Deck 13: Sedative-Hypnotic and Anxiolytic Medications

Question 1

The treatment for overdose of barbiturates is:

A) administration of the specific antidote for barbiturates.
B) respiratory support.
C) cardiovascular support.
D) both respiratory and cardiovascular support.

Answer 1

D

Question 2

The sedative-hypnotic properties of sedatives most likely results from effects on:

A) acetylcholine.
B) glutamate.
C) GABA.
D) AMPA.

Answer 2

C

Question 3

The most common symptom of withdrawal from normal clinical doses of barbiturates is:

A) hallucinations.
B) convulsions.
C) disorientation.
D) sleeplessness.

Answer 3

D

Question 4

The elimination half-life of all the various barbiturates is:

A) one minute.
B) one week.
C) 5 days.
D) variable.

Question 5

Barbiturates are in a class of drugs known as:

A) CNS stimulants.
B) sedative-anxiolytics.
C) sedative-hypnotics.
D) narcotics.

Question 6

If your grandmother was born in the 1930s and developed mild epilepsy when she was in her 20's (the 1950s),she would have most likely have been treated with:

A) alcohol.
B) antipsychotics
C) benzodiazepines.
D) barbiturates.

Question 7

Magnetic resonance imaging (MRI)suggests that panic disorder patients may exhibit abnormalities in the:

A) amygdala.
B) hippocampus.
C) substantia nigra.
D) basal ganglia.

Question 8

The "nonbarbiturate" sedatives:

A) neither structurally resemble nor act like barbiturates.
B) structurally resemble (without the barbiturate nucleus),but do not act like,barbiturates.
C) act like,but do not structurally resemble,the barbiturates.
D) structurally resemble (without the barbiturate nucleus)and act like the barbiturates.

Question 9

The barbiturates:

A) suppress memory and increase REM sleep.
B) suppress memory and decrease REM sleep.
C) decrease REM sleep but do not affect memory.
D) increase REM sleep but do not affect memory.

Question 10

Quaaludes can be classified as:

A) barbiturates sedatives.
B) nonbarbiturates sedatives.
C) aphrodisiacs.
D) narcotics.

Question 11

The ultrashort-acting barbiturates are highly ________; the longer-acting barbiturates are ________.

A) water soluble; highly fat soluble
B) fat soluble; highly fat soluble
C) water soluble; highly water soluble
D) fat soluble; more watersoluble

Question 12

The most common cause of death when combining benzodiazepines with another CNS depressant or alcohol is:

A) hypotension.
B) bradychardia.
C) seizures.
D) respiratory depression.

Question 13

The brain site(s)mediating anxiety and/or panic is(are)the:

A) amygdala.
B) limbic cortex.
C) superior colliculi.
D) pons.

Question 14

The most common symptom(s)of withdrawal from excessively high doses of barbiturates is:

A) headaches.
B) convulsions.
C) nausea.
D) coughing.

Question 15

In cases of barbiturates overdose,treatment:

A) focuses on support of the cardiovascular and respiratory system.
B) concentrates on stimulating kidney function.
C) focuses on stimulating the gastrointestinal tract to induce vomiting.
D) is rarely necessary.

Question 16

Barbiturates are:

A) cognitive enhancers.
B) cognitive inhibitors.
C) analgesics.
D) stimulating.

Question 17

The sedative-hypnotic properties of sedatives most likely results from ______ neurotransmission.

A) impairment of GABA-induced
B) facilitation of GABA-induced
C) impairment of glutamate-induced
D) stimulation of glutamate-induced

Question 18

The use of barbiturates has declined over the years for all of the following reasons EXCEPT:

A) barbiturates are usually lethal in overdose.
B) the dosage range for the effectiveness of barbiturates is very close to its toxic range.
C) barbiturates interact dangerously with a wide range of drugs.
D) barbiturates are sedating.

Question 19

The hypnotic action of the ultrashort-acting barbiturates is terminated by:

A) absorption.
B) redistribution.
C) degradation.
D) elimination.

Question 20

The so-called "Mickey Finn" is comprised of _____ and ethanol.

A) Soma
B) Quaaludes
C) paraldehyde
D) chloral hydrate

Question 21

Benzodiazepines differ from one another in their:

A) basic structure.
B) plasma half-lives.
C) binding sites.
D) site of action.

Question 22

Presently,the drug of choice for the treatment of chronic anxiety is:

A) benzodiazepines.
B) depressants.
C) sedatives.
D) antidepressants.

Question 23

Benzodiazepines may be useful for treating all of the following EXCEPT:

A) anxiety.
B) insomnia.
C) alcohol withdrawal.
D) intoxication.

