Sketchy Pharm: Benzodiazepines and Flumazenil

Question 1

What is a short-acting benzodiazepine?

Answer 1

Oxazepam (the running bull, charging fast)

Question 2

The -olam suffix is typical of _________ benzodiazepines.

Answer 2

short-acting

Question 3

________ metabolism accounts for degradation of all benzodiazepines.

Answer 3

Hepatic (recall the ox with the liver spot)

Question 4

The benzodiazepines activate the ___________ receptor.

Answer 4

GABA A (think of the “Cab-A” cab)

Question 5

What else binds to the GABA (A) receptor?

Answer 5

Alcohol (hence, benzodiazepines are given in alcohol withdrawal)
Barbiturates
Phenytoin
Neurosteroids

Question 6

Benzodiazepines used alone can provide ___________ sedation.

Answer 6

conscious (such as for a colonoscopy –think of the patient with the “lite” drink representing lite anesthesia)

Question 7

Benzodiazepines can be used to treat ___________, but they’re not first line due to potential for physical dependence.

Answer 7

insomnia/parasomnias

Question 8

What is a major risk of benzodiazepine use?

Answer 8

Tolerance! Using anything that stimulates GABA channels will cause them to down-regulate. Thus, you will need more GABA-channel inducer to get the same effect.

Question 9

Overuse of sedative hypnotics is a major cause of ____________ (gerontologic concern).

Answer 9

confusion in the elderly

Question 10

What is the antidote for benzodiazepine overdose?

Answer 10

Flumazenil (GABA A antagonist) –think of the “fluffy muzzled dog” blocking the delivery boy trying to get to the cab; its use remains controversial, though, because it has been known to induce seizures in those addicted to benzodiazepines.