Deck 10: Sedative-Hypnotics, Anxiolytics, and Anticonvulsants

Question 1

A factor in the development of alcoholism that has scientific support is

A)impurities in alcoholic beverages
B)vitamin deficiencies
C)genetics
D)all of these

Answer 1

C

Question 2

Which of the following drugs is used to treat alcoholism by making alcoholic intake an unpleasant experience?

A)antipsychotics
B)anxiolytics
C)disulfiram (Antabuse)
D)antidepressants

Answer 2

C

Question 3

What are two features of benzodiazepine sedative-hypnotics that distinguish them pharmacologically from barbiturate sedative-hypnotics?

Answer 3

Barbiturates have a relatively low therapeutic index, whereas benzodiazepines have a relatively high therapeutic index.Barbiturates can significantly elevate P450 enzymes with chronic exposure, while benzodiazepines tend not to.Barbiturates tend to suppress REM sleep, whereas benzodiazepines tend to interfere with deeper stages of sleep.Barbiturates are effective anesthetics, whereas benzodiazepines are not.Although both barbiturates and benzodiazepines work on GABA_A receptors to enhance GABA activity, barbiturates can activate GABA_A receptors independently of GAB

Question 4

Why did benzodiazepines generally replace barbiturates in the treatment of insomnia?

Question 5

Some actions of alcohol appear to be due to nonspecific actions on neurons that result from

A)altering the fluidity of neuronal membranes
B)exciting the presynaptic axon terminal
C)preventing the reuptake of catecholamines
D)inhibiting monoamine oxidase activity

Question 6

Alcohol is a somewhat unique psychoactive drug in that it is a _______________________molecule.

A)small, water soluble
B)large, lipid soluble
C)small, lipid soluble
D)water soluble, ionized

Question 7

Alcohol differs significantly from barbiturates in terms of

A)the potential level of physical dependence
B)the ability to depress CNS functions
C)its sedative effects
D)none of these

Question 8

What is a primary reason for the brain damage that is sometimes associated with alcoholism?
e.g., synergistic effects of ethanol, acetaldehyde (the first metabolite of ethanol), thiamine deficiency, liver disease, and excessive NMDA receptor activity (which can be excitotoxic) during alcohol withdrawal.

Question 9

Benzodiazepines

A)may be used as anticonvulsants
B)are widely used as general anesthetics
C)reduce muscle relaxation
D)all of these

Question 10

The clearest linkage between brain damage and chronic alcohol intake in humans is one involving

A)insufficient intake of proper nutrients, such as thiamine
B)the toxic effects of alcohol on DNA
C)increased susceptibility to venereal disease
D)reduced levels of testosterone

Question 11

Although alcohol is often classified as a general CNS depressant

Question 12

What are three primary pharmacological differences between the anxiolytics buspirone (BuSpar) and the benzodiazepines like Valium?

Question 13

With respect to the production of action potentials, high doses of alcohol are most likely to exert

A)excitatory effects
B)inhibitory effects
C)inhibitory and then excitatory effects
D)neither of these, as the action potential is not affected by alcohol

Question 14

The "therapeutic index" of alcohol would probably be around

A)3
B)10
C)50
D)100

Question 15

Which of the following pharmacodynamic actions is exhibited with high doses of alcohol?

A)individual neurons become less excitable
B)neurons repolarize more slowly after firing
C)enhanced activity of GABA at its receptors
D)all of the above

Question 16

What is a theoretical basis of the use of disulfiram (Antabuse) in the treatment of alcoholism?

Question 17

Describe two major pharmacological differences between alcohol and the short acting benzodiazepines.
e.g., NMDA and GABA, whereas benzodiazepines bind specifically to GABA receptors.Alcohol has a relatively low therapeutic index and exerts toxic effects on numerous organs of the body,
e.g., liver, brain, whereas benzodiazepines have a relatively high therapeutic index and exerts minimal toxic effects on the body.Alcohol tends to elevate P450 enzymes, while benzodiazepines tend not to.Alcohol tends to suppress REM sleep, whereas benzodiazepines tend to interfere with deeper stages of sleep.

