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</p> Signup and view all the answers

    What is the onset of action for buspirone?

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

    What is the primary metabolic pathway for buspirone?

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

    What is the half-life range of buspirone?

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

    What is a common adverse reaction associated with barbiturates?

    <p>Agitation</p> Signup and view all the answers

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

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

    What is the primary clinical use of phenobarbital and mephobarbital?

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

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

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

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

    <p>Serotonin</p> Signup and view all the answers

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

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

    What is the primary indication for using buspirone?

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

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

    <p>Nervousness</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</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</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</p> Signup and view all the answers

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

    <p>Haloperidol</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</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</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</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</p> Signup and view all the answers

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

    <p>Barbiturates</p> Signup and view all the answers

    What is the Pregnancy Category classification of buspirone?

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

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

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

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

    <p>Pentobarbital</p> Signup and view all the answers

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

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

    Which drug interaction can potentially increase serum levels of buspirone?

    <p>Ketoconazole</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</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</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</p> Signup and view all the answers

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

    <p>Intravenous</p> Signup and view all the answers

    Which enzyme system is responsible for the metabolism of barbiturates?

    <p>CYP2C19</p> Signup and view all the answers

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

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

    Which barbiturate has the longest half-life?

    <p>Butabarbital</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</p> Signup and view all the answers

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

    <p>Seizures</p> Signup and view all the answers

    Which barbiturate has the shortest duration of action?

    <p>Pentobarbital</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</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.</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.</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.</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.</p> Signup and view all the answers

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

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

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