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Behavioral Health > Benzodiazepines > Flashcards

Benzodiazepines Flashcards

1
Q

MOA of benzos

A
  • bind to GABA receptors in the synapse

- decrease the excitability of neurons by increasing efficiency of GABA

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2
Q

metabolism of benzos

A

CYP450

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3
Q

side effects of benzos

A
  • MC: sedation, impaired concentration

- dizziness, ataxia, muscle twitching

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4
Q

what side effects of benzos should you be alert to?

A

disinhibition with paradoxical agitation and/or aggression

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5
Q

overdose sx of benzos

A

respiratory depression (esp if combined with ETOH)

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6
Q

what determines the severity of withdrawal symptoms from benzos

A

the faster the serum levels of the drug falls, the worse the sx

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7
Q

which benzo is known for its withdrawal?

A

xanax

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8
Q

symptoms of withdrawal from benzos

A

increased anxiety, tremor or shakiness, muscle twitching, sweating, tachycardia, HTN, zeizures

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9
Q

pros of long acting benzos

A

provide less symptom fluctuation and less severe withdrawal

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10
Q

cons of long acting benzos

A

higher potential for drug accumulation and therefore sedation

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11
Q

how should you start dosing benzos?

A

LOW and go SLOW

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12
Q

how long until a patient can develop tolerance/dependence from benzos?

A

3 weeks

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13
Q

what is the biggest mistake when it comes to benzos?

A

continuing them indefinitely

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14
Q

safest and efficient strategy of benzos

A
  • start with a short/intermediate acting benzo at a low dose to begin, then titrate up
  • continue for 2-6 weeks followed by a 1-2 week taper
  • during those 6 weeks, start SSRI
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15
Q

alprazolam

A

xanax

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16
Q

indications for xanax

A

panic d/o, GAD, social phobia

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17
Q

onset of xanax

A

fast

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18
Q

how many times is xanax taken a day?`

A

can be multiple

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19
Q

why is there an abuse potential with xanax?

A

fast euphoria commonly reported

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20
Q

how sedating is xanax?

A

less than other benzos`

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21
Q

diazepam

A

valium

22
Q

indications for valium

A

anxiety, ETOH w/d, adjunct tx of muscle spasm and movement disorders

23
Q

half-life of valium

A

a really really long time (100 hours)

24
Q

downside of valium

A

longer half life leads to accumulation of active metabolites, especially in elderly

25
Q

lorazepam

A

ativan

26
Q

indications for ativan

A

anxiety, ETOH w/d, adjunct in acute psychotic agitation

27
Q

are there active metabolites in ativan?

A

NO

28
Q

metabolism of ativan

A

NOT CYP450 - good choice if pt on other meds or has comorbid conditions

29
Q

how is ativan excreted?

A

renally - unique!

30
Q

special quality of ativan

A

ONLY benzo in IM form that has a rapid, predictable and complete absorption

31
Q

chlordiazepoxide

A

librium

32
Q

indications for librium

A

anciety and ETOH w/d

33
Q

half life of librium

A

> 100 hours

34
Q

what is the caution with librium and the elderly?

A

since the long half life ensures drug will accumulate with multiple dosing, they may become suddenly obtunded

35
Q

metabolism of librium

A

CYP450

36
Q

clonazepam

A

klonopin

37
Q

indication for klonopin

A

initially an anticonvulsant, NOW for panic d/o, social phobia and GAD

38
Q

half like of klonopin

A

long, but has a rapid onset & is very potent

39
Q

metabolism of klonopin

A

CYP450

40
Q

triazolam

A

halcion

41
Q

onset of halcion

A

rapid after oral administration

42
Q

half life of halcion

A

shortest of all benzos

43
Q

indication for halcion

A

initiation of sleep issues

44
Q

estazolam

A

prosom

45
Q

action of prosom

A

intermediate

46
Q

temazepam

A

restoril

47
Q

action of restoril

A

intermediate

48
Q

flurazepam

A

dalmane

49
Q

action of dalmane

A

long

50
Q

quazepam

A

doral

51
Q

action of doral

A

long

52
Q

Oxazepam

A

Serax - short

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