Question 18

Alcoholism is often defined in terms of

A)loss of control over alcoholic intake
B)the functional or structural damage due to use of alcohol
C)a person's compulsion to use alcohol despite its adverse consequences
D)all of the above

Question 19

A blood-alcohol content (BAC) of __(1)___ % is most likely to induce socially and legally acceptable subjective and behavioral effects, whereas a BAC of ___(2)___ % is most likely to induce death in the average person.

A)(1) .05; (2) .50
B)(1) .01; (2) .05
C)(1) 1.0; (2) 5.0
D)(1) .05; (2) .25

Question 20

What is alcoholism?

Question 21

After chronic use, which of the following drugs is LEAST likely to induce an abstinence syndrome?

A)buspirone (BuSpar)
B)benzodiazepines
C)barbiturates
D)alcohol

Question 22

In high doses, barbiturates

A)reduce the activity of GABA at its receptors
B)decrease the excitability of most CNS neurons
C)increase cerebral glucose metabolism in all areas of the brain
D)all of the above

Question 23

Delirium tremens

A)often occurs following regular exposure to small amounts of alcohol
B)occurs in heavy alcohol users typically 2 to 4 days after drinking ceases
C)results from a rapid drop in an alcoholic's blood sugar level
D)all of the above

Question 24

The barbiturates were eventually replaced by the benzodiazepines in the treatment of insomnia because benzodiazepines have

A)higher therapeutic indexes
B)less disruptive effects on REM sleep
C)less effect on liver drug metabolizing enzymes
D)all of these

Question 25

Participation in Alcoholics Anonymous is

A)difficult to assess for effectiveness, primarily because it is almost always voluntary.
B)one of the most accepted approaches to dealing with alcoholism.
C)useful because the group can address the alcoholic's denial and rationalizations over drinking.
D)all of the above

Question 26

A whiskey which is 80-proof would be ______ ethanol.

A)80 percent
B)60 percent
C)50 percent
D)40 percent

Question 27

Antabuse (disulfiram) has been found in the majority of studies to be a

A)very useful treatment for most alcoholics
B)minimally effective treatment for alcoholism
C)way of reducing the toxic effects of acetaldehyde on the body
D)way of decreasing alcohol craving in alcoholics

Question 28

Buspirone (BuSpar) has

A)been shown to be comparable to benzodiazepines in the treatment of anxiety
B)the same basic molecular structure as benzodiazepines
C)been shown to be cross tolerant with benzodiazepines
D)all of the above

Question 29

Controlled drinking training

A)is generally regarded by most American clinicians as an inappropriate way of dealing with heavy alcohol use.
B)has been suggested to be a potentially useful alternative way of dealing with problem drinkers who are not physically dependent on alcohol.
C)is unlikely to be useful in the treatment of alcoholics who are physically dependent on alcohol.
D)all of the above

Question 30

The most commonly prescribed anxiolytics with sedative-hypnotic properties are

A)benzodiazepines
B)barbiturates
C)GABA derivatives
D)meprobamate derivatives

Question 31

Recent studies on the effectiveness of institutional treatment of alcoholism have

A)not found substantial benefits of inpatient treatment over outpatient treatment
B)noted that the benefits of treatment are highly dependent on who is selected for treatment
C)found in selected samples that residential treatment may be significantly better than outpatient treatment
D)all of the above

Question 32

Recent studies with identical twins have supported the view that _________of the variance in liability to develop alcoholism can be traced to genetic factors.

A)all
B)approximately 10%
C)approximately 50%
D)approximately 90%

Question 33

Benzodiazepine anxiolytics have

A)relatively low therapeutic indexes
B)GABA enhancing properties
C)strong anesthetic properties
D)all of the above

Question 34

Which of the following is NOT a characteristic of ethanol?

A)high in calories
B)highly lipid soluble
C)the active molecule is small and nonionized
D)toxic to liver cells in high doses

Question 35

The drugs categorized as barbiturates differ primarily with respect to their

A)recommended clinical uses
B)duration of effects
C)intensity of effects
D)all of these

Question 36

There are problems with using benzodiazepines in the treatment of insomnia because they

A)act synergistically with alcohol to produce potentially lethal effects
B)can cause symptoms in the elderly that can be confused with senility
C)can suppress deep stages of sleep
D)all of the above

Question 37

The pharmacological profile of the anxiolytic buspirone (BuSpar) is similar to that of

A)alcohol
B)barbiturates
C)benzodiazepines
D)none of these

Question 38

Cirrhosis of the liver

A)occurs in a minority of heavy alcohol users
B)occurs in the vast majority of heavy alcohol users
C)only occurs in heavy drinkers in conjunction with poor nutrition
D)is essentially the same thing as a fatty liver

Question 39

It is not advisable for persons to consume alcoholic beverages in a cold environment because alcohol

A)actually makes people feel cold at first
B)decreases blood circulation to the skin
C)increases the rate of loss of body heat
D)increases oxygen consumption

Question 40

When alcohol is consumed chronically, it is likely that there will be a substantial degree of

A)tolerance to its behavioral effects
B)tolerance to its lethal effects
C)cross-tolerance with other sedative-hypnotic drugs
D)only a and c above

Question 41

Low concentrations of certain depressant drugs, such as alcohol, can induce

A)only inhibitory effects on neuronal activity
B)excitatory effects due to a transient increase in the release of excitatory neurotransmitters
C)excitatory effects due to depression of inhibitory systems
D)both b and c

Question 42

Which of the following drugs was most recently approved for the treatment of alcoholism because it was shown to reduce the craving for alcohol by alcoholics?

A)naltrexone (ReVia)
B)a benzodiazepine
C)disulfiram (Antabuse)
D)a tricyclic antidepressant

Question 43

While barbiturates are more likely to reduce ___(1)___ sleep, benzodiazepines are more likely to disrupt ___(2)___ sleep.

A)(1) REM; (2) deep
B)(1) deep; (2) REM
C)(1) deep; (2) light
D)(1) nocturnal; (2) diurnal

Question 44

Which of the following drugs facilitate the action of GABA at its receptors?

A)ethanol
B)barbiturates
C)benzodiazepines
D)all of these

Question 45

Which of the following types of drugs requires several days of use before there is a noticeable reduction in the symptoms of anxiety?

A)benzodiazepines
B)barbiturates
C)buspirone (BuSpar)
D)all of these

Question 46

Which of the following drugs is used to treat alcoholism because it induces nausea when alcohol is consumed?

A)naltrexone (ReVia)
B)the benzodiazepine Valium
C)disulfiram (Antabuse)
D)a tricyclic antidepressant

Question 47

Which of the following do low doses of alcohol facilitate?

A)GABA mediated chloride (Cl^-) ion channel opening
B)NMDA mediated calcium (Ca⁺⁺) ion channel opening
C)voltage sensitive ion channel opening
D)all of the above

Question 48

The greatest dependence liability and most intense abstinence syndrome would result from chronic exposure to sedative-hypnotic drugs with

A)rapid onset and brief duration of action
B)rapid onset and long duration of action
C)slow onset and brief duration of action
D)slow onset and long duration of action

Question 49

Tremulousness, hallucinations, seizures, and delirium are symptoms that are most likely to occur with

A)cocaine withdrawal
B)narcotic withdrawal
C)buspirone (BuSpar) withdrawal
D)alcohol withdrawal

Question 50

The drugs categorized as benzodiazepines differ primarily with respect to their

A)recommended clinical uses
B)duration of effects
C)intensity of effects
D)all of these

Question 51

Although they were developed for the treatment of depression and do not display typical sedative hypnotic properties, _______________________ have been shown to be effective in the treatment of most symptoms associated with anxiety disorders.

A)selective serotonin reuptake inhibitors
B)psychostimulants
C)antiseizure drugs
D)antipsychotics

Question 52

In terms of their responses to moderate doses of ethanol, sons of alcoholics typically exhibit ________________________________________ than sons of nonalcoholics (assuming these individuals are tested prior to their drinking heavily).

A)greater reactions during the rising arm of the blood alcohol time curve
B)greater reactions during the falling arm of the blood alcohol time curve
C)lesser reactions during the falling arm of the blood alcohol time curve
D)both a and c

Question 53

A deficiency in the ability to metabolize acetaldehyde, the first byproduct of alcohol metabolism, would most likely

A)increase a person's likelihood of becoming an alcoholic
B)decrease a person's likelihood of becoming an alcoholic
C)enhance the euphoric properties of alcohol
D)decrease the person's ability to metabolize alcohol

Question 54

Benzodiazepines are clinically preferred over barbiturates because the former

A)are better at sedating people
B)are better at inducing sleep in people
C)have considerably higher therapeutic indexes
D)all of the above

Question 55

Which of the following is likely to produce nausea and headache through its pharmacodynamic actions?

