Neurological (Benzodiazepines)

Question 1

Examples of drug (Benzodiazepines)

Answer 1

• Diazepam
• Lorazepam
• Midazolam

Question 2

Mechanism of action (Benzodiazepines)

Answer 2

• Increases GABA affinity for GABA receptor
• GABA binding to receptor increases chloride flow through chloride channels
• Hyperpolarization occurs - reducing activity of limbic, thalamic and hypothalamic areas of the brain.

Question 3

Indications (Benzodiazepines)

Answer 3

• Anxiety
• Epilepsy
• Muscle spasm
• Alcohol withdrawal

Question 4

Side effects (Benzodiazepines)

Answer 4

• Sedation
• Ataxia
• Altered mental status
• Insomnia

Question 5

Important pharmacokinetics/pharmacodynamics (Benzodiazepines)

Answer 5

• Diazepam is a long acting benzodiazepine with active metabolites so can accumulate in longer term use and in patients with liver failure. It can be given orally, rectally or parenterally.
• Lorazapam accumulates less with long term use or in patients with liver failure so is preferred in this setting. It cannot be given rectally.
• Midazolam is a potent and short acting benzodiazepine typically given parenterally, although buccal preparations exist.

Question 6

Patient information (Benzodiazepines)

Answer 6

• Monitor breathing and report if severe breathlessness or palpitations
• Only prescribed for short terms – risk of addiction