MCQs of Sedation for 5DDS 1. Anxiolytics are used to treat: ☑ Neurosis ☒ Psychosis ☒ Narcolepsy ☒ Bipolar disorders 2. Anxiolytic agents should: ☒ Relieve pain ☑ Reduce anxiety and exert a calming effect ☒ Improve mood and behavior in patient with psychotic symptoms ☒ Produce drowsiness, encourage the onset and maintenance of a state of sleep 3. Anxiolytics are also useful for: ☒ Treatment of epilepsy and seizures ☒ Insomnia ☒ Muscle relaxation in specific neuromuscular disorders ☑ All are corrected. 4. Indicate the agents of choice in the treatment of most anxiety states: ☒ Barbiturates ☑ Benzodiazepines ☒ Lithium salts ☒ Phenothiazines 5. The choice of benzodiazepines for anxiety is based on: ☒ A relatively high therapeutic index ☒ Availability of flumazenil for treatment of overdose ☒ A low risk of physiologic dependence ☑ All are corrected 6. Which of the following anxiolitics is a benzodiazepine derivative: ☒ Buspirone ☑ Clordiazepoxide ☒ Meprobamate ☒ Chloral hydrate 7. Indicate the benzodiazepine, which has the shortest elimination half-life: ☒ Quazepam ☑ Triazolam ☒ Diazepam ☒ Clorazepate 8. Which of the following benzodiazepines has the shortest duration of action? ☑ Triazolam ☒ Clorazepate ☒ Prazepam ☒ Clordiazepoxide 9. Which of the following benzodiazepines is less likely to cause cumulative and residual effects with multiple doses? ☒ Clorazepate ☒ Quazepam ☑ Lorazepam ☒ Prazepam 10. Anxiolytic dosage reduction is recommended: ☒ In patients taking cimetidine ☒ In patients with hepatic dysfunction ☒ In elderly patients ☑ All are corrected 11. Which of the following benzodiazepines is preferred for elderly patients? ☒ Clorazepate ☒ Clordiazepoxide ☑ Triazolam ☒ Prazepam 12. Which of the following anxiolytics is preferred in patient with limited hepatic function? ☑ Buspirone ☒ Quazepam ☒ Diazepam ☒ Chlordiazepoxide 13. Indicate the mechanism of hypnotic benzodiazepine action: ☒ Increasing the duration of the GABA-gated Cl-channel openings ☒ Directly activating the chloride channels ☑ Increasing the frequency of Cl-channel opening events ☒ All are corrected 14. Which of the following anxiolytics is a partial agonist of brain 5-HT1A receptors? ☑ Buspirone ☒ Alprozolam ☒ Chlorazepat ☒ Lorazepam 15. Indicate the competitive antagonist of benzodiazepine receptors: ☑ Flumazenil ☒ Buspirone ☒ Picrotoxin ☒ Diazepam 16. Indicate the agent, which interferes with GABA binding: ☒ Chlordiazepoxide ☑ Bicuculline ☒ Thiopental ☒ Picrotoxin 17. Antianxiety agents have: ☒ Sedative and hypnotic activity ☒ Muscle relaxing and anticonvulsant effects ☒ Amnesic properties ☑ All are corrected 18. Which of the following disadvantages does not limit using benzodiazepines as antianxiety agents? ☒ Tendency to develop psychologic dependence ☑ A high risk of drug interactions based on liver enzyme induction ☒ Synergic CNS depression with concomitant use of other drugs ☒ The formation of active metabolites 19. Indicate the anxiolitic agent, which relieves anxiety without causing marked sedative effects: ☒ Diazepam ☒ Chlordiazepoxid ☑ Buspirone ☒ Clorazepate 20. Which of the following anxiolytics has minimal abuse liability? ☒ Oxazepam ☑ Buspirone ☒ Flumazenil ☒ Alprazolam 21. In contrast to benzodiazepines, buspirone: ☒ Interact directly with gabaergic system ☒ Has more marked hypnotic, anticonvulsant, or muscle relaxant