Deck 11: Antianxiety Agents

Question 1

Benzodiazepines enhance or facilitate the action of the neurotransmitter:

A) acetylcholine.
B) epinephrine.
C) g-aminobutyric acid (GABA).
D) serotonin.

Answer 1

g-aminobutyric acid (GABA).

Question 2

Which of the following sleep stages is enhanced with the use of benzodiazepines?

A) Latency period
B) Rapid eye movement (REM)sleep
C) Non-rapid eye movement (NREM)sleep stages 3 and 4
D) Non-rapid eye movement (NREM)sleep stage 2

Answer 2

Non-rapid eye movement (NREM)sleep stage 2

Question 3

The benzodiazepines are preferable to the barbiturates as hypnotics because the risk of physical addiction or serious poisoning is much less. The efficacy of the benzodiazepines in the treatment of chronic insomnia has been demonstrated for longer than 2 years.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true; the second statement is false.
D) The first statement is false; the second statement is true.

Answer 3

The first statement is true; the second statement is false.

Question 4

Which of the following agents used for dental anxiety has a fast onset and short half-life?

A) Triazolam
B) Diazepam
C) Lorazepam
D) Alprazolam

Question 5

Which of the following benzodiazepines is the drug of choice for treatment of repetitive, intractable seizures that require IV therapy?

A) Chlordiazepoxide (Librium)
B) Diazepam (Valium)
C) Zolpidem (Ambien)
D) Eszopiclone (Lunesta)

Question 6

The clinical effects of benzodiazepines in humans are _____ at lower doses.

A) drowsiness and sleep
B) drowsiness and anxiety reduction
C) anxiety reduction and panic reduction
D) anxiety reduction and sleep

Question 7

Which benzodiazepine is preferred for use in elderly patients?

A) Benzodiazepines that require phase I metabolism and not phase II metabolism
B) Benzodiazepines that require phase II metabolism and not phase I metabolism
C) Benzodiazepines that require both phase I and phase II metabolism
D) Benzodiazepines that require neither phase I nor phase II metabolism

Question 8

______ is the only intravenously (IV)administered benzodiazepine that is used for conscious sedation in oral health care.

A) Chlordiazepoxide (Librium)
B) Lorazepam (Ativan)
C) Triazolam (Halcion)
D) Midazolam (Versed)

Question 9

The therapeutic index of benzodiazepines is _____ that of the barbiturates.

A) wider than
B) narrower than
C) the same as
D) None of the above are correct.

Question 10

Benzodiazepines are indicated for epilepsy because they:

A) reduce the electrical activity in the seizure focus.
B) limit the spread of abnormal activity to other parts of the brain.
C) produce analgesia so the patient does not feel any pain.
D) reduce hallucinations.

Question 11

_____ may be used to reverse some of the effects of a benzodiazepine.

A) Ramelteon (Rozerem)
B) Phenobarbital (Luminal)
C) Flumazenil (Romazicon)
D) Carisoprodol (Soma)

Question 12

Barbiturates act on nerves by enhancing the binding of which neurotransmitter to its receptor?

A) Glutamate
B) Serotonin
C) GABA
D) Chloride

Question 13

Which benzodiazepine would be most suitable for intramuscular (IM)administration?

A) Midazolam
B) Diazepam
C) Alprazolam
D) Flurazepam

Question 14

Which of the following agents are the most commonly prescribed antianxiety drugs?

A) Nonbenzodiazepine-nonbarbiturate sedative-hypnotics
B) Nonbenzodiazepine-nonbarbiturate receptor agonists
C) Benzodiazepines
D) Barbiturates

Question 15

Which of the following parenteral benzodiazepines seems to have the greatest likelihood to produce amnesia?

A) Diazepam (Valium)
B) Midazolam (Versed)
C) Triazolam (Halcion)
D) Eszopiclone (Lunesta)

Question 16

Antianxiety agents are most commonly orally administered because the effective dose of a particular antianxiety agent is very predictable.

A) Both parts of the statement are true.
B) Both parts of the statement are false.
C) The first part of the statement is true; the second part is false.
D) The first part of the statement is false; the second part is true.

Question 17

All of the following habits should be followed to minimize insomnia except for one. Which one is the exception?

A) Light snack (warm milk)at bedtime
B) Awake at 6 AM even if sleep only began at 5 AM
C) Exercise within 3 hours of bedtime
D) Remaining in bed no longer than 20 minutes without sleeping
E) No smoking within 8 hours of bedtime

Question 18

Which of the following agents may decrease the effectiveness of benzodiazepines?

