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Discussion Starter · #1 ·
70 yo white male with Parkinson disease comes to your clinic complaining of insomnia. History reveals that he is concerned about his quality of life that he has trouble sleeping for 2 months. You consider short-term pharmacologic therapy along with sleep hygiene instructions. Which of the following medicines enhances fall risk for your patient?
A zolpidem
B triazolam
C oxazepam
D flurazepam
E alprazolam
 

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70 yo white male with Parkinson disease comes to your clinic complaining of insomnia. History reveals that he is concerned about his quality of life that he has trouble sleeping for 2 months. You consider short-term pharmacologic therapy along with sleep hygiene instructions. Which of the following medicines enhances fall risk for your patient?
A zolpidem
B triazolam
C oxazepam
D flurazepam
E alprazolam
D. Flurazepam is a long-lasting benzo and its side effect includes day-time drowsiness therefore increasing the chance of falling.
All the other options are short-lasting benzos and they can be summarized into TOMAZ- Triazolam, Oxazepam, Midazolam, Alprazolam and Zolpidem.
 

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Discussion Starter · #3 ·
main side effect of benzodiazepines is daytime drowsiness.
this 'hangover' effect effect increases the risk of falling as it is associated with ataxia, impaired judgement and concentration.
in addition, these meds are more addictive.
another aspect of benzos is tolerance that readily develops with long-term use
the answer to this question hinges on half-life of benzos
long-acting benzo causes more severe drowsiness than short-acting benzo
< 10 hr half life - alprazolam, triazolam, oxazepam
10 - 20 hr half life - estazolam, lorazepam, temazepam
> 20 hr half life - chlordiazepoxide, clorazepate, diazepam, flurazepam
 
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