Benzos

Question 1

Diazepam/Valium

Answer 1

Use: Anxiety, Delirium tremens, catatonia, insomia
- Treats anxiety related to MI

Start 2mg (BID-QID)
- Tabs in 2, 5, 10; Solution in 5mg/5mL

Side effects
- Taper
- Adjust for renal/hepatic
- Sedation, fatigue, depression, dizziness, ataxia, slurred speech, weakness, forgetfulness, confusion
- CYP450, 2c19, 3A4 receptors

Question 2

Clonazepam/Klonopin

Answer 2

Use: Panic d/o (agoraphobia), other anxiety d/o, acute mania adjunct, acute psychosis adjunct, insomnia, catatonia

Start 0.5mg, max 4 mg BID
Larger dose at bedtime

Side effects:
- Short term use
- longer half life, less euphoria and dependance
- 1/2 dose of alprazolam when switching
- Caution renal/hepatic/elderly- lower dose

Question 3

Lorazepam/Ativan

Answer 3

Use: Anxiety d/o, insomnia, muscle spasm, ETOH w/d, panic disorder, acute mania adjunct, acute psychosis adjunct, delirium (with haldol), catatonia

Start 0.5 mg, BID-TID, max 10mg
- Tabs in 0.5, 1, 2

-Taper

Question 3

Alprazolam/Xanax

Answer 3

Use: GAD (IR), Panic d/o (IR and XR)

Start 0.25 mg BID-TID, max 4 mg
- Tabs in 0.25, 0.5, 1, 2
- XR= less sedating

-Dependence