Question 24

The drug of choice for the induction of anterograde amnesia is:

A) benzodiazepines.
B) depressants.
C) sedatives.
D) antidepressants.

Question 25

Generally speaking,the long-acting benzodiazepines are biotransformed into _____ products; the short-acting benzodiazepines are biotransformed into ______ products.

A) inactive; inactive
B) active; active
C) inactive; active
D) active; inactive

Question 26

Gamma hydroxybutyric acid (GHB)acts to:

A) inhibit panic attacks.
B) inhibit sexual performance.
C) potentiate sedation and depress central nervous system function.
D) enhance cognition.

Question 27

Effects of the benzodiazepines include:

A) sedation.
B) anxiolysis.
C) muscle relaxation.
D) All of the answers are correct.

Question 28

Of the benzodiazepines,only _______ is available in an injectable formulation.

A) trinazepam (Lipizam)
B) lorazepam (Ativan)
C) midazolam (Versed)
D) diazepam (Valium)

Question 29

Benzodiazepines ________ binding at the ________ receptor.

A) facilitate; GABA
B) facilitate; 5-HT
C) inhibit; GABA
D) inhibit; 5-HT

Question 30

The main effect of the benzodiazepine antagonist flumazenil is:

A) anxiolysis.
B) anxiety.
C) sedation.
D) non-existent.

Question 31

Early withdrawal signs following cessation of long-term benzodiazepine use include:

A) general calm.
B) sleepiness.
C) restlessness.
D) All of the answers are correct.

Question 32

Higher doses of benzodiazepines produce:

A) exhilaration.
B) depression.
C) amnesia.
D) cognitive enhancement.

Question 33

When mixed with alcohol,______ produces amnesia without loss of consciousness similar to a "Mickey Finn."

A) lorazepam (Ativan)
B) flunitrazepam (Rohypnol)
C) midazolam (Versed)
D) diazepam (Valium)

Question 34

Compared with young adults,the elderly:

A) are less sensitive to the benzodiazepines.
B) are more tolerant to the benzodiazepines.
C) more readily metabolize benzodiazepines.
D) less readily metabolize benzodiazepines.

Question 35

Perhaps the best use of benzodiazepines is in:

A) treating epilepsy.
B) treating chronic anxiety.
C) treating panic disorder.
D) intentionally producing anterograde amnesia.

Question 36

Benzodiazepines facilitate the action of the neurotransmitter:

A) GABA.
B) ACh.
C) NE.
D) 5-HT.

Question 37

The preferred pharmacological treatment for benzodiazepine overdose is:

A) stimulants.
B) coffee.
C) GABA_A receptor antagonists.
D) benzodiazepine receptor antagonists.

Question 38

The benzodiazepines are best prescribed for:

A) directly relaxing muscles.
B) alleviating depression.
C) treating chronic anxiety.
D) treating short-term anxiety.

Question 39

Benzodiazepines differ from one another mainly in:

A) pharmacodynamics.
B) pharmacokinetics.
C) both pharmacodynamics and pharmacokinetics.
D) neither pharmacodynamics nor pharmacokinetics.

Question 40

Long-term benzodiazepine use is associated with an increase in:

A) depression.
B) bipolar disorder.
C) Parkinson's disease.
D) cognitive deficits.

Question 41

Zolpidem is a:

A) benzodiazepine receptor agonist.
B) benzodiazepine receptor antagonist.
C) nonbenzodiazepine BZRA.
D) nonbenzodiazepine receptor antagonist.

Question 42

Of the injectable anesthetics,______ is an ultrashort-acting barbiturate.

A) methohexital (Brevital)
B) propofol (Diprovan)
C) fospropofol (Lusedra)
D) etomidate (Amidate)

Question 43

The inhaled anesthetics include:

A) morphine.
B) ketamine.
C) phenobarbital.
D) nitrous oxide.

Question 44

Of the benzodiazepines prescribed for their hypnotic properties,______ is the shortest acting.

A) flurazepam (Dalmane)
B) estazolam (ProSom)
C) temazepam (Restoril)
D) triazolam (Halcion)

Question 45

Buspirone is useful for treating ________ in the elderly.

A) alcohol withdrawal
B) benzodiazepine withdrawal
C) insomnia
D) agitated dementia

Question 46

Of the nonbenzodiazepine BZRAs,_______ has the shortest half-life.

A) eszopiclone (Lunesta)
B) zaleplon (Sonata)
C) zolpidem (Ambien)
D) triazolam (Halcion)

Question 47

Zaleplon (Sonata)is a:

A) long-acting anxiolytic.
B) long-acting hypnotic.
C) short-acting anxiolytic.
D) short-acting hypnotic.

