Benzodiazapines - diazepam

Question 1

What are the indications of diazepam?

Answer 1

1) 1st line for siezures and status epilepticus
2) 1st line for alcohol withdrawal reactions
3) sedation for interventional procedures
4) short term for sever anxiety
5) short term for sever insomnia

Question 2

How does diazepam (benzodiazepine) work?

Answer 2

Diazepam targets GABA type A receptors. They enhance the binding of GABA to the GABAa receptor this opens opens the channel allows Cl- to flow into the cell making it more resistant to depolarisation. This is a depressant effect on synaptic transmission.

• reduced anxiety
• sleepiness
• sedation
• anticonvulsive

Question 3

What are the side effects of diazepam (benzodiazepine)?

Answer 3

• drowsiness
• sedation
• coma
• loss of airway reflex —? airway obstruction and death.
• addiction
• withdrawal similar to alcohol withdrawal

Question 4

What are the contraindications of benzodiazepine (diazepam)

Answer 4

• elderly (give lower dose)
• respiratory impairment
• neuromuscular disease e.g. myesthenia gravis
• liver failure (can causes hepatic enchephalopathy)

Question 5

what are the drug interactions of benzodiazepines?

Answer 5

• sedating drugs, alcohol, opioids.

- benzodiazepines are dependant on cytochrome P450 enzymes for elimination so don't use with cytochrome P450 inhibitors e.g. 
amiodarone, 
diltiazem, 
macrolides,
fluconazole, 
protease inhibitors

Question 6

What is the prescription of diazepam for siezures?

Answer 6

10 mg IV

or rectal solution