Serotonergic Anxiolytics
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Questions and Answers

What is the primary mechanism of action of buspirone?

  • Agonist of serotonin receptors (correct)
  • Agonist of GABA receptors
  • Antagonist of serotonin receptors
  • Antagonist of dopamine D2 receptors

How does the absorption of buspirone change when taken with food?

  • Absorption is not affected by food intake
  • Absorption is decreased due to delayed gastric emptying
  • Absorption is increased due to reduced first-pass metabolism (correct)
  • Absorption is increased due to enhanced solubility

Which of the following is a contraindication for the use of buspirone?

  • Severe hepatic disease (correct)
  • Panic disorder
  • Mild to moderate anxiety
  • Alcohol withdrawal

What is the relationship between buspirone and benzodiazepines?

<p>Buspirone has no effect on the GABA receptor (D)</p> Signup and view all the answers

What is the onset of action for buspirone?

<p>Slow, up to 6 weeks (A)</p> Signup and view all the answers

What is the primary metabolic pathway for buspirone?

<p>Oxidation by CYP450 3A4 enzymes (A)</p> Signup and view all the answers

What is the significance of buspirone's noradrenergic metabolite?

<p>It explains why buspirone is contraindicated in panic attacks (B)</p> Signup and view all the answers

What is the half-life range of buspirone?

<p>1 to 10 hours (D)</p> Signup and view all the answers

How does buspirone's mechanism of action differ from that of benzodiazepines?

<p>Buspirone has no effect on the GABA receptor, unlike benzodiazepines (C)</p> Signup and view all the answers

What is the key difference in the effects of buspirone in a state of serotonin excess versus serotonin deficit?

<p>In a state of serotonin excess, buspirone acts as an antagonist, while in a deficit state, it acts as an agonist (D)</p> Signup and view all the answers

What is a common adverse reaction associated with barbiturates?

<p>Agitation (B)</p> Signup and view all the answers

Which drug interaction may result from the concurrent use of barbiturates?

<p>Reduced theophylline effectiveness (D)</p> Signup and view all the answers

What is the primary clinical use of phenobarbital and mephobarbital?

<p>Preanesthetic sedation (A)</p> Signup and view all the answers

Which adverse reaction requires cautious use of barbiturates in patients in alertness-demanding situations?

<p>Persistent sedation (A)</p> Signup and view all the answers

Why are phenobarbital and mephobarbital not considered first-line treatments for certain medical emergencies?

<p>There are more appropriate alternatives available (A)</p> Signup and view all the answers

What can happen following the abrupt withdrawal of barbiturates during daily administration for treatment of seizure disorders?

<p>Status epilepticus rebound (B)</p> Signup and view all the answers

What is the mechanism of action of buspirone in terms of serotonin receptors?

<p>Full agonist at the presynaptic 5-HT 1a receptor (A)</p> Signup and view all the answers

How does buspirone differ from barbiturates and benzodiazepines in terms of its effects?

<p>Exerts effects without CNS depression and sedation (B)</p> Signup and view all the answers

Why is buspirone considered relatively safe, even in high doses?

<p>Few drug interactions and little risk of dependence (C)</p> Signup and view all the answers

Which neurotransmitter system does buspirone primarily act on for its anxiolytic effects?

<p>Serotonin (C)</p> Signup and view all the answers

What differentiates buspirone from barbiturates and benzodiazepines in terms of addiction potential?

<p>Low risk of addiction (A)</p> Signup and view all the answers

Why was buspirone initially thought to be an atypical antipsychotic similar to clozapine?

<p>Shared chemical structure with haloperidol (A)</p> Signup and view all the answers

What is the primary indication for using buspirone?

<p>Generalized anxiety disorder (B)</p> Signup and view all the answers

What is the main effect of barbiturates on anticoagulants?

<p>Induces metabolism and causes rebound bleeding when barbiturate is stopped (B)</p> Signup and view all the answers

Which side effect is considered one of the most common adverse reactions to buspirone?

<p>Nervousness (C)</p> Signup and view all the answers

What is the recommended dosage range for phenobarbital in the treatment of epilepsy in adults?

<p>60-100 mg daily (A)</p> Signup and view all the answers

Which of the following is a correct statement about the effects of barbiturates on other drugs?

<p>Barbiturates decrease the effectiveness of drugs like beta blockers, steroids, and protease inhibitors (D)</p> Signup and view all the answers

How is the dosing regimen typically initiated for a patient starting buspirone?

<p>Beginning with 5 mg two or three times a day for 4 days (C)</p> Signup and view all the answers

Which medication interaction with buspirone can lead to elevated serum levels of haloperidol?

