conventional adult dose
Hypertension is a common adverse effect of benzodiazepines in elderly patients
Over-the-counter cold medications may antagonize the hypnotic effects of the drug
The patient may experience amnesia, especially if she also consumes alcoholic beverages
Triazolam is distinctive in that it does not cause rebound insomnia on abrupt discontinuance
A 28-year-old woman has sporadic attacks of intense anxiety with marked physical symptoms, including hyperventilation, tachycardia, and sweating. If she is diagnosed as suffering from a panic disorder, the most appropriate drug to use is
Propranolol
Eszopiclone
Flurazepam
Clonazepam
Ramelteon
Which drug used in the maintenance treatment of patients with tonic-clonic or partial seizure states increases the hepatic metabolism of many drugs including both warfarin and phenytoin?
Buspirone
Chlordiazepoxide
Eszopiclone
Phenobarbital
Triazolam
A patient with liver dysfunction is scheduled for a surgical procedure. Lorazepam or oxazepam can be used for preanesthetic sedation in this patient without special concern regarding excessive CNS depression because these drugs are
Actively secreted in the renal proximal tubule
Eliminated via the lungs
Metabolized via conjugation extrahepatically
Reversible by administration of naloxone
Selective anxiolytics like buspirone
This drug used in the management of insomnia facilitates the inhibitory actions of GABA, but it lacks anticonvulsant or muscle-relaxing properties and has minimal effect on sleep architecture. Its actions are antagonized by flumazenil.
Buspirone
Chlordiazepoxide
Eszopiclone
Ramelteon
Phenobarbital
The following is a very potent and short acting benzodiazepine whose use as hypnotic has been noted to cause psychiatric disturbances in some cases:
Flurazepam
Nitrazepam
Temazepam
Triazolam
Select the correct statement about flumazenil:
It is a CNS stimulant used as an antidote for benzodiazepine poisoning
It is a CNS depressant but blocks the action of diazepam
It has no CNS effect of its own but blocks the depressant effects of benzodiazepines as well as barbiturates
It has no CNS effect of its own but blocks the depressant effect of diazepam as well as stimulant effect of beta carbolines
Which of the following is not a CNS depressant but increases the tendency to fall asleep at night:
Pyridoxine
Diphenhydramine
Melatonin
Ethanol
The barbiturate having higher anticonvulsant: sedative activity ratio is:
Pentobarbitone
Phenobarbitone
Butabarbitone
Thiopentone
