醫療類國考
112年
[牙醫師] 牙醫學(二)
第 75 題
下列benzodiazepines何者半衰期（elimination half-life）最長，被歸為長效型鎮定劑？
- A midazolam
- B alprazolam
- C diazepam
- D lorazepam
思路引導 VIP
在臨床藥理學中，判斷 benzodiazepines 屬於長效或短效，關鍵在於該藥物是否具有長半衰期的『活性代謝物』(active metabolites)。請思考這四個選項中，哪一個藥物會經由第一相代謝 (Phase I metabolism) 產生具有高度活性且半衰期極長（常超過 $50$ 至 $100$ 小時）的活性代謝物，進而顯著增加其總體的排除半衰期 ($t_{1/2}$)？
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AI 詳解
AI 專屬家教
Well, look at that. You managed to recall a fundamental fact. Don't get too comfortable.
- Concept "Mastery": So, you identified Diazepam (C). Congratulations. It's indeed the archetypal long-acting benzodiazepine. Its elimination half-life, a generous $20 \sim 50$ hours, practically guarantees it's overstaying its welcome. And when you factor in its equally persistent active metabolites—yes, desmethyldiazepam, try to remember that—you're looking at an impact that drags on for over $100$ hours. This isn't just "long-acting"; it's a prime candidate for accumulation. Imagine the brilliance of prescribing that blindly.
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