<p>Haloperidol (B)</p> Signup and view all the answers

What is the main effect of combining barbiturates with alcohol, antihistamines, or benzodiazepines?

<p>Increased sedation and CNS depression (B)</p> Signup and view all the answers

Why is it essential for patients taking buspirone to be informed that the drug cannot be used on an as-needed basis?

<p>To ensure maximum benefits (C)</p> Signup and view all the answers

What is the recommended dosage range for phenobarbital in the treatment of status epilepticus in children?

<p>12-20 mg/kg intravenously over 10-12 minutes (A)</p> Signup and view all the answers

What is the effect of barbiturates on the metabolism of caffeine?

<p>Barbiturates antagonize the effects of caffeine, leading to increased insomnia (B)</p> Signup and view all the answers

Which drug class was historically utilized for anxiety treatment before benzodiazepines became widely used?

<p>Barbiturates (D)</p> Signup and view all the answers

What is the Pregnancy Category classification of buspirone?

<p>Category B (C)</p> Signup and view all the answers

Which of the following is a correct statement about the therapeutic range of plasma barbiturate levels?

<p>The therapeutic range is 12-40 mcg/mL, and levels should be monitored frequently (C)</p> Signup and view all the answers

Which of the following is NOT a common adverse effect associated with buspirone use?

<p>Blurred vision (C)</p> Signup and view all the answers

Which of the following barbiturates is a Schedule II controlled substance?

<p>Pentobarbital (B)</p> Signup and view all the answers

What instruction should be given to patients regarding the daily use of buspirone?

<p>Take daily (D)</p> Signup and view all the answers

What is the recommended dosage range for phenobarbital in the treatment of partial and generalized tonic-clonic seizures in adults?

<p>60-100 mg daily (D)</p> Signup and view all the answers

Which drug interaction can potentially increase serum levels of buspirone?

<p>Ketoconazole (D)</p> Signup and view all the answers

What is the main implication of the interaction between barbiturates and anticoagulants?

<p>Increased need for dose adjustment of the anticoagulant (B)</p> Signup and view all the answers

What is the primary mechanism of action for barbiturates?

<p>They bind to GABAA receptors and prolong chloride ion channel opening (A)</p> Signup and view all the answers

Which of the following is NOT a factor that can increase the risk of barbiturate toxicity?

<p>Taking barbiturates with food (B)</p> Signup and view all the answers

Which route of administration for barbiturates results in the fastest onset of action?

<p>Intravenous (D)</p> Signup and view all the answers

Which enzyme system is responsible for the metabolism of barbiturates?

<p>CYP2C19 (D)</p> Signup and view all the answers

Which of the following is a contraindication for the use of barbiturates?

<p>All of the above (D)</p> Signup and view all the answers

Which barbiturate has the longest half-life?

<p>Butabarbital (B)</p> Signup and view all the answers

What is a potential risk associated with the use of barbiturates during pregnancy?

<p>Teratogenic effects on the fetus (D)</p> Signup and view all the answers

Which of the following is a potential withdrawal symptom associated with abrupt discontinuation of barbiturates?

<p>Seizures (C)</p> Signup and view all the answers

Which barbiturate has the shortest duration of action?

<p>Pentobarbital (A)</p> Signup and view all the answers

What is a potential consequence of barbiturate-induced tolerance?

<p>Need to increase the dose to achieve the same effect (B)</p> Signup and view all the answers

What is the main difference between transient and short-term insomnia?

<p>Transient insomnia lasts a few days, while short-term insomnia lasts 2-3 weeks. (C)</p> Signup and view all the answers

What is the primary treatment recommendation for chronic insomnia according to the passage?

<p>Medication for a few months, then taper off the medication. (C)</p> Signup and view all the answers

Which of the following is NOT a recommended sleep hygiene measure mentioned in the passage?

<p>Limiting the bedroom to sleep and sex only. (A)</p> Signup and view all the answers

What is the main difference between onset insomnia and terminal insomnia according to the passage?

<p>Onset insomnia is a symptom of anxiety, while terminal insomnia is a symptom of depression. (A)</p> Signup and view all the answers

Which benzodiazepine hypnotic is described as having a rapid onset and long-acting effects?

<p>Flurazepam (Dalmane) (C)</p> Signup and view all the answers

According to the passage, what is the maximum recommended duration for daily dosing of benzodiazepine hypnotics?

<p>3 weeks (D)</p> Signup and view all the answers

What is the main reason the passage recommends against using benzodiazepines for insomnia long-term?

<p>They can cause dependence and tolerance. (D)</p> Signup and view all the answers

According to the passage, what is the recommended approach if chronic insomnia persists after initial treatment?

<p>Refer the patient for a sleep laboratory study. (A)</p> Signup and view all the answers

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