Butabarbital MCQs With Answer

Butabarbital MCQs With Answer

Butabarbital MCQs With Answer for B.Pharm students: This concise, Student-friendly post covers key aspects of butabarbital — an intermediate-acting barbiturate — including pharmacology, mechanism of action, clinical uses, adverse effects, pharmacokinetics, drug interactions, contraindications, and overdose management. Designed to reinforce classroom learning and exam preparation, these targeted MCQs highlight synthesis basics, GABAergic modulation, CYP-mediated metabolism, and safety considerations such as dependence and respiratory depression. Ideal for pharmacy undergraduates preparing for pharmacology and therapeutics exams, this set builds depth beyond basics while remaining clear and practical. Now let’s test your knowledge with 50 MCQs on this topic.

Q1. Which class of drugs does butabarbital belong to?

• Nonnarcotic analgesics
• Barbiturates
• Benzodiazepines
• Selective serotonin reuptake inhibitors

Correct Answer: Barbiturates

Q2. The primary mechanism of action of butabarbital involves modulation of which receptor?

• NMDA receptor
• Alpha-2 adrenergic receptor
• GABA-A receptor
• Dopamine D2 receptor

Correct Answer: GABA-A receptor

Q3. Butabarbital primarily enhances which property of the GABA-A receptor chloride channel?

• Frequency of channel opening
• Duration of channel opening
• Receptor internalization
• GABA synthesis

Correct Answer: Duration of channel opening

Q4. Which of the following is a common clinical use of butabarbital?

• Long-term management of chronic anxiety
• Treatment of bacterial infections
• Short-term treatment of insomnia and preoperative sedation
• First-line therapy for neuropathic pain

Correct Answer: Short-term treatment of insomnia and preoperative sedation

Q5. Butabarbital is best described pharmacokinetically as which type of barbiturate based on duration?

• Ultra-short-acting
• Short-acting
• Intermediate-acting
• Long-acting

Correct Answer: Intermediate-acting

Q6. The metabolism of butabarbital largely occurs in which organ?

• Kidney
• Skin
• Liver
• Pancreas

Correct Answer: Liver

Q7. Which metabolic effect is commonly associated with chronic barbiturate use including butabarbital?

• CYP enzyme inhibition
• No effect on drug metabolism
• CYP enzyme induction
• Direct renal excretion without metabolism

Correct Answer: CYP enzyme induction

Q8. A major safety concern with butabarbital is its potential to cause:

• Autoimmune disease
• Severe respiratory depression
• Hyperthyroidism
• Renal stone formation

Correct Answer: Severe respiratory depression

Q9. Co-administration of butabarbital with alcohol most likely results in:

• Reduced hypnotic effect
• Additive CNS depression
• Prevention of tolerance
• Enhanced immune response

Correct Answer: Additive CNS depression

Q10. Which patient condition is a contraindication to butabarbital use?

• Acute intermittent porphyria
• Mild seasonal allergies
• Controlled hypertension
• Hyperlipidemia

Correct Answer: Acute intermittent porphyria

Q11. The development of tolerance to butabarbital primarily affects which of the following?

• Renal clearance rate only
• Requirement for higher doses to achieve the same effect
• Immediate allergic reactions
• Enhancement of therapeutic index

Correct Answer: Requirement for higher doses to achieve the same effect

Q12. Withdrawal from chronic butabarbital use can lead to which serious complication?

• Hypertension crisis
• Seizures
• Renal failure
• Hyperglycemia

Correct Answer: Seizures

Q13. Which laboratory monitoring is most relevant when assessing potential hepatic effects of butabarbital?

• Serum creatinine
• Complete blood count only
• Liver function tests (ALT, AST)
• Serum calcium

Correct Answer: Liver function tests (ALT, AST)

Q14. In the context of drug interactions, butabarbital is likely to decrease plasma levels of which co-administered drug?

