A.25.Benzodiazepines Flashcards
Mechanism of action of Benzodiazepines
- enhances the potency of endogenous GABA–> less GABA is needed to initiate the same response
- ↑ frequency of Cl⁻ channel opening
- no GABA mimetic effects
what agent is the only clinically used GABAʙ agonist
Baclofen
name the short-acting Benzodiazepines
Nitrazepam Midazolam (ultra-short)
name the intermediate-acting Benzodiazepines
Lorazepam
Alprazolam
name the long-acting Benzodiazepines
Diazepam
Clonazepam
which Benzodiazepines can be given orally and IV?
“DML”
Midazolam
Lorazepam
Diazepam
*all the others are only oral
which Benzodiazepines are safe to use in liver disease?
“LOT”
Lorazepam
Oxazepam
Temazepam
metabolism is extrahepatic conjugation (inactive metabolite)
all other BZ–> hepatic conjugation (active metbolite)
what BZ’s do you give for sleep disorders, insomnia?
"NETT" Nitrazepam Trizolam Estazolam Temazepam
what BZ’s do you give for anxiety, panic and phobic disorders?
"DOLAC" Oxazepam Alprazolam Lorazepam Clonazepam Diazepam
what BZ’s are used for preoperative sedation and status epilepticus?
“DML”
Lorazepam
Midazolam
Diazepam
which BZ is used for withdrawal states and muscle spasticity?
Diazepam
what are the indications for Clonazepam?
bipolar disorders
seizures
anxiety, panic and phobic disorders
adverse effects of benzodiazepines
- cognitive impairment
- ↓ psychomotor skills
- daytime sedation (↑ risk in elderly)
- anterograde amnesia (high dose)
- CV and respiratory depression (toxic doses or additive drug interactions)
what CNS depressants cause an additive sedation effect when used with BZ’s
Antihistamines (1st gen') anesthetics alcohols Barbiturates opioid analgesics β-blockers 𝝰₂- agonists
possible life-threatening respiratory depression
what type of dependence does BZ have?
psychologic and physiologic
