AGENTS, CONTROLLING THE FUNCTIONS OF THE CENTRAL NERVOUS SYSTEM - Hypnotic drugs

Question 1

Hypnotic drugs are used to treat

Answer 1

Sleep disorders

Question 2

Hypnotic drugs should

Answer 2

Produce drowsiness, encourage the onset and maintenance of sleep

Question 3

Which chemical agents are used in the treatment of insomnia?

Answer 3

• Benzodiazepines
• Imidazopyridines
• Barbiturates

Question 4

Select a hypnotic drug, which is a benzodiazepine derivative

Answer 4

Flurazepam

Question 5

Tick a hypnotic agent – a barbituric acid derivative

Answer 5

Thyopental

Question 6

Select a hypnotic drug, which is an imidazopyridine derivative

Answer 6

Zolpidem

Question 7

Which hypnotic agents is absorbed slowly?

Answer 7

Temazepam

Question 8

Which barbiturates is an ultra-short-acting drug?

Answer 8

Thiopental

Question 9

Indicate the barbituric acid derivative, which has 4-5 days elimination half-life

Answer 9

Phenobarbital

Question 10

Indicate the hypnotic benzodiazepine, which has the shortest elimination half-life

Answer 10

Triazolam

Question 11

Which hypnotic drugs is more likely to cause cumulative and residual effects?

Answer 11

Phenobarbital

Question 12

Which hypnotic drugs increases the activity of hepatic drug-metabolizing enzyme systems?

Answer 12

Phenobarbital

Question 13

Hepatic microsomal drug-metabolizing enzyme induction leads to

Answer 13

Barbiturate tolerance

Question 14

True or False. Hypnotic benzodiazepines are more powerful enzyme inducers than barbiturates.

Answer 14

FALSE

Question 15

Indicate the hypnotic drug, which does not change hepatic drug-metabolizing enzyme activity?

Answer 15

• Flurazepam
• Zaleplon
• Triazolam

Question 16

Barbiturates increase the rate of metabolism of

Answer 16

• Anticoagulants
• Digitalis compounds
• Glucocorticoids

Question 17

Which agents inhibits hepatic metabolism of hypnotics?

Answer 17

Cimetidin

Question 18

Which factors can influence the biodisposition of hypnotic agents?

Answer 18

• Alterations in the hepatic function resulting from a disease
• Old age
• Drug-induced increases or decreases in microsomal enzyme activities

Question 19

Which hypnotics is preferred for elderly patients?

Answer 19

Temazepam

Question 20

Which hypnotics is preferred in patients with limited hepatic function?

Answer 20

Zolpidem

Question 21

Indicate the mechanism of barbiturate action (at hypnotic doses)

Answer 21

Increasing the duration of the GABA-gated Cl- channel openings

Question 22

Imidazopyridines are

Answer 22

Selective agonists of the BZ1 (omega1) subtype of BZ receptors

Question 23

Which hypnotic agents is a positive allosteric modulator of GABA-A receptor function?

Answer 23

• Zaleplon
• Flurazepam
• Zolpidem

Question 24

Indicate a hypnotic drug - a selective agonist at the BZ1 receptor subtype

Answer 24

Zolpidem

Question 25

Which hypnotic agents is able to interact with both BZ1 and BZ2 receptor subtypes?

Answer 25

Flurazepam

Question 26

Indicate the competitive antagonist of BZ receptors

Answer 26

Flumazenil

Question 27

Flumazenil blocks the actions of

Answer 27

Zolpidem

Question 28

Indicate the agent, which interferes with GABA binding

Answer 28

Bicuculline

Question 29

Which agents blocks the chloride channel directly?

Answer 29

Picrotoxin

Question 30

Which agents is preferred in the treatment of insomnia?

Answer 30

Hypnotic benzodiazepines

Question 31

Barbiturates are being replaced by hypnotic benzodiazepines because of

Answer 31

• Low therapeutic index
• Suppression in REM sleep
• High potential of physical dependence and abuse

Question 32

Which benzodiazepines is used mainly for hypnosis?

Answer 32

Flurazepam

Question 33

Indicate the main claim for an ideal hypnotic agent

Answer 33

• Rapid onset and sufficient duration of action
• Minor effects on sleep patterns
• Minimal “hangover” effects

Question 34

Which stage of sleep is responsible for the incidence of dreams?

Answer 34

REM sleep

Question 35

During slow wave sleep (stage 3 and 4 NREM sleep)

Answer 35

Somnambulism and nightmares occur

Question 36

All of the hypnotic drugs induce

Answer 36

Decrease the duration of REM sleep

Question 37

Which hypnotic drugs causes least suppression of REM sleep?

Answer 37

Flurazepam

Question 38

Although the benzodiazepines continue to be the agents of choice for insomnia, they have

Answer 38

• The possibility of psychological and physiological dependence
• Synergistic depression of CNS with other drugs (especially alcohol)
• Residual drowsiness and daytime sedation

Question 39

Hypnotic benzodiazepines can cause

Answer 39

A dose-dependent decrease in both REM and slow wave sleep

Question 40

Which hypnotic benzodiazepines is more likely to cause rebound insomnia?

Answer 40

Triazolam

Question 41

Which hypnotic benzodiazepines is more likely to cause “hangover” effects such as drowsiness, dysphoria, and mental or motor depression the following day?

Answer 41

Flurazepam

Question 42

Indicate the hypnotic drug, which binds selectively to the BZ1 receptor subtype, facilitating GABAergic inhibition

Answer 42

Zolpidem

Question 43

Which statements is correct for zolpidem?

Answer 43

• Causes minor effects on sleep patterns
• The risk of development of tolerance and dependence is less than with the use of hypnotic benzodiazepines
• Has minimal muscle relaxing and anticonvulsant effects

Question 44

Which agent exerts hypnotic activity with minimal muscle relaxing and anticonvulsant effects?

Answer 44

Zaleplon

Question 45

True or False. Zolpidem and zaleplon have effectiveness similar to that of hypnotic benzodiazepines in the management of sleep disorders.

Answer 45

TRUE

Question 46

Which hypnotic drugs is used intravenously as anesthesia?

Answer 46

Thiopental

Question 47

Indicate the usual cause of death due to overdose of hypnotics

Answer 47

Depression of the medullar respiratory center

Question 48

Toxic doses of hypnotics may cause a circulatory collapse as a result of

Answer 48

Action on the medullar vasomotor center