Ph TBL 2.5 Chunk 2 Benzodiazepines and Barbiturates

Which statement best explains how benzodiazepines produce central nervous system suppression as described in the text?

They suppress the central nervous system by potentiating GABA-mediated inhibitory neurotransmission

Which feature most accurately explains why benzodiazepines replaced barbiturates in clinical practice?

Benzodiazepines produce sedation while being safer than barbiturates in overdose

Which definition best matches drug tolerance as described in this lecture?

A reduced response requiring increasing doses to maintain the original effect

Which clinical use of benzodiazepines is most closely linked to their short duration of action?

Emergency termination of seizures due to rapid onset and short half-life

Which statement best explains why tolerance develops with long-term benzodiazepine use?

Repeated exposure leads to reduced receptor responsiveness requiring higher doses

Which benzodiazepine property most directly determines whether it is classified as short-, medium- or long-acting?

The plasma half-life determining duration of clinical effect

Which clinical situation most appropriately requires a short-acting benzodiazepine according to the lecture?

Acute termination of an ongoing seizure requiring rapid onset

Why is buccal midazolam particularly useful for seizure control outside hospital settings?

It acts rapidly and does not require intravenous access

Which benzodiazepine group is most suitable for maintenance therapy in epilepsy?

Long-acting benzodiazepines taken regularly to prevent seizures

Which factor most influences the choice of a benzodiazepine for insomnia rather than seizure control?

Onset and duration of action relative to sleep architecture

Which adverse effect most directly explains why benzodiazepines are avoided for long-term treatment of insomnia?

Development of tolerance leading to reduced clinical effectiveness

What is meant by “dependence” in relation to benzodiazepine use?

A physiological or psychological need causing withdrawal on sudden cessation

Why are benzodiazepines more likely to cause harm in elderly patients?

Enhanced central nervous system effects increasing confusion and falls

Which combination most strongly increases the risk of benzodiazepine adverse effects?

Concomitant alcohol use potentiating central nervous system depression

Why must benzodiazepines not be stopped abruptly after prolonged use?

Sudden withdrawal can precipitate withdrawal symptoms including seizures

Which feature most clearly distinguishes Z-drugs from benzodiazepines according to the lecture?

Different molecular structure despite acting at the same receptor site

What is the principal clinical role of Z-drugs such as zopiclone and zolpidem?

Short-term treatment of insomnia

Why did benzodiazepines largely replace barbiturates in clinical practice?

They are safer with a lower risk of fatal respiratory depression

Which barbiturate remains widely used for epilepsy and is listed as an essential medicine?

Phenobarbital

Which property most explains why barbiturates are more dangerous in overdose than benzodiazepines?

Greater potency causing profound respiratory depression

In which condition are barbiturates specifically contraindicated due to worsening of disease?

Porphyria due to exacerbation of underlying metabolic pathways

Why should barbiturates be avoided in patients with severe asthma or COPD?

They cause respiratory depression that can worsen hypoventilation

Which adverse effect most distinguishes barbiturates from benzodiazepines in overdose?

High risk of fatal coma due to profound CNS and respiratory depression

Which barbiturate is used for rapid induction of anaesthesia due to its short onset of action?

Sodium thiopental

Why are barbiturates considered more addictive than benzodiazepines?

Greater reinforcement due to stronger CNS depressant effects