Benzodiazepines

Question 1

Benzodiazepine general info (3)

Answer 1

1. Amnesia with minimal cardiorespiratory effects
2. Anticonvulsant activity
3. Low incidence of tolerance and dependence

Question 2

Midazolam brand name

Answer 2

Versed

Question 3

Midazolam onset and duration of action

Answer 3

Onset: <5 minutes
Duration: approx 1 hour

Question 4

Midazolam mechanism of action

Answer 4

Binds to benzodiazepine receptors in the GABA neuron complex&raquo_space; increases GABA chloride channel permeability&raquo_space; reduced neuron excitability

Question 5

When would midazolam be used in conscious sedation?

Answer 5

When propofol is not an option

Question 6

Midazolam is often used in conjunction with _____ because ______

Answer 6

morphine, midazolam does not have analgesic properties

Question 7

Midazolam advantages: (2)

Answer 7

1. strong amnesia effect with very little hangover effect

2. minimal cardiorespiratory depression

Question 8

Midazolam disadvantages: (2)

Answer 8

1. can cause nausea/vomiting

2. cardiorespiratory depression is possible depending on dose and patient response

Question 9

Midazolam doses: (anxiety and ICU)

Answer 9

0.1-0.3 mg/kg (anxiety)

20-100 mcg/kg/hr (ICU)

Question 10

Diazepam brand name

Answer 10

Valium

Question 11

Diazepam mechanism of action

Answer 11

Similar to midazolam, binds to benzodiazepine receptors in the GABA neuron complex&raquo_space; increases GABA chloride channel permeability&raquo_space; reduced neuron excitability

Question 12

Diazepam indications: (2)

Answer 12

1. Acute symptom relief in anxiety disorders

2. Treatment of alcohol withdrawal

Question 13

Diazepam adverse effects

Answer 13

Associated with dependence

Question 14

Diazepam onset and duration of action

Answer 14

Onset: <5 minutes
Duration: Approximately 12 hours

Question 15

Diazepam potency compared to midazolam

Answer 15

1/2 to 1/3 potency of midazolam

Question 16

Diazepam doses (anxiety, pre-op sedation, ICU sedation)

Answer 16

Anxiety: 2-10 mg PO
Pre-Op Sedation: 10 mg IM
ICU sedation: 0.03-0.1 mg/kg

Question 17

Flumazenil mean half life

Answer 17

1/2 hour

Question 18

Etomidate brand name

Answer 18

Amidate

Question 19

etomidate drug class (4)

Answer 19

IV anesthetic, sedative, hypnotic, induction agent

Question 20

Etomidate mechanism of action

Answer 20

Thought to depress CNS through GABA

Question 21

Etomidate indications (3)

Answer 21

1. RSI
2. Head injuries
3. Cardiac complications

Question 22

Etomidate adverse effects and considerations (4)

Answer 22

1. No significant CVS effects
2. Decreases oxygen demand and metabolism
3. No analgesic properties
4. Can suppress cortisol production

Question 23

Etomidate onset and duration of action

Answer 23

Onset: 30 seconds
Duration: 10 minutes

Question 24

Etomidate induction dose

Answer 24

0.3-0.6 mg/kg IV

Question 25

Etomidate side effects

Answer 25

Nausea, vomiting on emergence from anesthesia