Benzodiazepines Flashcards
1
Q
What are the generic and brand names of benzodiazepines?
A
- Diazepam (Diazemuls)
- Temazepam
- Lorazepam
- Midazolam
2
Q
What is the method of action of benzodiazepines?
A
- Targets GABA type A receptor which is a Cl- channel
- Facilitates the binding of GABA to the GABA type A receptor
- This causes the receptor channel to open and Cl- to flood in, making the cell more resistant to depolarisation
- = widespread depressant effect on synaptic transmission
- Ethanol also acts on GABA receptors so benzodiazepines prevents the excitatory withdrawal effect in a gradual, controlled way
3
Q
What are the indications for benzodiazepines?
A
- 1st line management for seizures and status epilepticus
- 1st line management for alcohol withdrawal reaction
- Sedation for interventional procedures, if GA unavailable
- Short term treatment for anxiety
- Short tern treatment for insomnia
4
Q
What are the contraindications of benzodiazepines?
A
- Elderly
- Respiratory impairment
- Neuromuscular diseases e.g. myasthenia gravis
- Liver failure – may causes hepatic encephalopathy (Lorazepam best choice in this case)
5
Q
What are the side effects of benzodiazepines?
A
- Drowsiness
- Sedation
- Coma
- Airway obstruction
- Death
- Dependence – used over a few weeks
- Withdrawal reaction – similar to that of alcohol
6
Q
What are the interactions with benzodiazepines?
A
- Alcohol – addictive nature
- Opiods – addictive nature
- Amiodarone – cytochrome P450 inhibitor so effects ↑
- Dilitiazem – cytochrome P450 inhibitor so effects ↑
- Macrolids – cytochrome P450 inhibitor so effects ↑
- Fluconazole – cytochrome P450 inhibitor so effects ↑
- Protease inhibitor – cytochrome P450 inhibitor so effects ↑
7
Q
Which organ eliminates benzodiazepines?
A
Kidney
8
Q
What information should be given to patient taking benzodiazepines?
A
- Try and avoid daily use if possible due to addictive nature and no longer than 4 weeks
- Do not drive/operate machinery
- Sleepiness may persist the following day
