NEURO: BENZODIAZEPINES Flashcards
1
Q
BENZOs - LORAZEPAM: INDICATIONS
A
- 1st line = seizures, status epilepticus, alcohol withdrawl rxns
- Common Choice = Sedation of interventional procedures (eg general anaesthesia)
- ST Tx = anxiety, insomnia
2
Q
BENZOs - LORAZEPAM: MOA
A
- Target is GABAa, choloride channel that opens in reponse to binding with GABA
- GABA is the main inhibitory NT, TF opening of channel = more chloride into cell and cell more resistant to depolarisation
- Benzos enhance the binding of GABA to GABAa receptor = widespread depressant effect on synaptic transmission
- Clinical effects = reduced anxiety, sleepiness, sedation and anti convulsive effects
3
Q
BENZOs - LORAZEPAM: ADVERSE EFFECTS
A
- Dose dependent drowsiness, sedation and coma
- Little cardiorespiratory depression
- Loss of reflexes = AWO and death
- Dependence
- Abrupt cessation = withdrawl rxn
4
Q
BENZOs - LORAZEPAM: WARNINGS
A
- Elderly
- Patients with respiratory impairment or NMDx
- Avoid in Liver failure because can precipitate ENCEPHALOPATHY
- If use is essential, Lorazepam is the best choice, as less dependent on liver for its elimination
5
Q
BENZOs - LORAZEPAM: IMPORTANT INTERACTIONS
A
- Additive to those sedating drugs = alcohol and opioids
- Most dependent on cytochrome p450 enzymes for elimination
- So concurrent use with cytochrome p450 inhibitors (amiodarone, macroclides, flucanazole etc) may increase their effects
6
Q
BENZOs - LORAZEPAM: EXAMPLES
A
- Lorazepam
- Chlordiazepoxide
- ‘am’
