WBR0432

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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 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 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 BZDs, 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.
References: ]]

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::