Deck 11: Antianxiety Agents

Question 1

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

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

Answer 1

GABA

Question 2

Benzodiazepines enhance or facilitate the action of the neurotransmitter

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

Answer 2

g-aminobutyric acid (GABA).

Question 3

Which is the primary adverse reaction associated with the use of benzodiazepines for conscious sedation?

A)Anterograde amnesia
B)Retrograde amnesia
C)Spiking blood pressure
D)Respiratory depression

Answer 3

Respiratory depression

Question 4

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 5

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

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

Question 6

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 7

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

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

Question 8

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 is false.
D)The first statement is false,the second is true.

Question 9

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 10

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

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

Question 11

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 12

______ is an 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 13

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

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

Question 14

_____ 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 15

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 16

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 17

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 18

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 19

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 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 is false.
D)The first statement is false,the second is true.

Question 21

The nonbenzodiazepine,benzodiazepine receptor agonists (NBRAs)are used to treat

A)panic attacks.
B)generalized anxiety.
C)insomnia.
D)seizures.

Question 22

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 23

Which is best for all types of anxiety and muscle strain?

A)Barbiturates
B)Meprobamate
C)Benzodiazepines
D)Placebo

Question 24

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 25

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

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

Question 26

Which of the following is the longest acting barbiturate?

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

Question 27

Each of the following is true of melatonin except one.Which is the exception?

A)Melatonin is a naturally occurring hormone.
B)Melatonin is a scheduled drug that requires a prescription.
C)Melatonin may cause daytime sedation.
D)Melatonin has been shown to have no benefit over a placebo in several clinical trials.

Question 28

Most patients with generalized anxiety disorder and panic attacks are being treated with

A)benzodiazepines.
B)barbiturates.
C)nonbenzodiazepine-nonbarbiturate sedative-hypnotics.
D)antidepressants.

Question 29

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 30

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 first trimester has been reported.
B)Benzodiazepines do not cross the placental barrier.
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 31

What percentage of Americans only seek oral health care when absolutely necessary?

A)0%
B)5%
C)10%
D)20%

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 muscle relaxants has peripheral rather than central action?

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

Question 34

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)First-order kinetics

Question 35

What should be done once a patient being treated with a benzodiazepine for "dental appointment" insomnia sees there is no reason to fear the appointment?

A)Cut the dose by one-half.
B)Switch to a nonbenzodiazepine,benzodiazepine receptor agonist such as eszopiclone.
C)Utilize nonpharmacologic sleep measures prior to the next appointment.
D)Don't make any changes in the prescription.

Question 36

Suvorexant (Belsorma)works by

A)facilitating the action of g-aminobutyric acid (GABA).
B)blocking orexin neuropeptides from binding to their receptors.
C)enhancing GABA-receptor binding.
D)binding to serotonin in the CNS.

Question 37

Which of the following agents is a melatonin receptor agonist?

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

Question 38

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

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

Question 39

A sedative-hypnotic agent can produce varying degrees of central nervous system (CNS)depression.The same drug may be either a sedative or a hypnotic.

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

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

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

Question 42

Barbiturates have no significant analgesic effects.

Question 43

Benzodiazepines are contraindicated in wide-angle glaucoma.

Question 44

Sedatives potentiate analgesic agents.

Question 45

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 46

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

Question 47

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