Benzodiazepines

Question 1

What is it indicated for?

Answer 1

First line management of status epilepticus

First line management of alcohol withdrawal reactions

Sedation palliative care for interventional procedures or rapid tranquilisation

Short-term treatment of anxiety or insomnia

Question 2

How does it work?

Answer 2

They enhance binding of GABA to the GABA type A receptors causing reduced anxiety, sleepiness and anticonvulsive effects

Question 3

What are the side effects of drugs in this class?

Answer 3

Drowsiness
Sedation
Coma
Can cause airway obstruction and death in overdose
Dependence
Withdrawal symptoms on abrupt cessation

Question 4

What are the warnings of this drug class?

Answer 4

Older people more susceptible to effects- should get lower dose

Avoid in respiratory impairment or neuromuscular diseases

Avoid in liver failure may cause hepatic encephalopathy

Question 5

What drug would be best in liver failure if a benzo had to be used?

Answer 5

Lorazepam is less dependent on the liver for elimination

Question 6

What are the important interactions with this drug class?

Answer 6

Sedating drugs like alcohol and opioids
CYP inhibitors may increase effects