Which statement about diazepam is true?

Which statement about diazepam is true?

• A. Undergoes enterohepatic recirculation -> longest half life
• B. It is used as a rapid induction agent
• C. It has no anticonvulsant properties
• D. It does not affect skeletal muscle tone

Answer: (A)

Diazepam’s long duration is explained by two pharmacokinetic features: formation of long-acting active metabolites and enterohepatic recirculation. After liver metabolism, diazepam is converted to active metabolites (notably desmethyldiazepam) that persist in the body. These metabolites are secreted into the bile and into the gut, where they can be reabsorbed back into the bloodstream. This enterohepatic recirculation effectively recycles the drug and its active metabolites, extending the terminal half-life and the overall duration of action, especially with repeated dosing or in older patients who clear more slowly. Because of this long half-life and potential for accumulation, diazepam is not used as a rapid induction agent. It is a long-acting anxiolytic with anticonvulsant properties and skeletal muscle relaxant effects via potentiation of GABA-A receptor activity. The statements claiming no anticonvulsant properties or no effect on skeletal muscle tone don’t fit its pharmacology, and the idea of a rapid induction role conflicts with its prolonged action.

Diazepam’s long duration is explained by two pharmacokinetic features: formation of long-acting active metabolites and enterohepatic recirculation. After liver metabolism, diazepam is converted to active metabolites (notably desmethyldiazepam) that persist in the body. These metabolites are secreted into the bile and into the gut, where they can be reabsorbed back into the bloodstream. This enterohepatic recirculation effectively recycles the drug and its active metabolites, extending the terminal half-life and the overall duration of action, especially with repeated dosing or in older patients who clear more slowly.

Because of this long half-life and potential for accumulation, diazepam is not used as a rapid induction agent. It is a long-acting anxiolytic with anticonvulsant properties and skeletal muscle relaxant effects via potentiation of GABA-A receptor activity. The statements claiming no anticonvulsant properties or no effect on skeletal muscle tone don’t fit its pharmacology, and the idea of a rapid induction role conflicts with its prolonged action.