Question 1

Select the adverse effects associated with the use of the barbiturate class of drugs.

Accepted Answer

The adverse effects associated with the barbiturates are an extension of their therapeutic action (CNS depression). Drowsiness, dry mouth, lethargy, and lack of coordination occur most frequently.

Question 2

Differentiate between triazolam (Halcion),temazepam (Restoril),flurazepam (Dalmane),and estazolam (ProSom),and select the drug product that is a short-acting hypnotic and does not produce active metabolites.

Accepted Answer

Triazolam is a short-acting hypnotic with no active metabolites. This hypnotic does not usually cause residual effects the day following a hypnotic dose.

Question 3

Flurazepam (Dalmane) is classified as a long-acting benzodiazepine.The antianxiety effects of flurazepam are usually evident the day after taking the flurazepam dose.Select the precaution that you will emphasize to the patient when you give him the prescription the doctor has written.

Accepted Answer

Remind the patient to avoid hazardous activities when using hypnotic drugs. The depressant effects of the long-acting hypnotics can persist during the next day and can cause drowsiness and impaired motor coordination. Instruct the patient of the dangers of combining hypnotics with other CNS depressants such as alcohol and antianxiety drugs. The combination can cause significant CNS depression and respiratory difficulties.

Question 4

In large doses,barbiturates lead to cardiovascular and central nervous system depression.Use critical thinking to select the reason this depression occurs.

Accepted Answer

Inhibition of vasomotor centers in the medulla oblongata removes sympathetic control of the blood vessels, which contributes to the production of hypotension and shock. In the presence of hypotension, kidney function decreases. Medullary respiratory centers also are depressed, leading to irregular breathing and hypoxia (cyanosis).

Question 5

Select the correct indication of use for zaleplon (Sonata).

Accepted Answer

Zaleplon is rapidly absorbed and provides a short duration of action. It is useful for individuals having difficulty falling asleep; it has not been shown to increase total sleep time.

Question 6

An elderly patient requests that the physician prescribe her chloral hydrate in place of zaleplon or zolpidem.You research the drug and find that chloral hydrate is an old drug related to alcohol that is still being used today,primarily in the elderly.The usual dosage range is 500-1000 mg.The patient states that she is having difficulty swallowing tablets because they stick to her tongue.Select the dosage form of chloral hydrate that is commercially available and could be prescribed for this patient.

Accepted Answer

The main use of chloral hydrate is as a hypnotic, particularly in the elderly. The usual dosage is 500-1000 mg administered as capsules or syrup; rectal suppositories are also available.

Question 7

Select the contributing factor that leads to physical dependency while taking barbiturates.

Accepted Answer

Physical dependency on barbiturates usually develops when greater therapeutic dosages are taken on a regular basis for more than 1 to 2 months.

Question 8

Differentiate between secobarbital,amobarbital,pentobarbital,and phenobarbital,and select the product indicated for patients who have difficulty falling asleep but not staying asleep.

Accepted Answer

Secobarbital is a short-acting hypnotic, with a duration of action of 2 to 4 hours. The hypnotic indication is for individuals who have difficulty falling asleep but not staying asleep.

Question 9

Select the primary mechanism of action of disulfiram (Antabuse).

Accepted Answer

Disulfiram inhibits the enzyme acetaldehyde dehydrogenase, which slows the conversion of acetaldehyde to acetyl coenzyme A, leading to an accumulation of acetaldehyde in the body when alcohol is consumed. This accumulation causes unpleasant side effects, such as flushing, vomiting, and headache, which discourage the individual from drinking alcohol.

Question 10

Barbiturates affect the rate of metabolism of certain drugs.Select the drug class that has a decreased pharmacological effect as a result of concurrent use of barbiturates.

Accepted Answer

Because barbiturates cause enzyme induction, other drugs may be metabolized more rapidly in their presence. This rapid metabolism results in a decreased pharmacological effect of drugs such as the oral anticoagulants and oral contraceptives.

Quiz 12: Sedative-Hypnotic Drugs and Alcohol

Select the adverse effects associated with the use of the barbiturate class of drugs.

Differentiate between triazolam (Halcion) ,temazepam (Restoril) ,flurazepam (Dalmane) ,and estazolam (ProSom) ,and select the drug product that is a short-acting hypnotic and does not produce active metabolites.

Flurazepam (Dalmane) is classified as a long-acting benzodiazepine.The antianxiety effects of flurazepam are usually evident the day after taking the flurazepam dose.Select the precaution that you will emphasize to the patient when you give him the prescription the doctor has written.

In large doses,barbiturates lead to cardiovascular and central nervous system depression.Use critical thinking to select the reason this depression occurs.

Select the correct indication of use for zaleplon (Sonata) .

Select the contributing factor that leads to physical dependency while taking barbiturates.

Differentiate between secobarbital,amobarbital,pentobarbital,and phenobarbital,and select the product indicated for patients who have difficulty falling asleep but not staying asleep.

Select the primary mechanism of action of disulfiram (Antabuse) .

Barbiturates affect the rate of metabolism of certain drugs.Select the drug class that has a decreased pharmacological effect as a result of concurrent use of barbiturates.