Check your Basics: Benzodiazepines

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Check your Basics: Benzodiazepines

Q: Which of the following benzodiazepine (used primarily for insomnia treatment) shares ALL of the following features:
- Peak blood levels at 20 minutes resulting in rapid onset of action.
- Metabolism: Oxidized in the liver with NO active major metabolite.
- Most number of FDA reports of anterograde amnesia from this medication.

(a) Flurazepam
(b) Temazepam
(c) Quazepam
(d) Triazolam

Admin wrote:.
Check your Basics: Benzodiazepines

Q: Which of the following benzodiazepine (used primarily for insomnia treatment) shares ALL of the following features:
- Peak blood levels at 20 minutes resulting in rapid onset of action.
- Metabolism: Oxidized in the liver with NO active major metabolite.
- Most number of FDA reports of anterograde amnesia from this medication.

(a) Flurazepam
(b) Temazepam
(c) Quazepam
(d) Triazolam

Ans: (d) Triazolam

Flurazepam: Peak blood levels reached in 30 mins. Flurazepam is oxidized in liver with active major metaboilite (desalkylflurazepam).

Temapzepam: Peak blood levels reached in 45-60 mins (so instruct patient to take the medication ~1 hr before going to bed). Temazepam is conjugated with a glucuronide radical in the liver with no active metabolite.

Quazepam: Quazepam is oxidized in liver with active major metaboilite (desalkylflurazepam). Quazepam's only special feature is that it binds selectively to type 1 benzodiazepine receptors, whereas flurazepam and other older benzodiazepines bind equally to both type 1 and type 2 sites in the brain.

Triazolam: Peak blood levels at 20 minutes resulting in rapid onset of action. Oxidized in the liver with NO active major metabolite. Most number of FDA reports of anterograde amnesia from this medication.
Source: Bunney WE, Azarnoff DL, Brown BW, et al: Report of the Institute of Medicine Committee on the Efficacy and Safety of Halcion. Arch Gen Psychiatry 56:349–352, 1999