Benzodiazepines

Question 0

Benzo name endings + 2 that don’t follow name ending guide.

Answer 0

ending in “epam” or “olam” +Chlordiazepoxide, Clorazepate

Question 1

Benzo’s used to Tx children

Answer 1

Chlordiazepxide, Clonazepam, Clorazepate, Diazepam have established PEDS dosage guides. Some others used with age and weight calc.

Question 2

Benzodiazepines Actions

Answer 2

on lymbic system and the reticular activating system (RAS). enhance GABAs effects by increasing the frequency of the channel opening events

Question 3

Treatment indications for Benzo’s

Answer 3

Anxiety disorders, Alcohol Withdrawal, Hyperexcitability/agitation, preoperative relief of anxiety/tension to ensure balanced anesthesia.

Question 4

Specific benzo (s) usual for alcohol withdrawal

Answer 4

Chlordiazepoxide, Clorazepate, Diazepam, Oxazepam

Question 5

Specific benzo (s) usual for Panic Disorder/Attack

Answer 5

Alprazolam, Clonazepam

Question 6

Specific benzo (s) usual for Hypnotic Tx of Insomnia

Answer 6

Estazolam, Flurazepam, Quezepam, Temazepam, Triazolam

Question 7

Specific benzo (s) usual for preoperative anxiolytic

Answer 7

Chlordiazepam, Diazepam, Lorazepam

Question 8

Specific benzo (s) usual for seizures, partial seizures, and anti-epileptic

Answer 8

Clonazepam=seizure disorders, Clorazepate = partial seizure disorders. Diazepam= antiepileptic, antitetanus.

Question 9

Benzo anxiolytic preferred for elderly

Answer 9

Oxazepam Tx of Anxiety and Alcohol withdrawal. Slow onset.

Question 10

Benzo Anxiolytics to monitor injection sites after administration

Answer 10

Chlordiazepoxide, Diazepam, Lorazepam

Question 11

Midazolam

Answer 11

Conscious sedation for short procedures, Sedation for intubation or ventilation. Don’t admin inter-arterially. Be prepared to breath for pt. May require a loading dose for in critical care

Question 12

Specific Benzo (s) usual for restless leg syndrome

Answer 12

Clonazepam-monitor for suicidal ideation. (also for panic and seizure)

Question 13

pharmacokinetics of Benzo (general)

Answer 13

well absorbed, well distributed, lipid soluble, crosses into placenta and BM. Onset 30-2 h. liver metabolized, urine excreted.

Question 14

Benzo general contraidications

Answer 14

Allergy, acute narrow angle glaucoma, coma, acute alcohol intoxication. All can be exacerbated by depressed CNS effects. Pregnancy=cleft lip/palate, and other defects.

Question 15

Benzo’s and African American

Answer 15

15-20% of African Americans predisposed to delayed metabolism causes build up and <adverse effects. Use smallest dose possible.

Question 16

Benzo general adverse effects

Answer 16

Sedation, Drowsy, Depression, lethargy, blurred vision, HA, apathy, Light headed, amnesia, confusion, *mild paradoxical excitation, GI-dry mouth, C,N,V. HypoTN, HTN, Arrhythmia, Palpitation, respiratory distress, anemia, urinary retension, >libido, Withdrawal.

Question 17

Diazepam Prototype Indications

Answer 17

Anxiety, Alcohol withdrawal, Muscle relaxer, Tx Tetanus, Antiepileptic in status epilepticus, preoperative anxiety and tension.

Question 18

Benzo general DD interaction

Answer 18

Alcohol or other CNS Depressants, Cimetidine, oral contraceptive, Disulfiram= increased effects

Theophyllines or Ranitidine=Decreased effects

Question 19

Diazepam Prototype Actions

Answer 19

Acts on Limbic System and RAS. May act of Spinal cord and supraspinal sites to relax muscles.
<effects of GABA (inhibitory NT)

Question 20

Diazepam Prototype pharmacokinetics

Answer 20

routes: Oral-O=30-60 min, D=3h. Others=IM,IV,R

Liver in/Urine out in 20-80 h.

Question 21

Diazepam Prototype Adverse effects

Answer 21

Drowsy, Depressed, Lethargic, Apathy, fatigue, restless, brady, tachy, GI=D,C. Incontinence/urinary retention, changed libido, withdrawal/dependence.

Question 22

Benzo’s Nursing Implementations

Answer 22

No Intra-arterial admin, No mixed drug in solution IV, Oral forms preffered, push IV slowly to >risks, >narcotic analgesic to > risks, monitor L&K Fx., Taper after long term therapy.

Question 23

Paradoxical Effect

Answer 23

Opposite reaction from desired effect

Can have for first 2 weeks of therapy: Insomnia, Rage, Excitation