A)ethanol
B)acetaldehyde
C)acetic acid
D)carbon dioxide

Question 56

Some of the reinforcing properties of ethanol have been attributed to its ability to directly or indirectly amplify dopaminergic input into the nucleus accumbens via its actions on

A)GABA_A receptors
B)NMDA receptors
C)Kappa receptors
D)both a and b

Question 57

The benzodiazepine anxiolytics are believed to reduce anxiety symptoms

A)because they suppress the symptoms of depression that underlie anxiety
B)by facilitating the action of GABA at its receptors
C)by inhibiting the action of GABA at its receptors
D)by reducing functions carried out by the medulla

Question 58

Inhalants,

A)are one of the more common drugs used by very young individuals for their euphoric effects
B)exert nonspecific effects on neuronal membranes that alter neuron ion channel activity
C)may induce considerable physiological damage when used chronically
D)all of the above
E)g., gases and industrial solvents,

Question 59

Prior to their drinking heavily, which characteristics has research suggested to be found in individuals with the strongest genetic predisposition to develop alcoholism?

A)people with high need for social rewards and low degree of novelty seeking
B)people with high antisocial characteristics and the least notable signs of intoxication an hour or so after low doses of alcohol are consumed
C)people with low antisocial characteristics who are averse to getting in harmful situations
D)females who prefer alcohol over illicit drugs

Question 60

At equal blood-alcohol concentrations (BAC) in the brain, the behavioral effects of alcohol are

A)greatest during the rising arm of the BAC function
B)greatest during the falling arm of the BAC function
C)approximately the same during both the rising and falling arms of the BAC function
D)enhanced by the first-pass metabolism effect

Question 61

Buspirone (BuSpar), a partial 5-HT_1A receptor agonist, differs from benzodiazepine and barbiturate anxiolytics in terms of

A)dependence liability
B)tolerance development
C)synergistic actions with alcohol
D)all of these

Question 62

Which of the following drugs has been suggested to exert anxiolytic effects primarily due to its ability to down-regulate 5-HT_1A receptors?

A)buspirone (BuSpar)
B)benzodiazepines
C)ethanol
D)barbiturates

Question 63

Acamprosate (Campral) has recently been approved for use in the treatment of alcoholism.Its primary benefit appears to be

A)reduction of opioid receptor activity
B)reduction in desire for drinking alcohol
C)induction of aversive effects when alcohol is consumed

Question 64

Based on its low dependence liability, minimal effects on sleep stages, and absence of respiratory depression even with high doses, _____________ has become the most commonly prescribed drug for the treatment of insomnia in the United States.

A)zolpidem (Ambien)
B)chlorpromazine (Thorazine)
C)triazolam (Halcion)
D)fluoxetine (Prozac)

Question 65

Which of the following actions are associated with acute low dose alcohol exposure?

A)enhanced GABA mediated chloride (Cl^-) ion channel opening
B)inhibited NMDA mediated channel opening
C)inhibited voltage sensitive calcium (Ca⁺⁺) ion channel opening
D)all of the above Chapter 10 Answers to multiple choice questions and

Question 66

The behavioral manifestations of fetal alcohol syndrome or fetal alcohol effects typically

A)dissipate dramatically once the individuals become adults
B)increase dramatically as the individuals get older, at least up to adulthood
C)are evidenced throughout the lifespan of the individuals
D)display a cyclical pattern of waxing and waning

Question 67

Acute alcohol exposure in nonhumans has been shown to

A)reduce extracellular levels of dopamine in the nucleus accumbens area of the mesolimbic system
B)elevate extracellular levels of dopamine in the nucleus accumbens area of the mesolimbic system
C)enhance neuronal activity in the hippocampus

Question 68

The primary difference in the effects of drugs in the benzodiazepine class is due to differences in

A)their pharmacokinetic properties
B)their pharmacodynamic properties
C)the types of receptors they act on
D)altering membrane fluidity