Sedative-Hypnotics and Alcohol

Question 0

Side effect of Benzodiazepines

Answer 0

Anterograde amnesia
Decreased psychomotor skills
Unwated daytime sedation
Additive CNS depression with Ethanol

Question 1

Short-acting Benzodiazepine

Answer 1

Midazolam (Etizolam, Brotizolam, Triazolam, Oxazepam)

Question 2

Abnormal sleep pattern in Benzodiazepines

Answer 2

Decreased REM sleep

Question 3

Intermediate acting Benzodiazepines

Answer 3

Lorazepam (Clonazepam, Lormetazepam, Estazolam, Alprazolam, Nitrazepam, Temazepam)

Question 4

MOA of Benzodiazepines

Answer 4

GABA-A subunit binding, increased FREQUENCY of chloride channel opening

Question 5

Long acting Benzodiazepine

Answer 5

Diazepam (Flunitrazepam, Flurazepam, Chlordiazepoxide, Chlorazepate)

Question 6

Date-rape drugs

Answer 6

Ethanol
Funitrazepam
Gamma-hydroxybutirate

Question 7

Benzodiazepine with longest half-life

Answer 7

Chlordiazepoxide

Question 8

benzodiazepine overdose antidote

Answer 8

Flumazenil

Question 9

MOA of flumazenil

Answer 9

Benzodiazepine GABA-A receptor antagonist

Question 10

Side effect of short-acting benzodiazepine

Answer 10

Rebound insomnia/anxiety

Question 11

Rohypnol

Answer 11

Flunitrazepam

Question 12

Flumazenil Side effect

Answer 12

Benzodiazepine withdrawal syndrome

Question 13

Barbiturate MOA

Answer 13

Bind to GABA-A receptor sites, increase DURATION of chloride channel opening

Question 14

Ultrashort-acting Barbiturate

Answer 14

Thiopental (Methohexital, Thiamylal)

Question 15

Side effect of Barbiturates

Answer 15

CNS depression
Tolerance/Dependence
Acute intermittent porphyria

Question 16

Enzyme deficient in acute intermittent porphyria

Answer 16

Porphobilinogen deaminase

Question 17

Most catastropic side effect of sedative-hypnotic

Answer 17

Rebound suicide

Question 18

Class of Zolpidem

Answer 18

Imidazopyridine

Question 19

Short/Intermediate-acting Barbiturate

Answer 19

Pentobarbital (-bital, -butal)

Question 20

Long-acting Barbiturate

Answer 20

Phenobarbital (Mephobarbital, Pyrimidone)

Question 21

Imidazopyridine

Answer 21

Zolpidem, Zaleplon, Eszopiclone

Question 22

Indication for Zolpidem

Answer 22

Insomnia

Question 23

Side effect of Zolpidem

Answer 23

Modest day-after psychomotor depression

Dependence

Question 24

Reversal of Zolpidem side effects

Answer 24

Flumazenil

Question 25

Buspirone MOA

Answer 25

Partial agonist at 5-HT1a receptors and D2 receptors

Question 26

Buspirone indication

Answer 26

General Anxiety Disorder

Question 27

Metabolism of low to moderate doses of ethanol

Answer 27

Alcohol dehydrogenase

Question 28

Metabolism of high doses if ethanol (>100 mg/dL)

Answer 28

Microsomal Ethanol Oxidizing System (MEOS)

Question 29

Fixed capacity for ethanol metabolism

Answer 29

7-10 g/h

Question 30

Inhibits Acetaldehyde Dehydrogenase

Answer 30

Disulfiram

Question 31

Blood alcohol concentration for impaired driving ability

Answer 31

60-80 mg/dL

Question 32

Blood alcohol concentration for respiratory depssion and coma

Answer 32

>500 mg/dL

Question 33

Most common neurologic side effect of chronic ethanol consumption

Answer 33

Peripheral neuropathy

Question 34

Most common complication of chronic alcohol consumption

Answer 34

Liver disease - cirrhosis and hepatic failure

Question 35

Clinical manifestation of Wernicke-Korsakoff Syndrome

Answer 35

Ataxia Confusion Ophthalmoplegia

Question 36

pathologic brain findings in Wernicke-Korsakoff syndrome

Answer 36

Hemorrhagic necrosis of the mamillary bodies

Question 37

Cardiovascular complication of chronic alcohol consumption

Answer 37

Reversile dilated cardiomyopathy

Question 38

Amount of ethanol intake per day to increase HDL

Answer 38

10-15 g/day

Question 39

Most common manifestation of fetal alcohol syndrome

Answer 39

Mental retardation

Question 40

Manifestions of Delirium Tremens

Answer 40

Hallucination Autonomic disability Delirium

Question 41

Onset of Delirium Tremens

Answer 41

48-72 hours post-withdrawal

Question 42

Alcohol Withdrawal Syndrome DOC in patients with no co-morbids

Answer 42

Long acting Benzodiazepine

Question 43

Alcohol Withdrawal Syndrome DOC for patients with hepatic failure

Answer 43

Short-acting Benzodiazepine

Question 44

Alcoholism treatment options

Answer 44

Naltrexone (opioid receptor antagonist) Acamprosate (NMDA receptor antagonist) Disulfiram (acetaldehyde dehydrogenase inhibitor)

Question 45

Disulfiram reaction

Answer 45

Chlorpropamide Cefoperazone Cefamandole Procarbazine Metronidazole

Question 46

Methanol Toxicty accumlates what?

Answer 46

Formic acid and Formaldehyde

Question 47

Ethylene glycol toxicity accumulates what?

Answer 47

Oxalic acid

Question 48

DOC for Methanol and Ethylene Glycol toxicity

Answer 48

Ethanol | Fomepizole