Sedatives MCQs With Answer offers B. Pharm students a focused, practical review of sedative-hypnotic pharmacology. This concise introduction covers clinical uses, mechanisms at the GABA-A receptor, differences between benzodiazepines, barbiturates and Z-drugs, pharmacokinetics, metabolism (CYP450 vs glucuronidation), adverse effects, dependence and important drug interactions. Emphasis is placed on prescribing principles, overdose management and special populations to build strong exam-ready knowledge. The carefully crafted multiple-choice questions reinforce drug selection, receptor pharmacology, toxicity and counseling points essential for safe therapeutics. Now let’s test your knowledge with 30 MCQs on this topic.
Q1. Which of the following is a benzodiazepine commonly used for anxiety?
- Diazepam
- Phenobarbital
- Zolpidem
- Promethazine
Correct Answer: Diazepam
Q2. What is the primary mechanism of action of benzodiazepines at the GABA-A receptor?
- Enhance GABA-A receptor-mediated chloride channel opening frequency
- Directly open chloride channels independent of GABA
- Block GABA uptake into synaptic cleft
- Antagonize glutamate NMDA receptors
Correct Answer: Enhance GABA-A receptor-mediated chloride channel opening frequency
Q3. Which drug is classified as a “Z-drug” hypnotic?
- Zolpidem
- Alprazolam
- Phenobarbital
- Buspirone
Correct Answer: Zolpidem
Q4. Which agent is a specific benzodiazepine receptor antagonist used in overdose?
- Flumazenil
- Naloxone
- Physostigmine
- Atropine
Correct Answer: Flumazenil
Q5. Which barbiturate has a long half-life and is commonly used as an anticonvulsant?
- Phenobarbital
- Thiopental
- Secobarbital
- Meprobamate
Correct Answer: Phenobarbital
Q6. Which class of sedatives is most frequently associated with paradoxical agitation, especially in elderly or pediatric patients?
- Benzodiazepines (e.g., lorazepam)
- Z-drugs (e.g., zaleplon)
- Antihistamines (e.g., diphenhydramine)
- Barbiturates (e.g., phenobarbital)
Correct Answer: Benzodiazepines (e.g., lorazepam)
Q7. Sedation from benzodiazepines is primarily associated with which GABA-A receptor alpha subunit?
- α1
- α2
- α3
- γ2
Correct Answer: α1
Q8. Which hypnotic has the shortest elimination half-life and minimal next-day residual effect?
- Zaleplon
- Zolpidem
- Eszopiclone
- Temazepam
Correct Answer: Zaleplon
Q9. Which benzodiazepine is commonly preferred for treating alcohol withdrawal because of its long duration and anticonvulsant effect?
- Chlordiazepoxide
- Midazolam
- Zolpidem
- Buspirone
Correct Answer: Chlordiazepoxide
Q10. Which sedative-hypnotic barbiturate is classically used for intravenous induction of anesthesia due to ultra-short action?
- Thiopental
- Phenobarbital
- Secobarbital
- Oxazepam
Correct Answer: Thiopental
Q11. Barbiturates exert their sedative effects primarily by which mechanism?
- Prolong the duration of GABA-A receptor chloride channel opening and directly activate the receptor at high concentrations
- Increase the frequency of channel opening only in presence of GABA
- Block GABA synthesis
- Antagonize benzodiazepine binding site
Correct Answer: Prolong the duration of GABA-A receptor chloride channel opening and directly activate the receptor at high concentrations
Q12. Which benzodiazepine is metabolized to the active metabolite desmethyldiazepam (nordiazepam), prolonging its effects?
- Diazepam
- Lorazepam
- Oxazepam
- Midazolam
Correct Answer: Diazepam
Q13. Which hypnotic benzodiazepine is most associated with pronounced anterograde amnesia when used for insomnia?
- Triazolam
- Clonazepam
- Diazepam
- Phenobarbital
Correct Answer: Triazolam
Q14. Which of the following is NOT a benzodiazepine but is a non-benzodiazepine hypnotic?