A) Tobacco
B) Omeprazole
C) Valproic acid
D) Fluoxetine

Question 19

When benzodiazepines are used in dentistry to produce conscious sedation, the appearance of __________ is used as an initial endpoint for the dose administered.

A) flushed skin
B) miosis
C) ptosis
D) rapid eye movement

Question 20

Some benzodiazepines are transformed in the body to active metabolites. The active metabolites are formed by phase II drug metabolism.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true; the second statement is false.
D) The first statement is false; the second statement is true.

Question 21

Chronic use of barbiturates can lead to _____ dependence.

A) both physical and psychologic
B) physical but not psychologic
C) psychologic but not physical
D) neither physical nor psychologic

Question 22

Once a benzodiazepine is absorbed, the rate at which it reaches its site of action depends on which of the following? (Select all that apply.)

A) Lipid solubility
B) Protein binding
C) Ionization
D) The Food and Drug Administration (FDA)pregnancy category
E) First-order kinetics

Question 23

Chloral hydrate is the most popular sedative-hypnotic for children in the United States.

Question 24

Which of the following muscle relaxants has peripheral rather than central action?

A) Carisoprodol
B) Cyclobenzaprine
C) Tizanidine
D) Baclofen
E) Dantrolene

Question 25

Barbiturates can cause fetal harm if administered to a pregnant woman.

Question 26

Benzodiazepines are contraindicated in wide-angle glaucoma.

Question 27

Barbiturates have no significant analgesic effects.

Question 28

Anxiety control is only necessary for the first third of a dental appointment.

Question 29

Which of the following agents is a melatonin receptor agonist?

A) Buspirone
B) Zaleplon
C) Chloral hydrate
D) Ramelteon
E) Tizanidine

Question 30

Which agent has selective anxiolytic action without hypnotic, anticonvulsant, or muscle-relaxant properties?

A) Zolpidem
B) Flumazenil
C) Meprobamate
D) Buspirone
E) Tizanidine

Question 31

Barbiturates reduce the effects of the following drugs except which one?

A) Propoxyphene
B) Chlorpromazine
C) Warfarin
D) Phenytoin
E) Doxycycline

Question 32

Which of the following nonbenzodiazepine-benzodiazepine receptor agonists has the shortest half-life?

A) Zolpidem (Ambien)
B) Zaleplon (Sonata)
C) Eszopiclone (Lunesta)

Question 33

Which of the following statements are true concerning administration of benzodiazepines and pregnancy? (Select all that apply.)

A) An increased risk of congenital malformation in infants of mothers taking benzodiazepines in the second trimester has been reported.
B) Most of the benzodiazepines are classified as U.S. Food and Drug Administration (FDA)category D drugs; triazolam and temazepam are in FDA category X.
C) Near-term administration of benzodiazepines to the mother has resulted in floppy infant syndrome.
D) The administration of benzodiazepines is not a concern during pregnancy.

Question 34

Use of antianxiety agents in the dentist's office should be discouraged because it encourages addiction.

Question 35

Which of the following are rationales for the use of analgesic-sedative combinations? (Select all that apply.)

A) Relief of both anxiety and pain is often required in one patient.
B) Sedatives interfere with analgesic agents.
C) Sedatives may induce excitation when given without an analgesic to patients with uncontrolled pain.
D) Anxiety can raise the pain threshold.

Question 36

Although a lethal dose of barbiturates can only be approximated, severe poisoning will follow the ingestion of _____ times the hypnotic dose.

A) 5
B) 10
C) 15
D) 20

Question 37

Which of the following statements are true concerning the dental use of chloral hydrate? (Select all that apply.)

A) Chloral hydrate is the most popular drug used in dentistry for the preoperative sedation of children.
B) Benzodiazepines are a safer choice for sedation of children.
C) Chloral hydrate is no longer available for use in the United States.
D) Chloral hydrate is a benzodiazepine.

Question 38

Which of the following is considered to be the strongest centrally acting skeletal muscle relaxant?

A) Carisoprodol (Soma)
B) Methocarbamol (Robaxin)
C) Cyclobenzaprine (Flexeril)
D) Orphenadrine (Norflex)

Question 39

Which of the following is the longest acting barbiturate?

A) Methohexital (Brevital)
B) Pentobarbital (Nembutal)
C) Secobarbital (Seconal)
D) Phenobarbital (Luminal)

Question 40

The use of barbiturates is absolutely contraindicated in patients with a positive family history of:

A) high blood pressure.
B) diabetes.
C) porphyria.
D) adrenal insufficiency.

Question 41

Sedatives potentiate analgesic agents.