Benzos

Question 1

Relative onset and duration of ativan vs versed vs valium

Answer 1

Midazolam: quickest on and off
Diazepam: quick on and medium off
Lorazepam: 5-10 minutes on, 2-6 hours off

Question 2

Which benzos are good for IM dosing, which is not?

Answer 2

Ativan and Versed are good, with good absorption

Valium has erratic IM absorption and IM isn’t recommended.

Question 3

Do benzos affect QT?

Answer 3

No

Question 4

Considerations when giving benzos to intoxicated patients

Answer 4

Benzos+alcohol lead to respiratory depression and a lower starting dose may be considered.
However, benzos are still a first-line agent for agitation in alcohol intoxication.

Question 5

Which benzo is presferred in IM dosing?

Answer 5

Versed

Question 6

Which benzo is preferred in elderly?

Answer 6

Versed

Question 7

Which benzo has active metabolites that might be a problem in liver disease?

Answer 7

Diazepam

Question 8

What is the preferred agent for seizure? Why? What dose?

Answer 8

Ativan
Preferred because of the duration of action. Other agents are short acting and can cause relapse. Initial dose is 0.1mg/kg (max 4mg), can repeat 1-2 times.

Question 9

Benzo effects on hemodynamics

Answer 9

may have small effect on slowing heart rate, but overall there are little effects on hemodynamics