PART IX Anxiolytic agents
01. Anxiolytics are used to treat:
a) Neurosis
b) Psychosis
c) Narcolepsy
d) Bipolar disorders
02. Anxiolytic agents should:
a) Relieve pain
b) Reduce anxiety and exert a calming effect
c) Improve mood and behavior in patient with psychotic symptoms
d) Produce drowsiness, encourage the onset and maintenance of a state of sleep
03. Anxiolytics are also useful for:
a) Treatment of epilepsy and seizures
b) Insomnia
c) Muscle relaxation in specific neuromuscular disorders
d) All of the above
04. Indicate the agents of choice in the treatment of most anxiety states:
a) Barbiturates
b) Benzodiazepines
c) Lithium salts
d) Phenothiazines
05. The choice of benzodiazepines for anxiety is based on:
a) A relatively high therapeutic index
b) Availability of flumazenil for treatment of overdose
c) A low risk of physiologic dependence
d) All of the above
06. Which of the following anxiolitics is a benzodiazepine derivative:
a) Buspirone
b) Clordiazepoxide
c) Meprobamate
d) Chloral hydrate
07. Indicate the benzodiazepine, which has the shortest elimination half-life:
a) Quazepam
b) Triazolam
c) Diazepam
d) Clorazepate
08. Which of the following benzodiazepines has the shortest duration of action?
a) Triazolam
b) Clorazepate
c) Prazepam
d) Clordiazepoxide
09. Which of the following benzodiazepines is less likely to cause cumulative and residual effects with multiple doses?
a) Clorazepate
b) Quazepam
c) Lorazepam
d) Prazepam
10. Anxiolytic dosage reduction is recommended:
a) In patients taking cimetidine
b) In patients with hepatic dysfunction
c) In elderly patients
d) All of the above
11. Which of the following benzodiazepines is preferred for elderly patients?
a) Clorazepate
b) Clordiazepoxide
c) Triazolam
d) Prazepam
12. Which of the following anxiolytics is preferred in patient with limited hepatic function?
a) Buspirone
b) Quazepam
c) Diazepam
d) Chlordiazepoxide
13. Indicate the mechanism of hypnotic benzodiazepine action:
a) Increasing the duration of the GABA-gated Cl- channel openings
b) Directly activating the chloride channels
c) Increasing the frequency of Cl- channel opening events
d) All of the above
14. Which of the following anxiolytics is a partial agonist of brain 5-HT1A receptors?
a) Buspirone
b) Alprozolam
c) Chlorazepat
d) Lorazepam
15. Indicate the competitive antagonist of BZ receptors:
a) Flumazenil
b) Buspirone
c) Picrotoxin
d) Diazepam
16. Indicate the agent, which interferes with GABA binding:
a) Chlordiazepoxide
b) Bicuculline
c) Thiopental
d) Picrotoxin
17. Antianxiety agents have:
a) Sedative and hypnotic activity
b) Muscle relaxing and anticonvulsant effects
c) Amnesic properties
d) All of the above
18. Which of the following disadvantages does not limit using benzodiazepines as antianxiety agents?
a) Tendency to develop psychologic dependence
b) A high risk of drug interactions based on liver enzyme induction
c) Synergic CNS depression with concomitant use of other drugs
d) The formation of active metabolites
19. Indicate the anxiolitic agent, which relieves anxiety without causing marked sedative effects:
a) Diazepam
b) Chlordiazepoxid
c) Buspirone
d) Clorazepate
20. Which of the following anxiolytics has minimal abuse liability?
a) Oxazepam
b) Buspirone
c) Flumazenil
d) Alprazolam
21. In contrast to benzodiazepines, buspirone:
a) Interact directly with gabaergic system
b) Has more marked hypnotic, anticonvulsant, or muscle relaxant properties
c) Causes less psychomotor impairment and does not affect driving skills
d) Has maximal abuse liability
22. Which of the following sedative-hypnotic drugs does not potentiate the CNS depressant effects of ethanol, phenothiazines, or tricyclic antidepressants?
a) Buspirone
b) Phenobarbital
c) Diazepam
d) Chloralhydrate
23. Limitation of buspirone is:
a) A low therapeutic index
b) An extremely slow onset of action
c) A high potential of development of physical dependence
d) Impairment of mentation or motor functions during working hours
24. Which drugs may be used as antianxiety agents?
a) BETA-blocking drugs
b) Clonidine – a partial agonist of alfa2 receptors
c) Tricyclic antidepressants
d) All of the above
25. Which of the following benzodiazepines is more likely to cause “hangover” effects such as drowsiness, dysphoria, and mental or motor depression the following day?
a) Oxazepam
b) Triazolam
c) Clorazepat
d) Lorazepam
26. Additive CNS depression can be predicted if benzodiazepines are used with:
a) Ethanol
b) Morphine
c) Clorpromazine
d) All of the above
27. Which dosage of benzodiazepines for 60-90 days may produce severe withdrawal symptoms?
a) 50-60 mg/d
b) Less than 400 mg/d
c) More than 800 mg/d
d) Less than 40 mg/d
28. Restlessness, anxiety, orthostatic hypotension, generalized seizures, severe tremor, vivid hallucination, and psychosis are possible symptoms of:
a) Tolerance
b) Withdrawal
c) Drug interactions between barbiturate and diazepam
d) None of the above
29. Flumazenil is used to:
a) Reverse the CNS depressant effects of hypnotic benzodiazepines overdose
b) Hasten recovery following use of hypnotic benzodiazepines in anesthetic and diagnostic procedure
c) Reverse benzodiazepine-induced respiratory depression
d) All of the above
30. Flumazenil given intravenously:
a) Has intermediate onset and duration of action about 2 hours
b) Acts rapidly but has a short half-life
c) Has an effect lasting 3-5 hours
d) Has duration of action longer than 6 hours
