CNS Pharmacology Sedatives & Hypnotics 1. Hypnotic Hypnotic drugs drugs are used to treat: treat: a) Slee Sleep p diso disord rder ers s b) Parkin Parkinso sonia nian n disorde disorders rs c) Nar Narcolep oleps sy d) Psyc Psycho hosi sis s 2. Hypn Hypnoti otic c drugs drugs shoul should: d: a) Prevent mood mood swings swings in patients with bipolar bipolar affective affective disorders disorders b) Produce drowsiness drowsiness,, encourage encourage the onset onset and maintenance of sleep c) Induce Induce abs absenc ence e of sens sensati ation on d) Reduce Reduce anxiety anxiety and and exert exert a calming calming effect effect 3. Which of these hypnotic drugs is an imidazopyridine imidazopyridine derivative? a) Pent Pentob obar arbi bita tall b) Tema Temaze zepa pam m c) Zolpidem d) Chlo Chlora rall hydr hydrat ate e 4. The hypnotic drug which is slowly absorbed is : a) Tria Triazo zola lam m b) Diaze iazepa pam m c) Ph Phen enob obar arbi bita tall d) oxaz oxazep epam am
5. The ultra ultra - short short acting acting barbi barbiturat turate e is : a) Seco Secoba barb rbit ital al b) Amob Amobar arbi bita tall c) Thio Thiop penta entall d) Ph Phen enob obar arbi bita tall 6. The followi following ng barbitu barbiturate rate has has 8 - 24 hours half half - life : a) Seco Secoba barb rbit ital al b) Thio Thiope pent ntal al c) Ph Phen enob obar arbi bita tall d) Amyl Amylob obar arbi bito tone ne 7. The hypnotic benzodiazepine, which has the shortest half-life is : a) Nitr Nitraz azep epam am b) Diaze iazepa pam m c) Oxazepam d) Tria Triazo zola lam m 8. CYT p450 induction leads to: a) Barbit Barbitura urate te tole tolera rance nce b) Cumula Cumulativ tive e effect effects s c) Developmen Developmentt of of physi physical cal dependenc dependence e d) “hango “hangover ver” ” effect effects s 9. The hypnotic which is preferred for elderly patients is :
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CNS Pharmacology Sedatives & Hypnotics a) b) c) d)
Seco Secoba barb rbit ital al Flur Fluroz ozep epam am Tema Temaze zepa pam m Phen Ph enob obar arbi bita tall
10. The mechanism of barbiturate action (at hypnotic doses): a) Increasi Increasing ng the durati duration on of the GABA-in GABA-induce duced d Cl - channel openings b) Directly Directly activat activating ing the chlor chloride ide channel channels s c) Increa Increasin sing g the fre freque quenc ncy y of Cl channel opening events d) d)None d)None of the the abov above e
11. a) b) c) d)
Imidazopyridines are: Partial Partial agonist agonists s at brain brain 5-TH1A 5-TH1A recepto receptors rs Selective Selective agonists agonists of the BZ1 (omega1) (omega1) subtype subtype of BZ receptor receptors s Competiti Competitive ve antago antagonist nists s of BZ recept receptors ors Nonselec Nonselective tive agonists agonists of both BZ1 BZ1 and BZ2 receptor receptor subtypes subtypes
12. The competitive antagonist of BZ receptors is : a) Flum Flumaz azen enil il b) Picr Picrot otox oxin in c) Zaleplon d) Zolp Zolpiidem dem 13. Flumazenil blocks the actions of: a) Mor Morphine ine b) Ph Phen enob obar arbi bita tall c) Zolpidem d) Thio Thiope pent ntal al
14. 14. a) b) c) d)
Whic Which h of of the the foll follow owin ing g agen agents ts is pref prefer erre red d in the the trea treatm tmen entt of inso insomn mnia ia? ? Phen Ph enot othi hiaz azid ide e Benz Benzod odia iaze zepi pine nes s Opioids Barb Barbit itur urat ates es
15. 15. Barb Barbit itur urat ates es are are bei being ng rep repla lace ced d by hyp hypno noti tic c benz benzod odia iaze zep pines ines bec becau ause se of: a) Low therap therapeut eutic ic index index b) More More hang hang over over c) High potenti potential al of physical physical dependence dependence and withdra withdrawal wal syndrome syndrome d) All All of of the the abov above e hypnotic agent agent must has : 16. The ideal hypnotic a) Rapid Rapid onset onset and suffici sufficient ent duratio duration n of action action b) Minor Minor effect effects s on sleep sleep patter patterns ns c) Minima Minimall “hango “hangover ver” ” effect effects s d) All All of of the the abov above e 17. During slow wave sleep (stage 3 & 4):
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CNS Pharmacology Sedatives & Hypnotics a) b) c) d)
Drea Dreams ms occ occur ur The secreti secretion on of adrenal adrenal steroids steroids is at its its highest highest level level Somnambul Somnambulism ism (sleepwa (sleepwalkin lking) g) and nightmar nightmares es occur occur The secret secretion ion of somato somatotropi tropin n is at its lowes lowestt
