L7 ,sedative-hypotonics , toxicology

Lecture Video




1- Long acting barbiturates are characterized by the following except 

 a) They are rapidly metabolized in the liver 

 b) They are less lipid soluble 

 c) They are mostly ionized. 

 d) They are less plasma proteins bound. 

2- Long acting are 

 a) Used as general anesthetic in minor surgery 

 b) The duration of their action is 3 to 6 hours 

 c) Used as anticonvulsants e.g. phenobarbital 

 d) Used as narcotherapy e.g. thiopental 

 3- Short acting barbiturates are characterized by all of the following except: 

 a) They are highly protein bound 

 b) They are highly lipid soluble. 

 c) They are mostly ionized. 

 d) They are rapidly metabolized by the liver 

 4- Where do barbiturates exert their effects? 

 a) Chloride ion channel 

 b) Histamine receptors 

 c) Sodium channels 

 d) GABA A chloride ion channel frequency 


 5- Mechanism of toxicity of barbiturates includes the following except 

 a) Binding with GABA receptors 

 b) Opening chloride channels leading to chloride influx 

 c) Hypoplorizing neurons causing neuronal stimulation 

 d) Antagonizing the effect of neurotransmitter glutamate

6- Which of the following is most characteristic of barbiturate toxicity 

 a) Hallucinations 

 b) Respiratory depression 

 c) Hypertension 

 d) Hyperactivity 

7- Patient suffering from barbiturate toxicity may present with which of the following 

 a) Constricted pupils, sedation, poor coordination, decreased 

 respirations, weak and rapid pulse, and hypotension 

 b) Elevated blood pressure, watery eyes. aggression, and reactive 


 c) Pinpoint pupils, agitation, disorientation, nausea, and vomiting 

 d) Dilated pupils, agitation, flushed skin, and slow pulse 

 8- GIT manifestations of barbiturates overdose include all the following except

 a) Constipation. 

 b) Paralytic ileus. 

 c) Vomiting 

 d) Diminish emptying time.

9- A 17-year-old female is admitted to the intensive care unit 

 with somnolence due to a suspected overdose. A suicide note and 

 empty bottle of phenobarbital were at her bedside at home. 

Which statement is most accurate concerning phenobarbital overdose? 

 a) Symptoms include hyperthermia and tachycardia 

 b) Phenobarbital is an ultra-short-acting barbiturate; symptoms should 

 resolve in about 1 hour 

 c) Alkalinizing the urine may enhance the excretion of phenobarbital 

 d) Flumazenil is used to reverse phenobarbital toxicity 

 10- Coma due to barbiturate overdose is characterized by all the following except: 

 a) Hypotension. 

 b) Cyanosis. 

 c) Hyperthermia

 d) Slow and shallow respiration. 

11- Causes of shock in barbiturates overdose is all the following except 

 a) Depression of cerebral cortex. 

 b) Depression of myocardium. 

 c) Depression of vasomotor center. 

 d) Inhibition of vascular smooth muscle tone.

12- Adult male 20 years old suffering from seizures and taking overdose of his benzodiazepine medication and presented to BPCC in drowsy coma state, the best treatment can be given are: 

 a) Flumazenil and charcoal 

 b) Flumazenil and gastric lavage with endotracheal 

 c) Flumazenil and syrup of ipecac 

 d) Multiple activated charcoal 

 e) Gastric lavage with cuffed endotracheal tube 

 13- Which of the following is the appropriate treatment for severe respiratory depression resulting from barbiturate poisoning? 

 a) Hemodialysis 

 b) Naloxone 

 c) Flumazenil 

 d) Artificial ventilation 

14- Flumazenil is an antidotal therapy of toxicity of 

 a) Barbiturates 

 b) Methanol 

 c) Theophylline 

 d) Benzodiazepine 

 e) Naltrexone 

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15- Urinary Alkalinization will enhance excretion of short acting barbiturates. (   )

 16- Flumazenil can be used as antidote for all cases of benzodiazepine

 17- Long acting barbiturates are more toxic than short acting one. (   )

 18- According to mechanism of action, barbiturates are more toxic than

 19- Flumazenil can be used as empiric antidotes in unknown comatose patients. (   )

 20- Benzodiazepines overdose usually safe and death from its overdose alone extremely rare. (   )



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