Which of the following hypnotic benzodiazepines is more likely to cause “hangover” effects such as drowsiness dysphoria and mental or motor depression the following day?

Correct Answer: C

Rationale: In pharmacology, understanding the pharmacokinetics and pharmacodynamics of benzodiazepines is crucial to predict their effects. In this case, the correct answer is C) Flurazepam. Flurazepam is a long-acting benzodiazepine with active metabolites that can accumulate in the body, leading to prolonged sedative effects. Its half-life is longer compared to other benzodiazepines, contributing to the increased likelihood of "hangover" effects such as drowsiness, dysphoria, and mental or motor depression the next day. Now, let's analyze why the other options are incorrect: - A) Temazepam: Temazepam is an intermediate-acting benzodiazepine with a shorter half-life compared to Flurazepam. It is less likely to cause significant hangover effects due to its shorter duration of action. - B) Triazolam: Triazolam is a short-acting benzodiazepine, which is commonly used for insomnia due to its rapid onset of action and short duration. It is less likely to cause prolonged hangover effects compared to Flurazepam. - D) None of the above: This is incorrect as Flurazepam, as explained earlier, is more likely to cause hangover effects compared to the other options. Educationally, this question highlights the importance of considering the pharmacokinetic properties of drugs when predicting their side effects. Understanding the duration of action, metabolism, and potential for accumulation of drugs like benzodiazepines is crucial for healthcare professionals to make informed decisions regarding their use in clinical practice.

Correct Answer: C

Rationale: The correct answer is C: Fentanyl. Fentanyl is a phenylpiperidine derivative due to its specific chemical structure containing a piperidine ring attached to a phenyl group. Codeine (A) is an opioid, but not a phenylpiperidine derivative. Dezocine (B) is a benzomorphan derivative. Buprenorphine (D) is a thebaine derivative. Fentanyl stands out as the only option that fits the phenylpiperidine derivative category.

Correct Answer: B

Rationale: The correct answer is B: Analgin. Analgin is a pirazolone derivative, specifically metamizole. It is a non-opioid analgesic and antipyretic medication. Methylsalicylate is a salicylate derivative used as a topical pain reliever. Paracetamol is an analgesic and antipyretic drug but not a pirazolone derivative. Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) but not a pirazolone derivative. Therefore, Analgin is the only choice that fits the criteria of being a pirazolone derivative.

Correct Answer: D

Rationale: The correct answer is D. Lithium treatment is associated with various adverse effects. Cardiovascular anomalies in the newborn can occur if lithium is taken during pregnancy. Thyroid enlargement is a common side effect of lithium, as it interferes with thyroid hormone synthesis. Nephrogenic diabetes insipidus is another well-known adverse effect of lithium, leading to excessive urination and thirst. Choosing option D is correct as it encompasses all the mentioned adverse effects associated with lithium treatment. Other choices are incorrect as they do not cover the full spectrum of adverse effects linked to lithium.

Correct Answer: D

Rationale: Step-by-step rationale: 1. Amphetamine acts as a direct catecholaminergic agonist, stimulating the release of norepinephrine and dopamine (A). 2. It also inhibits monoamine oxidase, preventing the breakdown of these neurotransmitters (B). 3. Additionally, amphetamine increases the release of catecholaminergic neurotransmitters by reversing their transporters (C). 4. Therefore, the correct answer is D, as amphetamine's mechanism involves all of the actions mentioned in choices A, B, and C.