Questions and Answers
What effect do barbiturates have on blood pressure and heart rate at hypnotic doses?
Which therapeutic use is appropriate for phenobarbital and mephobarbital?
What is a common adverse effect of barbiturates linked to overdose?
How do low-lipid soluble barbiturates differ from highly lipid-soluble agents in terms of pharmacokinetics?
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Which of the following is a serious consequence of barbiturate toxicity?
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Which drug is commonly used for induction of anesthesia?
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What type of interactions do barbiturates commonly have with other medications?
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Which of the following is not an adverse effect commonly associated with barbiturates?
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What is the mechanism of action of ramelteon?
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Which of the following is a side effect associated with tricyclic antidepressants?
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Which of these medications may be used for performance anxiety?
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How do selective serotonin reuptake inhibitors (SSRIs) primarily function?
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What is a characteristic onset time for the effectiveness of tricyclic antidepressants?
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Which characteristic contributes to the popularity of benzodiazepine (BZP) over barbiturates?
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What is a significant advantage of drugs like zolpidem, zaleplon, and eszopiclone compared to traditional benzodiazepines?
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What is a primary clinical use of buspirone?
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What is a disadvantage associated with buspirone?
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Which of the following side effects is commonly associated with buspirone?
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How do 5-HT agonists like buspirone mainly exert their anxiolytic effects?
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What is a consequence of chronic buspirone treatment on serotonin receptors?
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What is a potential interaction effect noted when buspirone is taken with MAO inhibitors?
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What is the primary difference in effect between low and high doses of a hypnotic drug?
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Which of the following benzodiazepines is classified as short-acting?
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Which sedative-hypnotic medication has ultra-short acting properties?
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Which class of medications is NOT considered an anxiolytic?
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What is the duration of action for intermediate-acting benzodiazepines?
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What administration route is NOT recommended for chlordiazepoxide?
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What is the role of lipophilicity in the pharmacokinetics of anxiolytic medications?
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Which of the following treatments is NOT typically part of managing anxiety?
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What is a primary clinical use of ultra short-acting barbiturates like thiopental?
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What is the relationship between lipid solubility and duration of action in barbiturates?
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Which characteristic is common in all barbiturates regarding their effects on the CNS?
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What is a significant risk associated with barbiturate overdose?
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What is the primary reason barbiturates have been largely replaced by benzodiazepines?
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Which barbiturate is commonly used in the treatment of insomnia?
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In terms of pharmacologic effects, which sequence represents the progression of responses to barbiturates?
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What is the typical duration of action for long-acting barbiturates such as phenobarbital?
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Study Notes
Sedative-Hypnotics Overview
- Hypnotics can act as sedatives at low doses and produce general anesthesia at high doses.
- The spectrum includes sedation, hypnosis, and anesthesia.
Classification of Sedative-Hypnotics
- Barbiturates: Divided into ultra-short acting, short-immediate, and long-acting.
- Benzodiazepines: Varied by duration: short, intermediate, and long-acting.
- Miscellaneous: Includes specific agents like chloral hydrate and meprobamate.
Benzodiazepines Classification
- Short-acting: Oxazepam, Triazolam (3-8 hours).
- Intermediate-acting: Alprazolam, Lorazepam (10-20 hours).
- Long-acting: Diazepam, Flurazepam (1-3 days).
Pharmacokinetics of Benzodiazepines
- Well absorbed orally; absorption rates vary based on lipophilicity.
- Can be administered parenterally (IV, IM); some are available only for IV use.
Barbiturates Overview
- Classified by duration of action and lipid solubility.
- Ultra-short (e.g., Thiopental) is used for induction of anesthesia.
- Short to intermediate acting (e.g., Secobarbital) treats insomnia.
- Long-acting (e.g., Phenobarbital) is effective for seizure control.
Barbiturates Pharmacological Effects
- CNS depression progresses from sedation to anesthesia.
- Cardiovascular effects lead to hypotension with toxic doses.
- Induce hepatic drug-metabolizing enzymes.
Therapeutic Uses of Barbiturates
- Effective for seizure disorders, anesthesia induction, and insomnia (largely replaced by benzodiazepines).
- Notable adverse effects include respiratory depression and potential for abuse.
Benzodiazepines vs. Barbiturates
- Benzodiazepines have a higher therapeutic index and less respiratory impact.
- They produce less physical dependence and do not alter drug disposition through enzyme inhibition.
Benzodiazepine-Like Drugs
- Include zolpidem and zaleplon, interacting selectively with GABAA receptors.
- Antagonized by flumazenil.
5-HT Agonists (Buspirone)
- Acts as a partial agonist at 5HT1A receptors, inhibiting serotonin release.
- Shows delayed anxiolytic effects; ineffective for severe anxiety or panic disorder.
- Minimal risk of dependence or cognitive dysfunction.
Melatonin Agonist (Ramelteon)
- Activates melatonin receptors, regulating sleep-wake cycles.
Tricyclic Antidepressants (TCAs)
- Reduce the uptake of serotonin and norepinephrine.
- Effective for anxiety, especially in co-occurrence with depression.
- Side effects include dry mouth, postural hypotension, and sexual dysfunction.
Selective Serotonin Reuptake Inhibitors (SSRIs)
- Fluoxetine is a commonly used SSRI, significant for anxiety and panic disorders.
- Acts by blocking serotonin reuptake with delayed onset of action.
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Description
Explore the various classes of sedative-hypnotics, including barbiturates and benzodiazepines. This quiz covers their pharmacological characteristics, duration of action, and mechanisms, providing a comprehensive understanding of these important medications in clinical practice.