• Warfarin due to CYP induction
• Metformin via renal competition
• Insulin due to receptor blockade
• Vitamin C via conjugation

Correct Answer: Warfarin due to CYP induction

Q15. Which pharmacokinetic property influences onset and duration of barbiturate action including butabarbital?

• Protein binding only
• Lipid solubility
• Route of excretion in bile only
• Renal clearance exclusively

Correct Answer: Lipid solubility

Q16. Butabarbital acts as a positive allosteric modulator at GABA-A receptors; this leads to increased influx of which ion?

• Sodium (Na+)
• Potassium (K+)
• Calcium (Ca2+)
• Chloride (Cl-)

Correct Answer: Chloride (Cl-)

Q17. A key difference between benzodiazepines and barbiturates like butabarbital is that barbiturates can:

• Cause less respiratory depression at high doses
• Directly open the GABA-A chloride channel at high concentrations
• Be reversed with flumazenil
• Have no tolerance development

Correct Answer: Directly open the GABA-A chloride channel at high concentrations

Q18. Which adverse effect is MOST likely in elderly patients treated with butabarbital?

• Insomnia improvement without side effects
• Increased risk of falls and cognitive impairment
• Lower sensitivity to respiratory depression
• Decreased half-life due to enhanced clearance

Correct Answer: Increased risk of falls and cognitive impairment

Q19. During pregnancy, use of butabarbital is generally discouraged due to risk of:

• Enhanced fetal neural development
• Teratogenicity and neonatal respiratory depression
• Improved uteroplacental blood flow
• Prevention of gestational diabetes

Correct Answer: Teratogenicity and neonatal respiratory depression

Q20. In acute overdose of butabarbital, first priority in management is:

• Immediate forced diuresis at home
• Airway protection and supportive care
• Administration of naloxone as antidote
• Rapid administration of flumazenil

Correct Answer: Airway protection and supportive care

Q21. Which statement about urinary excretion of barbiturates like butabarbital is correct?

• They are strongly basic and excreted better in acidic urine
• Urinary alkalinization can increase excretion for some barbiturates
• They are completely excreted unchanged in urine
• Renal excretion is independent of urine pH

Correct Answer: Urinary alkalinization can increase excretion for some barbiturates

Q22. Which clinical test might predict increased sensitivity to CNS depressants like butabarbital?

• History of chronic alcohol consumption
• High baseline hematocrit only
• Elevated serum uric acid
• Positive skin prick test

Correct Answer: History of chronic alcohol consumption

Q23. Butabarbital-induced hepatic enzyme induction is most likely to affect which phase of drug metabolism?

• Phase III transporter activity only
• Phase I oxidative metabolism
• Phase II glucuronidation exclusively
• No effect on drug metabolism phases

Correct Answer: Phase I oxidative metabolism

Q24. A B.Pharm student studying formulation should note that butabarbital tablets require what primary consideration?

• Protection from light and moisture to maintain stability
• Storage at freezing temperatures
• Immediate mixing with alkaline solutions
• Co-administration with vitamin supplements for stability

Correct Answer: Protection from light and moisture to maintain stability

Q25. Which adverse hematologic reaction has been reported, though uncommon, with barbiturate therapy?

• Agranulocytosis
• Polycythemia vera
• Iron deficiency anemia due to iron binding
• Thrombocytosis only

Correct Answer: Agranulocytosis

Q26. Which monitoring is important when butabarbital is used chronically due to hepatic enzyme induction?

• Periodic ECG only
• Periodic liver function tests and drug level monitoring when indicated
• Monthly bone scans
• Frequent measurement of serum potassium

Correct Answer: Periodic liver function tests and drug level monitoring when indicated

Q27. Butabarbital dependence is mediated mainly by which adaptive changes?

• Upregulation of NMDA receptors and downregulation of GABAergic function
• Increase in insulin receptor sensitivity
• Permanent DNA mutation in neurons
• Enhanced serotonin synthesis only

Correct Answer: Upregulation of NMDA receptors and downregulation of GABAergic function

Q28. Which statement is correct regarding butabarbital and seizure disorders?

