Benzodiazepines

Question 1

Mechanism of BZDs (2)

Answer 1

binding increases GABA affinity allosterically mediating inhibitory synoptic transmission in CNS

increases channel number not open time or conductance

Question 2

Effects of overdose of BZDs (3)

Answer 2

prolonged sleep

life threatening with other CNS depressants

reversed with flumazenil

Question 3

Tolerance and Dependence of BZDs (2)

Answer 3

gradual increase in dose needed to keep effect

stopping abruptly causes increase anxiety, tremor, dizziness and insomnia

Question 4

BZDs and alcohol significance (2)

Answer 4

increased risk of abuse with alcohol due to cross tolerance

increased risk of relapse to alcohol

Question 5

Effects of BZDs (5)

Answer 5

decreased anxiety and aggression unless short acting in which case anxiety is increased (likely as a part of withdrawal)

decreases muscle tone and coordination

prolonged sleep and sedation

anticonvulsant as it blocks GABAa in spinal cord, be aware of airway collapse, tolerance develops to anticovnvulsant effects

anterograde amnesia associated with a5 subunit on GABAa

Question 6

Name a famous variety of BZDs (1)

Answer 6

Rohypnol

Question 7

Evidence of a5 subunit in anterograde amnesia (1)

Answer 7

selective agonists have been investigated to improve memory

Question 8

Name the paper that stated tolerance and dependence occurs in all BZDs due to receptor changes but by an unknown mechanism (1)

Answer 8

Wafford, 2005

Question 9

What two daily function does treatment with BZDs affect days after use (3)

Answer 9

coordination

driving

worse for anticonvulsants as there is a 24 day cooldown

Question 10

Can you get addicted to BZDs and why? (2)

Answer 10

Yes, but its unlikely

no strong psychological dependence, dependence is all physical, the withdrawal is worse than the reward pathway is good