18. Hypnotic agents induce: a) Increase Increase the duration duration of REM REM sleep sleep b) Decrease Decrease the durat duration ion of of REM REM sleep sleep c) Decrease Decrease the durat duration ion of of Non-REM Non-REM sleep sleep ( mainly mainly stage stage 2 ) d) Increase Increase the the duration duration of slow slow wave sleep sleep
19. 19. Whic Which h of of the the follo ollowi wing ng hypn hypnot otic ic drug drugs s cau cause ses s lea least st supp suppre res ssion sion of of REM REM sleep? a) Flum Flumaz azen enil il b) Ph Phen enob obar arbi bita tall c) Flu Fluraze razep pam d) Seco Secoba barb rbit ital al 20. 20. Alth Althou ough gh the the ben benzo zodi diaz azep epin ines es cont contin inue ue to be the the age agent nts s of of cho choic ice e for for insomnia, they have: a) The possibility of psychological psychological and physiological dependence b) Synergistic depression of CNS with other other drugs (especially alcohol) c) Residual Residual drowsine drowsiness ss and and daytime daytime sedati sedation on d) All All of of the the abov above e 21. Hypnotic benzodiazepines can cause: a) A dose-depen dose-dependent dent increas increase e in both REM and and slow wave wave sleep b) Do not not change change slee sleep p patter patterns ns c) A dose-depe dose-dependen ndentt decrease decrease in both both REM and and slow wave wave sleep sleep d) A dose-dependent dose-dependent increase increase in REM sleep and decrease in slow wave sleep sleep
22. 22. Whic Which h one one of of the the foll follow owin ing g hyp hypno noti tic c ben benzo zodi diaz azep epin ines es is mo more re lik likely ely to to cause rebound insomnia? a) Tria Triazo zola lam m b) Flur Fluraz azep epam am c) Tema Temaze zepa pam m d) All All of of the the abov above e 23. 23. The The foll follow owin ing g hyp hypno noti tic c dru drugs gs whic which h is is use used d int intra rave veno nous usly ly as anes anesth thet etic ic is : a) Thio Thiope pent ntal al b) Ph Phen enob obar arbi bita tall c) Flu Fluraze razep pam d) Zolp Zolpiidem dem 24. The usual ual ca cause use of death due to over overd dos ose e of hyp hypnoti notic cs: a) Depressi Depression on of the medul medullar lar respira respiratory tory center center
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CNS Pharmacology Sedatives & Hypnotics b) Hypo Hypoth ther ermi mia a c) Cere Cerebr bral al ede edema ma d) Status Status epilep epileptic ticus us
25. 25. Whic Which h of of the the follo ollowi wing ng state tateme ment nts s is corr correc ectt for for zolp zolpid idem em? ? a) Causes Causes minor minor effec effects ts on sleep patterns patterns b) It has a lowe lowerr risk risk of develo developme pment nt of tolera tolerance nce & depe depende ndenc nce e than than with with tthe he use use of of benzodiazepines c) Has minimal minimal muscle muscle relaxing relaxing and and anticonvul anticonvulsant sant effects effects d) All All of of the the abov above e 26. 26. a) b) c) d)
Tox oxic ic dose doses s of of hyp hypno noti tics cs may may cau caus se a cir circu cula lato tory ry col colla laps pse e as as a res resul ultt of: of: Blocking Blocking alfa adrenerg adrenergic ic recept receptors ors Increa Increasin sing g vagal vagal tone tone Action Action on on the medullar medullar vasomotor vasomotor center center All All of of the the abov above e
27. 27. Whic Which h of of the the follo ollowi wing ng hypn hypnot otic ic drug drug bind binds s sel selec ecti tive vely ly to the the BZ1 BZ1 receptor subtype, facilitating GABAergic inhibition: a) Thio Thiope pent ntal al b) Zolp Zolpiidem dem c) Flu Fluraze razep pam d) Ph Phen enob obar arbi bita tall T&F: 1. The following following chemical chemical agent(s) agent(s) is\are used used in the treatment treatment of insomnia : a) Opioids b) Imid Imidaz azop opyr yrid idin ines es c) Barb Barbit itur urat ates es d) Benz Benzod odia iaze zepi pine nes s Answer 2. Which of these hypnotic drugs is\are benzodiazepine benzodiazepine derivative: s: a) Zolpid lpidem em 1.a b) Flur Fluraz azep epam am 2.b c) Diszepam d) Ph Phen enob obar arbi bito tone ne 3.c 4.d 3. Which of these these hypnotic drugs is a barbituric acid derivative: 5.c a) Flur Fluraz azep epam am 6.d b) Zalep aleplo lon n 7.d c) Thiope iopen ntal tal 8.a d) phen phenob obar arbi bito tone ne 9.c 10.a REMEMBER :11.b Hypnotic barbiturates are more powerful enzyme inducers than benzodiazepines . 12.a 13.c 14.b 15.d 4
16.d 17.c 18.b 19.c 20.d 21.c 22.a 23.b 24.d 25.a 26.a 27.c T&F: 1. F T T T 2. F T T F
CNS Pharmacology Sedatives & Hypnotics Zolpidem and zaleplon have effectiveness similar to that of hypnotic benzodiazepines in the management of sleep disorders.
