CNS Pharmacology

Sedatives & Hypnotics

1. Hypnotic drugs are used to treat:
a) Sleep disorders
b) Parkinsonian disorders
c) Narcolepsy
d) Psychosis

2. Hypnotic drugs should:

a) Prevent mood swings in patients with bipolar affective disorders
b) Produce drowsiness, encourage the onset and maintenance of sleep
c) Induce absence of sensation
d) Reduce anxiety and exert a calming effect

3. Which of these hypnotic drugs is an imidazopyridine derivative?

a) Pentobarbital
b) Temazepam
c) Zolpidem
d) Chloral hydrate

4. The hypnotic drug which is slowly absorbed is :

a) Triazolam
b) Diazepam
c) Phenobarbital
d) oxazepam

5. The ultra - short acting barbiturate is :

a) Secobarbital
b) Amobarbital
c) Thiopental
d) Phenobarbital

6. The following barbiturate has 8 - 24 hours half - life :

a) Secobarbital
b) Thiopental
c) Phenobarbital
d) Amylobarbitone

7. The hypnotic benzodiazepine, which has the shortest half-life is :

a) Nitrazepam
b) Diazepam
c) Oxazepam
d) Triazolam

8. CYT p450 induction leads to:

a) Barbiturate tolerance
b) Cumulative effects
c) Development of physical dependence
d) “hangover” effects

1
 CNS Pharmacology
Sedatives & Hypnotics
9. The hypnotic which is preferred for elderly patients is :
a) Secobarbital
b) Flurozepam
c) Temazepam
d) Phenobarbital

10. The mechanism of barbiturate action (at hypnotic doses):

a) Increasing the duration of the GABA-induced Cl- channel openings
b) Directly activating the chloride channels
c) Increasing the frequency of Cl- channel opening events
d) d)None of the above

11. Imidazopyridines are:

a) Partial agonists at brain 5-TH1A receptors
b) Selective agonists of the BZ1 (omega1) subtype of BZ receptors
c) Competitive antagonists of BZ receptors
d) Nonselective agonists of both BZ1 and BZ2 receptor subtypes

12. The competitive antagonist of BZ receptors is :

a) Flumazenil
b) Picrotoxin
c) Zaleplon
d) Zolpidem

13. Flumazenil blocks the actions of:

a) Morphine
b) Phenobarbital
c) Zolpidem
d) Thiopental

14. Which of the following agents is preferred in the treatment of insomnia?

a) Phenothiazide
b) Benzodiazepines
c) Opioids
d) Barbiturates

15. Barbiturates are being replaced by hypnotic benzodiazepines because of:

a) Low therapeutic index
b) More hang over
c) High potential of physical dependence and withdrawal syndrome
d) All of the above

16. The ideal hypnotic agent must has :

a) Rapid onset and sufficient duration of action
b) Minor effects on sleep patterns
c) Minimal “hangover” effects
d) All of the above

2
 CNS Pharmacology
Sedatives & Hypnotics
17. During slow wave sleep (stage 3 & 4):
a) Dreams occur
b) The secretion of adrenal steroids is at its highest level
c) Somnambulism (sleepwalking) and nightmares occur
d) The secretion of somatotropin is at its lowest

18. Hypnotic agents induce:

a) Increase the duration of REM sleep
b) Decrease the duration of REM sleep
c) Decrease the duration of Non-REM sleep ( mainly stage 2 )
d) Increase the duration of slow wave sleep

19. Which of the following hypnotic drugs causes least suppression of REM sleep?
a) Flumazenil
b) Phenobarbital
c) Flurazepam
d) Secobarbital

20. Although the benzodiazepines continue to be the agents of choice for insomnia, they have:
a) The possibility of psychological and physiological dependence
b) Synergistic depression of CNS with other drugs (especially alcohol)
c) Residual drowsiness and daytime sedation
d) All of the above

21. Hypnotic benzodiazepines can cause:

a) A dose-dependent increase in both REM and slow wave sleep
b) Do not change sleep patterns
c) A dose-dependent decrease in both REM and slow wave sleep
d) A dose-dependent increase in REM sleep and decrease in slow wave sleep

22. Which one of the following hypnotic benzodiazepines is more likely to cause rebound insomnia?
a) Triazolam
b) Flurazepam
c) Temazepam
d) All of the above

23. The following hypnotic drugs which is used intravenously as anesthetic is :

a) Thiopental
b) Phenobarbital
c) Flurazepam
d) Zolpidem

24. The usual cause of death due to overdose of hypnotics:

a) Depression of the medullar respiratory center
b) Hypothermia
c) Cerebral edema

3
 CNS Pharmacology
Sedatives & Hypnotics
d) Status epilepticus

25. Which of the following statements is correct for zolpidem?

a) Causes minor effects on sleep patterns
b) It has a lower risk of development of tolerance & dependence than with the use of benzodiazepines
c) Has minimal muscle relaxing and anticonvulsant effects
d) All of the above

26. Toxic doses of hypnotics may cause a circulatory collapse as a result of:
a) Blocking alfa adrenergic receptors
b) Increasing vagal tone
c) Action on the medullar vasomotor center
d) All of the above

27. Which of the following hypnotic drug binds selectively to the BZ1 receptor subtype, facilitating
GABAergic inhibition:
a) Thiopental
b) Zolpidem
c) Flurazepam
d) Phenobarbital

T&F:

1. The following chemical agent(s) is\are used in the treatment of insomnia :

a) Opioids
b) Imidazopyridines
c) Barbiturates
d) Benzodiazepines

2. Which of these hypnotic drugs is\are benzodiazepine derivative: Answers : 16.d

a) Zolpidem 1.a 17.c
b) Flurazepam 2.b 18.b
c) Diszepam 3.c 19.c
d) Phenobarbitone 4.d 20.d
5.c 21.c
3. Which of these hypnotic drugs is a barbituric acid derivative:
a) Flurazepam 6.d 22.a
b) Zaleplon 7.d 23.b
c) Thiopental 8.a 24.d
d) phenobarbitone 9.c 25.a
10.a 26.a
REMEMBER :- 11.b 27.c
 Hypnotic barbiturates are more powerful enzyme inducers than benzodiazepines . 12.a T&F:
 Zolpidem and zaleplon have effectiveness similar to that of hypnotic
13.c 1. F T T T
benzodiazepines in the management of sleep disorders.
14.b 2. F T T F
15.d 3. F F T T