• Butabarbital is the drug of choice for all seizure types
• Barbiturates may be used as anticonvulsants but have narrow therapeutic windows and risk of sedation
• Butabarbital has no effect on neuronal excitability
• Barbiturates cure epilepsy permanently

Correct Answer: Barbiturates may be used as anticonvulsants but have narrow therapeutic windows and risk of sedation

Q29. Which effect on sleep architecture is associated with barbiturate hypnotics like butabarbital?

• Increase in REM sleep proportion
• Suppression of REM sleep and deep slow-wave sleep alterations
• No change in sleep stages
• Promotion of prolonged REM cycles only

Correct Answer: Suppression of REM sleep and deep slow-wave sleep alterations

Q30. When counseling a patient, which warning about butabarbital should a pharmacist emphasize?

• It enhances alertness and reaction time
• Avoid driving or operating heavy machinery due to sedation
• It prevents all forms of alcohol intoxication
• It has no potential for misuse

Correct Answer: Avoid driving or operating heavy machinery due to sedation

Q31. Which biochemical property of barbiturates influences their ability to cross the blood-brain barrier?

• High molecular weight only
• Lipid solubility
• Electric charge at room temperature only
• High degree of ionization at physiological pH exclusively

Correct Answer: Lipid solubility

Q32. In a patient with severe hepatic impairment, butabarbital dosing considerations should include:

• Using standard doses without adjustment
• Lowering dose or avoiding use due to impaired metabolism
• Increasing dose due to faster clearance
• Switching to an oral iron supplement

Correct Answer: Lowering dose or avoiding use due to impaired metabolism

Q33. Which interaction is expected when butabarbital is administered with oral contraceptives?

• Increased contraceptive efficacy
• Reduced contraceptive effectiveness due to CYP induction
• No interaction at all
• Immediate pregnancy prevention

Correct Answer: Reduced contraceptive effectiveness due to CYP induction

Q34. Which statement about tolerance development to different effects of butabarbital is accurate?

• Tolerance develops equally to respiratory and lethal effects, making higher doses safer
• Tolerance to sedative effects develops faster than to respiratory depressant effects, increasing overdose risk
• No tolerance develops to any effect
• Tolerance eliminates the risk of dependence

Correct Answer: Tolerance to sedative effects develops faster than to respiratory depressant effects, increasing overdose risk

Q35. From a medicinal chemistry perspective, barbiturates like butabarbital are derivatives of which parent compound?

• Barbituric acid
• Phenylalanine
• Imidazole
• Benzoic acid

Correct Answer: Barbituric acid

Q36. Which adverse effect is more characteristic of chronic barbiturate therapy rather than acute use?

• Transient dizziness only
• Psychological and physical dependence
• Immediate anaphylaxis in all patients
• Rapid hair growth

Correct Answer: Psychological and physical dependence

Q37. During pharmacokinetic studies, a B.Pharm student notes that butabarbital has a relatively large volume of distribution. This implies:

• Drug remains confined to plasma only
• Extensive distribution into tissues and possible accumulation in fat
• Rapid renal excretion with minimal tissue uptake
• Exclusive binding to red blood cells

Correct Answer: Extensive distribution into tissues and possible accumulation in fat

Q38. Which emergency medication is NOT effective as an antidote for barbiturate overdose?

