Deck 13: Anxiolytics,sedative Hypnotics,anesthetics,and Anticonvulsants

Question 1

All of the following are brain structures associated with mediating anxiety and fear EXCEPT the:

A)amygdala
B)insula
C)orbitofrontal cortex
D)pons

Answer 1

D

Question 2

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

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

Answer 2

A

Question 3

__________ is an anxiety disorder in which an individual fears being in places or situations that would be hard or embarrassing to escape from in the event of a panic attack.

A)Agoraphobia
B)Generalized anxiety disorder
C)Social anxiety disorder
D)Posttraumatic stress disorder

Answer 3

A

Question 4

Situated in the brain,the ______ mediates anxiety and panic.

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

Question 5

Benzodiazepines produce their effects by acting on ______ neurons in the ______.

A)glutamate; cortex
B)serotonin; thalamus
C)GABA; brainstem
D)GABA; limbic system

Question 6

If your grandmother was born in the 1930s and developed mild epilepsy when she was in her 20s during the 1950s,__________ would have most likely have been prescribed.

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

Question 7

Ultrashort-acting barbiturates are ______ while long-acting barbiturates are _______.

A)water soluble; lipid soluble
B)lipid soluble; water soluble
C)weaker; stronger
D)analgesic; sleep inducing

Question 8

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

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

Question 9

The primary advantage of _______ is that they are rarely fatal in the event that someone takes too many pills.

A)barbiturates
B)nonbarbiturates
C)benzodiazepines
D)anticonvulsants

Question 10

In the 1950s,______ was the primary medication for treating anxiety,epilepsy,and general anesthesia.

A)benzodiazepine
B)barbiturate
C)alcohol
D)an antipsychotic

Question 11

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

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 12

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

A)1 minute.
B)1 week.
C)5 days.
D)variable.

Question 13

Barbiturates were named according to their:

A)effect.
B)structure.
C)receptor affinity.
D)clinical action.

Question 14

In 2013,benzodiazepines were involved in about _____ percent of fatal overdoses in the United States.

A)20
B)30
C)40
D)50

Question 15

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 water soluble

Question 16

__________ is the most common cause of death when combining benzodiazepines with another CNS depressant or alcohol.

A)Hypotension
B)Bradycardia
C)Seizure
D)Respiratory depression

Question 17

Barbiturates are in a class of drugs known as:

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

Question 18

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

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

Question 19

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

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

Question 20

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

A)the therapeutic-to-toxic range is narrow.
B)an overdose is often lethal.
C)they have a relatively low potential for tolerance,dependence,and abuse.
D)they generally interact with a number of other drugs.

Question 21

Tolerance to barbiturates occurs via:

A)improved cell membrane transport.
B)altered drug metabolism.
C)inhibition of enzymes related to drug metabolism.
D)induction of drug-metabolizing liver enzymes.

Question 22

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

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

Question 23

Experiencing ______ is the most common symptom of withdrawal from normal clinical doses of barbiturates.

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

Question 24

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 25

The elderly __________ compared to young adults.

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 26

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

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

Question 27

Ariel must have brain surgery.In order to ensure that her brain tissue resection goes well,it is important that she be awake and cooperative for a portion of the surgery.However,it is preferable that she not remember the procedure.The anesthesiologist will induce a state of:

A)catatonia.
B)cognitive inhibition.
C)conscious sedation.
D)conscious torpor.

Question 28

Barbiturates are:

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

Question 29

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 30

Benzodiazepines differ from one another mainly in:

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

Question 31

Of the nonbarbiturate sedative-hypnotic drugs,only ______ has been placed on two FDA-classified schedules.

A)paraldehyde
B)gamma hydroxybutyrate (Xyrem)
C)chloral hydrate (Noctec)
D)methaqualone (Quaalude)

Question 32

The nonbarbiturate sedatives:

A)neither structurally resemble nor act like barbiturates.
B)structurally resemble but do not act like barbiturates and lack the barbiturate nucleus.
C)act like,but do not structurally resemble,the barbiturates.
D)structurally resemble and act like barbiturates but lack the barbiturate nucleus.

Question 33

Caution should be used when prescribing benzodiazepines to the elderly because they:

A)are rarely very effective.
B)may cause them to fall.
C)could interact with other medications reducing effectiveness.
D)may be metabolized into long-lasting,pharmacologically active metabolites.

Question 34

Paraldehyde:

A)is eliminated through the urine causing a change in the color to dark red.
B)was historically used to treat delirium tremens (DTs)during the detoxification of alcoholics.
C)has a reputation for use as a potent aphrodisiac.
D)is still used in the treatment of narcolepsy.

