WBR0432
| Author | [[PageAuthor::Rim Halaby, M.D. [1]]] |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Pharmacology |
| Sub Category | SubCategory::Neurology |
| Prompt | [[Prompt::An 82 year old male patient presents to the physician for insomnia. Following evaluation, the physician decides he wants to prescribe a benzodiazepine (BZD) to treat the patient’s condition. Several days later, the patient returns to the physician complaining of frequent falls, impaired balance and coordination, and dizziness. Which of the following medications have most likely been prescribed by the physician to treat this patient’s insomnia?]] |
| Answer A | AnswerA::Diazepam |
| Answer A Explanation | AnswerAExp::Diazepam is a long-acting BZD. Its side effects include falling, dizziness, and impaired balance and coordination. |
| Answer B | AnswerB::Alprazolam |
| Answer B Explanation | AnswerBExp::Alprazolam is a short-acting BZD. |
| Answer C | AnswerC::Triazolam |
| Answer C Explanation | AnswerCExp::Triazolam is a short-acting BZD. |
| Answer D | AnswerD::Oxazepam |
| Answer D Explanation | AnswerDExp::Oxazepam is a short-acting BZD. |
| Answer E | AnswerE::Midazolam |
| Answer E Explanation | AnswerEExp::Midazolam is a short-acting BZD. |
| Right Answer | RightAnswer::A |
| Explanation | [[Explanation::The patient is most likely prescribed a long-acting BZD. Side effects of long-acting BZDs are frequent falls, impaired balance and coordination, and dizziness especially in the elderly population. In contrast, short-acting BZDs have the worst addiction potential.
Long-acting BZDs include: Diazepam, clonazepam, nitrazepam, and flurazepam. Short-acting BZDs include: Alprazolam, triazolam, oxazepam, and midazolam. Educational Objective:
Long-acting BZD, such as diazepam, clonazepam, nitrazepam, and flurazepam, have side effects such as frequent falls, impaired balance and coordination, and dizziness especially in the elderly population. |
| Approved | Approved::No |
| Keyword | WBRKeyword::benzodiazepine, WBRKeyword::diazepam, WBRKeyword::side, WBRKeyword::effect, WBRKeyword::fall, WBRKeyword::elderly, WBRKeyword::dizziness, WBRKeyword::balance, WBRKeyword::long, WBRKeyword::short, WBRKeyword::acting |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |