A sleep apnea patient needs dental restorations. Which drug could cause dangerous RESPIRATORY DEPRESSION in this patient?

Correct answer: D. Diazepam (benzodiazepine — CNS depressant with respiratory depression risk)

• A. Ketorolac is an NSAID — it provides analgesia without CNS depression or respiratory effects.
• B. Ibuprofen is an NSAID with no respiratory depressant effects.
• C. Ketamine is a dissociative anesthetic that at subanesthetic doses maintains airway reflexes and respiratory drive — it is relatively safer for procedural sedation in patients with compromised airways.
• D. Correct. DIAZEPAM (and all benzodiazepines) cause CNS depression including respiratory depression by enhancing GABA-A activity. In patients with SLEEP APNEA — who already have compromised respiratory control and upper airway tone during sleep — benzodiazepines significantly worsen apneic episodes and can cause life-threatening respiratory depression. Benzodiazepines are CONTRAINDICATED or used with extreme caution in sleep apnea patients.