properties ☑ Causes less psychomotor impairment and does not affect driving skills ☒ 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? ☑ Buspirone ☒ Phenobarbital ☒ Diazepam ☒ Chloralhydrate 23. Limitation of buspirone is: ☒ A low therapeutic index ☑ An extremely slow onset of action ☒ A high potential of development of physical dependence ☒ Impairment of mentation or motor functions during working hours 24. Which drugs may be used as antianxiety agents? ☒ BETA-blocking drugs ☒ Clonidine - a partial agonist of alfa2 receptors ☒ Tricyclic antidepressants ☑ All are corrected 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? ☒ Oxazepam ☒ Triazolam ☑ Clorazepat ☒ Lorazepam 26. Additive CNS depression can be predicted if benzodiazepines are used with: ☒ Ethanol ☒ Morphine ☒ Clorpromazine ☑ All are corrected 27. Which dosage of benzodiazepines for 60-90 days may produce severe withdrawal symptoms? ☑ 50-60 mg/d ☒ Less than 400 mg/d ☒ More than 800 mg/d ☒ Less than 40 mg/d 28. Restlessness, anxiety, orthostatic hypotension, generalized seizures, severe tremor, vivid hallucination, and psychosis are possible symptoms of: ☒ Tolerance ☑ Withdrawal ☒ Drug interactions between barbiturate and diazepam ☒ None of all 29. Flumazenil is used to: ☒ Reverse the CNS depressant effects of hypnotic benzodiazepines overdose ☒ Hasten recovery following use of hypnotic benzodiazepines in anesthetic and diagnostic procedure ☒ Reverse benzodiazepine-induced respiratory depression ☑ All are corrected 30. Flumazenil given intravenously: ☒ Has intermediate onset and duration of action about 2 hours ☑ Acts rapidly but has a short half-life ☒ Has an effect lasting 3-5 hours ☒ Has duration of action longer than 6 hours 31. All are true about Minimal sedation, except ☒ Normal response to normal stimulation ☒ Possibly impaired cognitive function ☑ Affected ventilatory function ☒ Unaffected cardiovascular function 32. All are true regarding Moderate sedation, except ☒ Verbal commands are effective ☑ Cardiovascular function is affected ☒ Spontaneous ventilation is adequate ☒ Airway is patent 33. All are false about Moderate sedation, except ☒ Obstructed airway ☒ Inadequate ventilation ☒ Painful provocation is needed ☑ Unaffected cardiovascular function 34. All are true about Deep sedation, except ☒ Painful stimulation is needed ☒ Possibly impaired ventilatory function ☑ Easily aroused patient ☒ Possibly inadequate spontaneous ventilation 35. All are true about Deep sedation, except ☒ Cardiovascular function is maintained ☑ Patient is easily aroused ☒ Assistance might be required for patent airway maintaining ☒ Depression of consciousness is drug-induced 36. All are true about General anesthesia, except ☒ Loss of consciousness ☑ Painful stimulation is needed ☒ Patient is not able to be aroused ☒ Impaired ventilator function 37. All are true about General anesthesia, except ☒ Possibly impaired cardiovascular function ☒ Assistance might be required for patent airway maintaining ☑ Patient is not easily to be aroused ☒ Positive pressure ventilation may be required 38. Good effects of Benzodiazepines are all, except ☒ Amnesia ☒ Anxiolysis ☑ Airway clearing ☒ Anticonvulsant 39. All are good effects of Benzodiazepines, except ☒ Anticonvulsant ☒ Sedation ☒ Anxiety reliever ☑ Vision enhancement 40. The incorrect group of Benzodiazepines is ☒ Short-acting ☒ Intermediate-acting ☒ Long-acting ☑ Extra long-acting 41. The duration of action of Benzodiazepines is dependent on ☑ The half-life ☒ The complete-life ☒ The active component ☒ The patient’s body 42. The duration of action of Benzodiazepines is dependent on ☑ The metabolic fate ☒ The patient’s body ☒ Dose of drug ☒ Activeness of organs 43. Classification of action of Midazolam ☑ Short-acting ☒ Intermediate-acting ☒ Long-acting ☒ Extra long-acting 44. Classification of action of Triazolam ☑ Short-acting ☒ Intermediate-acting ☒ Long-acting ☒ Extra long-acting 45. Classification of action of Diazepam ☒ Short-acting ☒ Intermediate-acting ☑ Long-acting ☒ Extra long-acting 46. Classification of action of Lorazepam ☒ Short-acting ☑ Intermediate-acting ☒ Long-acting ☒ Extra long-acting 47. Classification of action of Alprazolam ☒ Short-acting ☑ Intermediate-acting ☒ Long-acting ☒ Extra long-acting 48. Drug class of Midazolam is all, except ☒ Benzodiazepines ☒ Sedative ☒ Anesthesia adjunct ☑ Long-acting 49. Mechanism of actions of Midazolam is all, except ☒ Anxiolysis ☒ Hypnosis ☑ Fatigue ☒ Amnesia 50. All are mechanism of actions of Midazolam, except ☒ Anticonvulsant ☒ Muscle relaxant ☑ Vision enhancement ☒ Anxiolysis 51. The incorrect use of Midazolam is for ☒ Conscious sedation ☒ GA induction ☒ Intubation ☑ Postoperative sedation 52. The incorrect use of Midazolam is for ☒ Sedation of diagnostic endoscope ☒ Amnesia ☒ Intubation ☑ LA replacement 53. All are true about pharmacokinetics of Midazolam, except ☒ 97% protein binding ☒ Primarily excreted in urine ☑ Can be removed through hemodialysis ☒ Well-absorbed after IM administration 54. All are true about pharmacokinetics of Midazolam, except ☑ Half-life: 30 minutes to 2 hours ☒ Metabolized in the liver to active metabolite ☒ 97% protein binding ☒ Well-absorbed after IM administration 55. All are frequent side effects of Midazolam, except ☒ Decreased respiratory rate ☒ Pain during injection ☑ Nausea ☒ Hiccups 56. All are frequent side effects of Midazolam, except ☑ Hypotension ☒ Oxygen desaturation ☒ Hiccough ☒ Pain during injection 57. The occasional side effect of Midazolam is ☒ Nausea ☒ Vomiting ☑ Hypotension ☒ Hiccups 58. The occasional side effect of Midazolam is ☒ Pain during injection ☑ Paradoxical CNS reaction ☒ Headache ☒ Coughing 59. The rare side effect of Midazolam is ☑ Coughing ☒ Hypertension ☒ Decreased respiratory rate ☒ Paradoxical CNS reaction 60. The rare side effect of Midazolam is ☑ Vomiting ☒ Hypotension ☒ Oxygen desaturation ☒ Tenderness at the injection site 61. All are the contraindications of use of Midazolam, except ☒ Patient with shock ☒ Patient with coma ☒ Patient with acute glaucoma ☑ Patient with epilepsy 62. All are drugs contraindicated with Midazolam, except ☒ Nelfinavir ☒ Ritonavir ☑ Erythromycin ☒ Indinavir 63. Inadequate or excessive dosage or improper administration may result in all, except ☒ Cerebral hypoxia ☒ Agitation ☒ Hyperactivity ☑ Voluntary movements 64. All are symptoms of overdose of Midazolam, except ☒ Loss of coordination ☒ Drowsiness ☒ Confusion ☑ Unable to speak 65. All are therapeutic effects of Lorazepam, except ☒ Anticonvulsant ☒ Antiemetic effects ☒ Anxiolysis ☑ Airway assisting 66. All are therapeutic effects of Lorazepam, except ☒ Sedation ☒ Muscle relaxant ☒ Anxiolysis ☑ Memory enhancement