Question 48

The most common cause of death with nitrous oxide is:

A) convulsions.
B) hypoxia.
C) stroke.
D) hypotension.

Question 49

The new low-dose formulation of zolpidem used for treating patients that wake during the night is called:

A) Intermezzo.
B) Halcion.
C) Edluar.
D) Ambien CR.

Question 50

Ambien (zolpidem)binds to:

A) glutamate receptors.
B) GABA_B receptors.
C) GABA_C receptors.
D) a subunit of the GABA_A receptor.

Question 51

The drug Ambien (zolpidem)is prescribed for treating:

A) anxiety.
B) depression.
C) insomnia.
D) agitation.

Question 52

The major mechanism of action of gabapentin (Neurontin)is:

A) blockade of voltage-dependent sodium channels.
B) enhanced GABA-mediated inhibition of neural activity.
C) blockade of GABA receptors.
D) enhanced glutamate-mediated neurotransmission.

Question 53

The major mechanism of action of the injectable anesthetics is probably:

A) perturbation of the cell membrane.
B) potentiation of GABA_A-induced neurotransmission.
C) potentiation of glutamate-induced neurotransmission.
D) induction of analgesia.

Question 54

______ is an agonist at melatonin receptors as well as an antagonist at serotonin 5-HT_2c receptors.

A) Eszopiclone (Lunesta)
B) Ramelteon (Rozerem)
C) Agomelatine (Valdoxan)
D) Zaleplon (Sonata)

Question 55

Nonbenzodiazepine BZRAs are prescribed for:

A) insomnia.
B) depression.
C) anxiety.
D) bipolar disorder.

Question 56

All of the following are inhalation anesthetics EXCEPT:

A) isoflurane.
B) propofol.
C) desflurane.
D) sevoflurane.

Question 57

The aim of research into "partial GABA agonists" is to manufacture a drug that produces:

A) sedation without anxiolysis.
B) anxiolysis without sedation.
C) sedation without ataxia.
D) ataxia without sedation.

Question 58

At the receptor level,buspirone acts as a(n)______ (postsynaptic)receptors.

A) agonist at 5-HT₃
B) antagonist at 5-HT₃
C) partial agonist at 5-HT1_A
D) partial antagonist at 5-HT1_A

Question 59

Ambien (zolpidem)differs from BZRAs in that:

A) its effects are qualitatively similar but greater than BZRAs.
B) its effects are qualitatively similar but weaker than BZRAs.
C) it produces anxiolysis without sedation.
D) it produces sedation without anxiolysis.

Question 60

Buspirone reduces:

A) both anxiety and depression within hours of administration.
B) anxiety within hours of administration,but depression only after weeks of administration.
C) depression within hours of administration,but anxiety only after weeks of administration.
D) both anxiety and depression,but only after weeks of administration.

Question 61

Benzodiazepines act directly to stimulate the GABA receptor.

Question 62

A major side effect of the benzodiazepines is amnesia.

Question 63

Drowsiness and alterations in judgment are common effects seen with barbiturate use.

Question 64

Benzodiazepines have a higher overdose toxicity than barbiturates.

Question 65

The nonbarbiturate sedatives act like,but do not structurally resemble,the barbiturates.

Question 66

Dreaming is vivid and excessive for those patients that stop taking barbiturates.

Question 67

At the cellular level,the novel antiepileptic agent lacosamide (Vimpat )affects:

A) K⁺ channel activation.
B) K⁺ channel modulation.
C) Na⁺ channel activation.
D) Na⁺ channel modulation.

Question 68

REM sleep is unaffected by barbiturates.

Question 69

Barbiturates are considered the classic prototype of sedative-hypnotic drugs.

Question 70

A number of benzodiazepines are biotransformed into active metabolites.

Question 71

The half-life of zaleplon (Sonata)is very long so it may be particularly effective for helping people get to sleep and stay asleep throughout the night.

Question 72

Benzodiazepines are an ideal treatment of choice for depression.

Question 73

The therapeutic-to-toxic range for barbiturates is very narrow.

Question 74

Fortunately,there are specific antidotes to barbiturates overdose.

Question 75

Benzodiazepines are a form of barbiturate.

Question 76

The benzodiazepines are ideal for the short-term treatment of debilitating anxiety.

Question 77

Barbiturates are considered to be effective analgesics.

Question 78

Benzodiazepines are the treatment of choice for chronic anxiety.

Question 79

Partial GABA_A antagonists like zolpidem (Ambien)reduce anxiety without producing sedation.

Question 80

The antiepileptic effect of benzodiazepines appears to involve effects on GABA receptors in the hippocampus and cerebellum.