Sedative-Hypnotics Guided Practice

Benzodiazepine pharmacology is most closely linked to which neurotransmitter system?
1. noradrenergic
2. GABA system
3. cholinergic
4. glycine system
Anxiolytic drug acting through serotonin receptors:
1. diazepam (Valium)
2. buspirone (BuSpar)
3. triazolam (Halcion)
4. phenobarbital
A comatose patient is brought to the emergency department with severe respiratory depression caused by diazepam overdosage. Reasonable intervention at this point include:
1. administer naloxone (Narcan) to block the drug's effect at the receptor
2. provide supportive therapy until the drug effect wears off.
3. administer flumazenil
4. B & C
A chronic alcohol and diazepam abuser is hospitalized for management of withdrawal symptoms. Buspirone, an anxiolytic, is administered to alleviate withdrawal, but the symptoms continue and worsen. Why?
1. Buspirone (BuSpar) dosage too low.
2. Buspirone (BuSpar) does not exhibit cross-tolerance with sedative-hypnotic/benzodiazepines.
3. Management of alcohol or benzodiazepine withdrawal must be managed with a stronger drug, such as haloperidol.
4. Buspirone (BuSpar) is too rapidly inactivated (first-pass effect) to be useful in managing withdrawal.
Short-acting benzodiazepine
1. diazepam (Valium)
2. flurazepam (Dalmane)
3. triazolam (Halcion)
4. buspirone (BuSpar)
Benzodiazepine most appropriate in patients with impaired hepatic function:
1. Lorazepam (Ativan) because of first-pass effects and because it lacks long-acting metabolites.
2. Oxazepam (Serax) since it has no long-acting metabolites and is conjugated to an inactive glucuronide directly.
3. Buspirone (BuSpar) since it has limited abuse potential
Anxiolytic effects
1. diazepam (Valium)
2. clonidine (Catapres)
3. both
4. neither
i.v. anesthetic used for induction.
1. methohexital (Brevital)
2. thiopental (Pentothal)
3. both
4. neither
Ion channel that contains the GABA receptor:
1. sodium
2. calcium
3. chloride
4. potassium
Zolpidem (Ambien):
1. antagonized by flumazenil (Romazicon)
2. muscle relaxation
3. minimal hypnotic properties
4. Long duration of action
Pharmacological basis for prescribing benzodiazepines for anxiety:
1. Low risk of drug interactions based on hepatic enzyme induction
2. high therapeutic index
3. availability of flumazenil (Romazicon) to manage overdosage
4. all of the above
Therapeutic disadvantage(s) of benzodiazepines:
1. Amestic effects
2. High cost
3. Psychologic dependencies
4. all of the above
Antianxiety drug(s)
1. propranolol (Inderal)
2. buspirone (BuSpar)
3. phenobarbital (Luminal)
4. all of the above
May be especially effective in treating anxiety associated with nicotine withdrawal:
1. meprobamate
2. clonidine (Catapres)
3. both
4. neither
Most useful in reversing symptoms of benzodiazepine overdosage:
1. amphetamine
2. buspirone (BuSpar)
3. flumazenil (Romazicon)
4. naltrexone (ReVia)
Skeletal muscle spasticity of CNS origin:
1. flumazenil (Romazicon)
2. diazepam (Valium)
Contraindicated in patients with a history of acute intermittent porphyria:
1. diazepam (Valium)
2. phenobarbital (Luminal)
3. clonazepam (Klonopin)
4. buspirone (BuSpar)
Pupillary constriction:
1. diazepam (Valium)
2. buspirone (BuSpar)
3. triazolam (Halcion)
4. flumazenil (Romazicon)