- Zolpidem
- Lorazepam
- Clonazepam
- Temazepam
Correct Answer: Zolpidem
Q15. Which over-the-counter antihistamine is commonly used for its sedative properties in mild insomnia?
- Diphenhydramine
- Ranitidine
- Ibuprofen
- Cetirizine
Correct Answer: Diphenhydramine
Q16. Concomitant use of benzodiazepines with opioids primarily increases the risk of which adverse outcome?
- Respiratory depression
- Hepatic enzyme induction
- Seizures
- Hypertension
Correct Answer: Respiratory depression
Q17. The functional GABA-A receptor is composed of how many subunits?
- Pentameric (five subunits)
- Tetrameric (four subunits)
- Hexameric (six subunits)
- Monomeric
Correct Answer: Pentameric (five subunits)
Q18. Which benzodiazepine is commonly used IV for procedural sedation because of rapid onset and short duration?
- Midazolam
- Clonazepam
- Diazepam
- Phenobarbital
Correct Answer: Midazolam
Q19. Which sedative is a well-known inducer of hepatic cytochrome P450 enzymes, affecting levels of other drugs?
- Phenobarbital
- Oxazepam
- Zolpidem
- Flumazenil
Correct Answer: Phenobarbital
Q20. Abrupt discontinuation of long-term high-dose benzodiazepines may precipitate which dangerous withdrawal symptom?
- Seizures
- Hyperprolactinemia
- Blindness
- Parkinsonism
Correct Answer: Seizures
Q21. Which property distinguishes barbiturates from benzodiazepines at high concentrations?
- Barbiturates can directly activate GABA-A receptors in absence of GABA
- Barbiturates only increase frequency of channel opening
- Barbiturates block benzodiazepine binding site competitively
- Barbiturates are 5-HT1A agonists
Correct Answer: Barbiturates can directly activate GABA-A receptors in absence of GABA
Q22. Which anxiolytic is a non-sedating 5-HT1A partial agonist used for generalized anxiety rather than acute sedation?
- Buspirone
- Diazepam
- Phenobarbital
- Zolpidem
Correct Answer: Buspirone
Q23. Which benzodiazepine is often preferred for status epilepticus because of its efficacy and relatively prolonged anticonvulsant action?
- Lorazepam
- Triazolam
- Zaleplon
- Promazine
Correct Answer: Lorazepam
Q24. Which class of sedatives has the narrowest therapeutic index and highest risk of fatal overdose?
- Barbiturates
- Benzodiazepines
- Z-drugs
- Antihistamines
Correct Answer: Barbiturates
Q25. For insomnia patients needing minimal next-day sedation and rapid sleep induction, which agent is most appropriate?
- Zaleplon
- Flurazepam
- Doxylamine
- Phenobarbital
Correct Answer: Zaleplon
Q26. Tolerance to hypnotic effects develops most rapidly with which class of drugs?
- Barbiturates
- Antihistamines
- SSRIs
- Beta-blockers
Correct Answer: Barbiturates
Q27. Which benzodiazepine undergoes direct glucuronidation (phase II metabolism) and is thus preferred in hepatic impairment?
- Oxazepam
- Diazepam
- Flurazepam
- Chlordiazepoxide
Correct Answer: Oxazepam
Q28. Which sedative-hypnotic has been most strongly associated with teratogenic risk and neonatal withdrawal when used in pregnancy?
- Phenobarbital
- Zolpidem
- Lorazepam
- Buspirone
Correct Answer: Phenobarbital
Q29. Co-administration of benzodiazepines with ethanol most likely produces which pharmacodynamic interaction?
- Synergistic CNS depression
- Reduced benzodiazepine clearance leading to hypertension
- CYP450 inhibition with opioid antagonism
- Reduced sedative effect due to receptor blockade
Correct Answer: Synergistic CNS depression
Q30. Long-term barbiturate therapy commonly leads to which effect on co-administered drugs?
- Increased hepatic metabolism of co-administered drugs via CYP450 induction
- Reduced renal clearance of all drugs
- Inhibition of phase II glucuronidation universally
- Permanent blockade of CYP3A4
Correct Answer: Increased hepatic metabolism of co-administered drugs via CYP450 induction
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