A nursing student asks a nurse what criteria are used to ...

[HCHenry]

A nursing student asks a nurse what criteria are used to determine which benzodiazepine is prescribed in different situations. The nurse correctly states that selection is based on differences in the onset and duration of effects, as well as on:
 
  a. differences in sites of action in the central nervous system.
  b. marketing decisions of pharmaceutical companies.
  c. relative differences in abuse potential.
  d. variations in adverse effects and drug interactions.

Question 2

A hospitalized patient who is given one dose of flurazepam continues to show drowsiness the next day. A nursing student asks the nurse the reason for this, because the drug's half-life is only 2 to 3 hours.
 
  Which response by the nurse is correct?
  a. Benzodiazepines commonly cause residual effects lasting into the day after the dose is given.
  b. The patient is having a paradoxical reaction to this medication.
  c. This patient must have developed a previous tolerance to benzodiazepines.
  d. When this drug is metabolized, the resulting compound has longer lasting effects.

[cat123]

Answer to Question 1

ANS: B
The principal factors determining the applications of a particular benzodiazepine are the pharmacokinetic properties having to do with absorption, metabolism, and excretion and the research and marketing decisions of the drug makers. All of the benzodiazepines produce a similar spectrum of responses, and all act at various sites in the CNS. All benzodiazepines have a lower abuse potential than barbiturates. Drug effects and drug interactions are similar for all benzodiazepines.

Answer to Question 2

ANS: D
Flurazepam has a half-life of 2 to 3 hours; however, its metabolite has a long half-life, so giving the drug results in long-lasting effects. Barbiturates, not benzodiazepines, are commonly associated with residual, or hangover, effects. A paradoxical reaction to a sedative would manifest as insomnia, euphoria, and excitation, not drowsiness. Tolerance means that the patient would need increased amounts of a drug to get the desired effects and would not have prolonged effects of the medication.

[HCHenry]

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[cat123]

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