Question 35

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

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

Question 36

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 37

__________ is the treatment for barbiturate overdose.

A)Administration of the specific antidote
B)Respiratory support
C)Cardiovascular support
D)Respiratory and cardiovascular support

Question 38

Experiencing ______ is the most common symptom of withdrawal from excessively high doses of barbiturates.

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

Question 39

Benzodiazepines differ from one another in their:

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

Question 40

Quaaludes can be classified as:

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

Question 41

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

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

Question 42

Following the loss of his wife due to an illness,Phil has developed panic attacks and generalized anxiety.__________ and __________ therapy is the preferred long-term treatment of this condition.

A)Benzodiazepine; amphetamine
B)Benzodiazepine; cognitive behavioral
C)Antidepressant; cognitive behavioral
D)Antidepressant; atypical antipsychotic

Question 43

The antiepileptic effects of benzodiazepines:

A)is thought to be due to activity at GABA receptors in the hippocampus.
B)involves reduced activity of GABA in the cerebellum.
C)could be due to toxic effects at a variety of receptors.
D)may involve GABA receptors in the brainstem that cause a suppression of discharge rate.

Question 44

Presently,______ are primarily used for the treatment of chronic anxiety.

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

Question 45

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 46

Benzodiazepines:

A)are recommended for long-term treatment of anxiety.
B)are all delivered orally.
C)may potentially induce dependence.
D)may be used to treat depression.

Question 47

The so-called nonbenzodiazepine BZRAs include all of the following EXCEPT:

A)ramelteon (Rozerem).
B)zaleplon (Sonata).
C)zolpidem (Ambien).
D)eszopiclone (Lunesta).

Question 48

The benzodiazepines are best prescribed for:

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

Question 49

Following cessation of long-term benzodiazepine use,episodes of __________ can be one of the early withdrawal signs.

A)general calm.
B)sleepiness.
C)restlessness.
D)general calm,sleepiness,and restlessness.

Question 50

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 51

Effects of the benzodiazepines include:

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

Question 52

Nonbenzodiazepine BZRAs are prescribed for:

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

Question 53

Benzodiazepines produce _________ when given to patients in higher doses.

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

Question 54

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

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

Question 55

Benzodiazepines facilitate the action of the neurotransmitter:

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

Question 56

__________ is the main effect of the benzodiazepine antagonist flumazenil.

A)Anxiolysis
B)Anxiety
C)Sedation
D)Nonexistent

Question 57

Benzodiazepines ________ binding at the ________ receptor.

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

Question 58

For benzodiazepine overdose,__________ are preferred for treatment.

A)stimulants
B)several cups of coffee
C)GABA_A receptor antagonists
D)benzodiazepine receptor antagonists

Question 59

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

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

Question 60

Perhaps __________ is the best use of benzodiazepines.

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

Question 61

Zolpidem is prescribed for treating:

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

Question 62

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

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

Question 63

Patients starting antiepileptic drugs should be monitored for any emerging signs of:

A)depression.
B)suicidality.
C)anxiety neurosis.
D)schizophrenia.

Question 64

Evidence suggests that ramelteon (Rozerem)is ______ effective at inducing sleep with ______ on total sleep time.

A)very; significant effects
B)modestly; little impact
C)very; modest effects
D)modestly; significant effects

Question 65

The majority of anticonvulsants appear to be safe for use during pregnancy with the exception of:

A)gabapentin (Neurontin).
B)pregabalin (Lyrica).
C)valproic acid (Depakote).
D)lamotrigine (Lamictal).

Question 66

All of the following are inhalation anesthetics EXCEPT:

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

Question 67

__________ is the most common cause of death from nitrous oxide.

A)Convulsions
B)Hypoxia
C)Stroke
D)Hypotension

Question 68

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 69

The inhaled anesthetics include:

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

Question 70

Zaleplon (Sonata)is a:

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

Question 71

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 72

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 73

Zolpidem binds to:

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

Question 74

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

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

Question 75

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 76

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 77

Zolpidem (Ambien)is a:

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

Question 78

Of the anticonvulsants,______ has a unique place in the treatment of not only epilepsy,but also chronic pain.

A)carbamazepine (Tegretol,Equitro)
B)phenytoin (Dilantin)
C)lamotrigine (Lamictal)
D)gabapentin (Neurontin)

Question 79

__________ is a recent low-dose formulation of zolpidem used for treating patients who wake during the night.

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

Question 80

______ 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)