Benzodiazepines Flashcards
Name 11 Benzodiazepines.
- Alprazolam
- Bromazepam
- cloBAZam
- CLONazepam
- Diazepam
- Flunitrazepam
- LORazepam
- Midazolam
- Nitrazepam
- OXazepam
- Temazepam
Describe the half-life of nitrazepam.
Nitrazepam has a long half-life.
Describe the half-life of midazolam.
Midazolam has a very short half-life
Describe the half-life of alprazolam.
Alprazolam has a short half-life
Describe the half-life of OXazepam.
OXazepam has a short half-life
Describe the half-life of temazepam.
Temazepam has a short half-life
Describe the half-life of bromazepam.
Bromazepam has a moderate half-life
Describe the half-life of LORazepam.
LORazepam has a moderate half-life
Describe the half-life of cloBAZam.
cloBAZam has a long half-life
Describe the half-life of CLONazepam.
CLONazepam has a long half-life
Describe the half-life of Diazepam.
Diazepam has a long half-life.
Describe the half-life of flunitrazepam.
Flunitrazepam has a long half-life.
Describe the benzodiazepine loading dose technique in the management of alcohol withdrawal.
The patient is given repeated doses of diazepam until symptoms have diminished to an acceptable level.
Describe the role of diazepam in alcohol withdrawal.
Diazepam is effective in the prevention and treatment of acute alcohol withdrawal seizures.
Can diazepam be used as monotherapy in alcohol withdrawal relief? Why/why not?
Because of the relatively large doses usually given, and the long half-life of diazepam, it may not be necessary to give any further medication for withdrawal relief.
What is the usual regimen for diazepam in alcohol withdrawal?
Use diazepam 20 mg orally, every 2 hours until symptoms subside. A cumulative dose of 60 mg daily is usually adequate.
If a patient with alcohol withdrawal has not settled with 60 mg diazepam, what should be done?
Review the diagnosis and consider the possibility of other conditions.
What is the upper limit of diazepam dosing for alcohol withdrawal.
Do not exceed 100 mg daily without seeking specialist advice.
Describe the duration of diazepam administration for alcohol withdrawal.
Diazepam may be administered over the subsequent 2 to 7 days if symptoms return but should not be continued beyond that.
What should be done if diazepam is needed by a patient undergoing home treatment for alcohol withdrawal?
If diazepam is needed, it can be collected daily by the patient or administration can be supervised by a reliable person living with the patient.
Describe the role of high-dose diazepam in alcohol withdrawal delirium (delirium tremens).
Very high doses of diazepam (greater than 100 mg daily) may be required, but seek specialist advice.
Describe the role of IV diazepam in alcohol withdrawal delirium (delirium tremens).
Intravenous injection of diazepam should be avoided if possible. Onset of action is not much faster than with oral administration and there is a greater likelihood of causing severe adverse effects such as respiratory depression.
What should be done if an injection of diazepam is necessary in the management of alcohol withdrawal delirium (delirium tremens).
If an injection of diazepam is necessary, it must not be diluted and it must be given slowly over several minutes to minimise the risk of respiratory depression or arrest. Close cardiorespiratory monitoring is essential.
What is an alternative to diazepam injections in alcohol withdrawal delirium (delirium tremens)?
Cautiously use parenteral midazolam as given for agitation in severe acute behavioural disturbance.
What is a risk associated with diazepam and, to a lesser extent, haloperidol and droperidol in alcohol withdrawal delirium (delirium tremens)?
They may worsen symptoms of hepatic encephalopathy.
