WBR0432

Author	[[PageAuthor::Rim Halaby, M.D. [1] (Reviewed by Alison Leibowitz)]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Pharmacology
Sub Category	SubCategory::Neurology
Prompt	[[Prompt::An 82-year-old male presents to the physician's office for insomnia. Following evaluation, you prescribe a benzodiazepine (BZD) to treat the patient’s condition. Several days later, the patient returns with complaints of frequent falls, impaired balance and coordination, and dizziness. Which of the following medications was most likely prescribed to treat this patient’s insomnia?]]
Answer A	AnswerA::Diazepam
Answer A Explanation	[[AnswerAExp::Diazepam, a long-acting BZD, has side effects such as 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 BZDs, such as diazepam, clonazepam, nitrazepam, and flurazepam, have side effects including frequent falls, impaired balance and coordination, and dizziness, especially in the elderly population. References: First Aid 2014 page 492]]
Approved	Approved::Yes
Keyword	WBRKeyword::benzodiazepine, WBRKeyword::diazepam, WBRKeyword::side effect, WBRKeyword::falling, WBRKeyword::elderly, WBRKeyword::dizziness, WBRKeyword::balance, WBRKeyword::long acting, WBRKeyword::addictive, WBRKeyword::BZD
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::