Benzodiazepines Flashcards

1
Q

Indications

A
  • 1st line for seizures and alcohol withdrawal

- short term for anxiety/disorders, insomnia, spastic/involuntary movements, surgery interventions

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2
Q

Drugs

A

Pams and Lams

alprazolam
clonazepam
diazepam
lorazepam

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3
Q

Addiction to Benzos and Withdrawal

A
  • dependence develops with regular use

- withdrawal symptoms with abrupt stoppage > REDUCE SLOWLY

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4
Q

S/S Benzo Withdrawal

A
Tremors
Anxiety
Dysphoria
Perceptual Disturbances
Potentially Serious
- Delirium
- Seizures
- Autonomic hyperactivity
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5
Q

Benzos Physiologically Addictive

A
  • DANGEROUS WITHDRAWAL
  • MUST TAPER OFF
    » Progress very slowly
    » Must be monitored
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6
Q

Kinetics of Benzos ***

A

Short Half Life < 12 hrs - (ATM)

  • Alprazolam
  • Triazolam
  • Midazolam
    • Used for insomnia bc shorter half life **
    • Usually abuse (especially alprazolam + lorazepam **

Intermittent Half Life 12-24 hrs - (TLC)

  • Temazepam
  • Lorazepam
  • Clonazepam

Long Half Life > 24 hrs - (CDC)

  • Chlordiazepoxide
  • Diazepam
  • Clorazepate
    • Used for anxiety **
    • Greater risk of accumulating in elder 2/2 long HL **
    • Reduced rebound effect **
    • Reduced withdrawal symptoms **
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7
Q

Benzo Contraindications and Precautions

A

Contraindications:
- Acute or Chronic Narrow Angle Glaucoma

Precautions:
- Compromised renal, hepatic, pulm systems
&raquo_space; May cause hepatic encephalopathy with liver
cirrhosis
&raquo_space; Depresses respirations
&raquo_space; Metabolized by Liver
&raquo_space; Excreted by Kidneys
- History of substance abuse
- CNS depressants including alcohol and opioids
- Elderly patients

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8
Q

Benzo Key Clinicals

A
  • Elderly are most likely to have S/E including falls so reduce the dose
  • Rebound/withdrawal less likely with long acting benzos
  • avoid in myasthenia gravis
  • Avoid in liver failure
  • S/E more increased with alcohol and opioids
  • CYP450 drugs cause more S/E
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9
Q

How quickly do they work?? **

A

within minutes to hours

aka not much of a delay

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