60 Questions
What is the primary mechanism of action of buspirone?
Agonist of serotonin receptors
How does the absorption of buspirone change when taken with food?
Absorption is increased due to reduced first-pass metabolism
Which of the following is a contraindication for the use of buspirone?
Severe hepatic disease
What is the relationship between buspirone and benzodiazepines?
Buspirone has no effect on the GABA receptor
What is the onset of action for buspirone?
Slow, up to 6 weeks
What is the primary metabolic pathway for buspirone?
Oxidation by CYP450 3A4 enzymes
What is the significance of buspirone's noradrenergic metabolite?
It explains why buspirone is contraindicated in panic attacks
What is the half-life range of buspirone?
1 to 10 hours
How does buspirone's mechanism of action differ from that of benzodiazepines?
Buspirone has no effect on the GABA receptor, unlike benzodiazepines
What is the key difference in the effects of buspirone in a state of serotonin excess versus serotonin deficit?
In a state of serotonin excess, buspirone acts as an antagonist, while in a deficit state, it acts as an agonist
What is a common adverse reaction associated with barbiturates?
Agitation
Which drug interaction may result from the concurrent use of barbiturates?
Reduced theophylline effectiveness
What is the primary clinical use of phenobarbital and mephobarbital?
Preanesthetic sedation
Which adverse reaction requires cautious use of barbiturates in patients in alertness-demanding situations?
Persistent sedation
Why are phenobarbital and mephobarbital not considered first-line treatments for certain medical emergencies?
There are more appropriate alternatives available
What can happen following the abrupt withdrawal of barbiturates during daily administration for treatment of seizure disorders?
Status epilepticus rebound
What is the mechanism of action of buspirone in terms of serotonin receptors?
Full agonist at the presynaptic 5-HT 1a receptor
How does buspirone differ from barbiturates and benzodiazepines in terms of its effects?
Exerts effects without CNS depression and sedation
Why is buspirone considered relatively safe, even in high doses?
Few drug interactions and little risk of dependence
Which neurotransmitter system does buspirone primarily act on for its anxiolytic effects?
Serotonin
What differentiates buspirone from barbiturates and benzodiazepines in terms of addiction potential?
Low risk of addiction
Why was buspirone initially thought to be an atypical antipsychotic similar to clozapine?
Shared chemical structure with haloperidol
What is the primary indication for using buspirone?
Generalized anxiety disorder
What is the main effect of barbiturates on anticoagulants?
Induces metabolism and causes rebound bleeding when barbiturate is stopped
Which side effect is considered one of the most common adverse reactions to buspirone?
Nervousness
What is the recommended dosage range for phenobarbital in the treatment of epilepsy in adults?
60-100 mg daily
Which of the following is a correct statement about the effects of barbiturates on other drugs?
Barbiturates decrease the effectiveness of drugs like beta blockers, steroids, and protease inhibitors
How is the dosing regimen typically initiated for a patient starting buspirone?
Beginning with 5 mg two or three times a day for 4 days
Which medication interaction with buspirone can lead to elevated serum levels of haloperidol?
Haloperidol
What is the main effect of combining barbiturates with alcohol, antihistamines, or benzodiazepines?
Increased sedation and CNS depression
Why is it essential for patients taking buspirone to be informed that the drug cannot be used on an as-needed basis?
To ensure maximum benefits
What is the recommended dosage range for phenobarbital in the treatment of status epilepticus in children?
12-20 mg/kg intravenously over 10-12 minutes
What is the effect of barbiturates on the metabolism of caffeine?
Barbiturates antagonize the effects of caffeine, leading to increased insomnia
Which drug class was historically utilized for anxiety treatment before benzodiazepines became widely used?
Barbiturates
What is the Pregnancy Category classification of buspirone?
Category B
Which of the following is a correct statement about the therapeutic range of plasma barbiturate levels?
The therapeutic range is 12-40 mcg/mL, and levels should be monitored frequently
Which of the following is NOT a common adverse effect associated with buspirone use?
Blurred vision
Which of the following barbiturates is a Schedule II controlled substance?
Pentobarbital
What instruction should be given to patients regarding the daily use of buspirone?
Take daily
What is the recommended dosage range for phenobarbital in the treatment of partial and generalized tonic-clonic seizures in adults?
60-100 mg daily
Which drug interaction can potentially increase serum levels of buspirone?
Ketoconazole
What is the main implication of the interaction between barbiturates and anticoagulants?
Increased need for dose adjustment of the anticoagulant
What is the primary mechanism of action for barbiturates?
They bind to GABAA receptors and prolong chloride ion channel opening
Which of the following is NOT a factor that can increase the risk of barbiturate toxicity?
Taking barbiturates with food
Which route of administration for barbiturates results in the fastest onset of action?
Intravenous
Which enzyme system is responsible for the metabolism of barbiturates?
CYP2C19
Which of the following is a contraindication for the use of barbiturates?
All of the above
Which barbiturate has the longest half-life?
Butabarbital
What is a potential risk associated with the use of barbiturates during pregnancy?
Teratogenic effects on the fetus
Which of the following is a potential withdrawal symptom associated with abrupt discontinuation of barbiturates?
Seizures
Which barbiturate has the shortest duration of action?
Pentobarbital
What is a potential consequence of barbiturate-induced tolerance?
Need to increase the dose to achieve the same effect
What is the main difference between transient and short-term insomnia?
Transient insomnia lasts a few days, while short-term insomnia lasts 2-3 weeks.
What is the primary treatment recommendation for chronic insomnia according to the passage?
Medication for a few months, then taper off the medication.
Which of the following is NOT a recommended sleep hygiene measure mentioned in the passage?
Limiting the bedroom to sleep and sex only.
What is the main difference between onset insomnia and terminal insomnia according to the passage?
Onset insomnia is a symptom of anxiety, while terminal insomnia is a symptom of depression.
Which benzodiazepine hypnotic is described as having a rapid onset and long-acting effects?
Flurazepam (Dalmane)
According to the passage, what is the maximum recommended duration for daily dosing of benzodiazepine hypnotics?
3 weeks
What is the main reason the passage recommends against using benzodiazepines for insomnia long-term?
They can cause dependence and tolerance.
According to the passage, what is the recommended approach if chronic insomnia persists after initial treatment?
Refer the patient for a sleep laboratory study.
Explore the world of serotonergic anxiolytics and their role in relieving anxiety. Learn about the different subtypes of serotonin receptors and how drugs like Buspirone affect anxiety levels.
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