• Flumazenil
• Supportive respiratory measures
• Activated charcoal (if indicated)
• Intravenous fluids and vasopressors if hypotensive

Correct Answer: Flumazenil

Q39. A property that differentiates butabarbital from long-acting barbiturates is:

• Butabarbital has a longer duration than phenobarbital
• Butabarbital has an intermediate duration with fewer daytime accumulation effects
• Butabarbital is ineffective as a hypnotic
• Butabarbital does not cross the blood-brain barrier

Correct Answer: Butabarbital has an intermediate duration with fewer daytime accumulation effects

Q40. In toxicity studies, butabarbital lethal effects are primarily due to:

• Severe metabolic alkalosis
• Profound CNS and respiratory depression leading to hypoxia
• Direct myocardial infarction
• Acute renal tubular necrosis only

Correct Answer: Profound CNS and respiratory depression leading to hypoxia

Q41. For safe dispensing, controlled status of butabarbital means pharmacists should:

• Ignore record-keeping since it is OTC
• Follow applicable controlled-substance regulations and maintain records
• Provide unlimited refills without documentation
• Store it with household supplements

Correct Answer: Follow applicable controlled-substance regulations and maintain records

Q42. Which clinical sign helps differentiate barbiturate intoxication from opioid intoxication?

• Miosis is exclusive to barbiturates
• Barbiturate intoxication often shows nystagmus and ataxia with variable pupil size
• Opioids never produce respiratory depression
• Barbiturates cause pinpoint pupils always

Correct Answer: Barbiturate intoxication often shows nystagmus and ataxia with variable pupil size

Q43. In the context of drug formulation, which excipient consideration is important for butabarbital tablets?

• Use of hygroscopic excipients to enhance moisture uptake
• Selection of non-reactive binders and moisture-protective coatings
• Formulating with high levels of peroxides
• Avoiding any coatings to increase degradation

Correct Answer: Selection of non-reactive binders and moisture-protective coatings

Q44. Which population requires extra caution or dose adjustment when prescribing butabarbital?

• Young healthy adults with no comorbidities
• Patients with severe hepatic disease and the elderly
• Individuals with seasonal allergies only
• Patients on topical antibiotics exclusively

Correct Answer: Patients with severe hepatic disease and the elderly

Q45. Which pharmacodynamic interaction is most concerning when butabarbital is combined with opioids?

• Mutual cancellation of effects
• Synergistic respiratory depression and sedation
• Reduced analgesic efficacy of opioids
• Prevention of opioid tolerance

Correct Answer: Synergistic respiratory depression and sedation

Q46. Which statement about butabarbital dosing for insomnia is appropriate from a B.Pharm perspective?

• It is recommended for indefinite nightly use for chronic insomnia due to lack of tolerance
• Short-term, lowest effective dose is preferred to minimize tolerance and dependence
• High initial doses improve long-term outcomes
• Dosing frequency should be increased to every 4 hours

Correct Answer: Short-term, lowest effective dose is preferred to minimize tolerance and dependence

Q47. Which metabolic interaction would most likely increase plasma concentration of a co-administered drug?

• Butabarbital-induced CYP induction of that drug’s metabolism
• Co-administration of a CYP inhibitor that interferes with butabarbital clearance
• Complete renal secretion enhancement
• Increased first-pass hepatic metabolism only

Correct Answer: Co-administration of a CYP inhibitor that interferes with butabarbital clearance

Q48. Which is a correct statement about prescribing butabarbital in pediatric patients?

• Pediatrics tolerate adult doses without adjustment
• Use with caution, adjust dose carefully, and consider alternatives due to sensitivity and risk
• It is a recommended first-line chronic hypnotic for children
• No special monitoring is required in children

Correct Answer: Use with caution, adjust dose carefully, and consider alternatives due to sensitivity and risk

Q49. For B.Pharm exam preparation, understanding which regulatory aspect of butabarbital is important?

• It is non-regulated and available OTC worldwide
• It is a controlled substance in many countries with prescription and dispensing restrictions
• It requires no labeling or record-keeping
• It is classed as a dietary supplement

Correct Answer: It is a controlled substance in many countries with prescription and dispensing restrictions

Q50. Which is the best practice when discontinuing long-term butabarbital therapy?

• Stop abruptly to prevent dependence
• Taper gradually under medical supervision to reduce withdrawal risk
• Double the dose for one week then stop
• Switch to another CNS stimulant immediately

Correct Answer: Taper gradually under medical supervision to reduce withdrawal risk

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