A 54-year-old woman suffering from initial insomnia was prescribed a hypnotic drug that increases the activity of a major neurotransmitter system in the brain. Which of the following neurotransmitter systems was most likely involved in the therapeutic action of that drug?

Correct Answer: D

Rationale: The correct answer is D) GABAergic. In this scenario, the woman was prescribed a hypnotic drug for initial insomnia, which suggests the need to enhance inhibitory pathways to promote sleep. GABA (gamma-aminobutyric acid) is the major inhibitory neurotransmitter in the brain that helps regulate sleep and reduce neuronal excitability. Drugs that increase GABA activity, such as benzodiazepines or non-benzodiazepine sedative-hypnotics, are commonly used to treat insomnia by promoting relaxation and sleep. Option A) Cholinergic is incorrect because cholinergic neurotransmission is more associated with functions such as memory, muscle movement, and cognitive processing rather than sleep regulation. Option B) Noradrenergic is incorrect as noradrenaline plays a role in arousal, attention, and stress response, which are typically not targeted for insomnia treatment. Option C) Glutamatergic is incorrect because glutamate is the major excitatory neurotransmitter in the brain and is involved in cognitive functions, learning, and memory, rather than sleep promotion. Understanding the role of different neurotransmitter systems in drug actions is crucial for healthcare professionals to make informed decisions when prescribing medications for specific conditions like insomnia. This knowledge helps ensure safe and effective treatment outcomes for patients.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Anterograde amnesia. Anterograde amnesia is a common side effect of sedative medications like benzodiazepines. It is characterized by the inability to form new memories after the sedation wears off. This symptom is often seen in patients recovering from sedation due to the impact of the medication on memory formation processes in the brain. Option A) Nausea and vomiting is not typically associated with recovery from sedation but may occur as side effects during sedation administration. Option B) Increased respiratory rate is not a common symptom upon recovery from sedation. In fact, sedatives usually have a depressant effect on the respiratory system. Option D) Limb muscle spasms are also not a typical symptom upon recovery from sedation. Sedatives generally have a muscle-relaxing effect rather than causing muscle spasms. Educationally, understanding the common side effects and symptoms associated with sedative medications is crucial for healthcare professionals to provide safe and effective care to patients recovering from sedation. This knowledge helps in monitoring patients for expected outcomes and identifying any potential complications promptly.

Correct Answer: A

Rationale: The patient's oversedation and spending the whole day dozing is a common side effect of Zolpidem, which is a sedative-hypnotic drug used for insomnia. Zolpidem is known to cause drowsiness and oversedation, especially in the elderly population. The patient taking a "sleeping pill" from a friend that he couldn't remember the name of is consistent with Zolpidem being the cause of his symptoms.

Correct Answer: C

Rationale: In this scenario, the most appropriate drug for the 49-year-old woman complaining of sleep disturbances would be option C, Eszopiclone. Eszopiclone is a non-benzodiazepine sedative-hypnotic used to treat insomnia by helping the patient fall asleep faster and stay asleep longer. It is a suitable choice for addressing sleep disturbances without causing significant next-day drowsiness. Option A, Flunitrazepam, is a benzodiazepine commonly known as Rohypnol, primarily used as a sedative and for anesthesia induction. However, due to its high potential for abuse and dependence, it is not recommended for treating sleep disturbances in this case. Option B, Buspirone, is an anxiolytic drug used for generalized anxiety disorder. While anxiety may contribute to sleep disturbances, buspirone does not directly address the primary issue of insomnia. Option D, Fluoxetine, is a selective serotonin reuptake inhibitor (SSRI) used to treat depression, anxiety disorders, and certain other conditions. While depression can be associated with sleep disturbances, fluoxetine is not the first-line choice for addressing primary insomnia. In an educational context, understanding the pharmacological properties of different drugs is crucial for making appropriate treatment decisions. Healthcare providers need to consider the specific symptoms and underlying conditions when selecting the most suitable medication to optimize patient outcomes. In this case, choosing Eszopiclone aligns with best practices for managing sleep disturbances in the given patient demographic.

Correct Answer: A

Rationale: The MAC (minimum alveolar concentration) of an inhalational anesthetic is defined as the alveolar concentration at which 50% of patients do not move in response to a surgical stimulus. It is related to the blood/gas partition coefficient of the anesthetic, which determines the rate at which the anesthetic enters and leaves the bloodstream, influencing its potency.