Week 13: Benzo

Question 1

Benzo examples, & indication

Answer 1

“-zepam” “-zolam”

Chlordiazepoxide (Librium)
Diazepam (Valium)
Lorazepam (Ativan)
Alprazolam (Xanax)
Midazolam (Versed)

Used for anxiety, panic disorders, alcohol withdrawal, seizures, insomnia, muscle spasms, pre-anesthesia sedation, IBS, restless leg syndrome, and chemotherapy induced nausea and vomiting

Question 2

benzodiazepine MOA

“-zepam” “-zolam”

Answer 2

increasing GABA action (which is an inhibitory NT) which decreases the effect of neuronal excitation

Question 3

benzodiazepine caution/contran

“-zepam” “-zolam”

Answer 3

dependence
CNS effects (drowsiness, ataxia, fatigue, confusion)
high risk falls

NO preg, lactation, hepatic/renal dz, < 6 yrs old, glaucoma

Question 4

benzodiazepine drug interactions

“-zepam” “-zolam”

Answer 4

• increase digoxin
• increase plasma TCA’s
• CNS depression
• clozapine (increase sedation, salivation, hypotension, delirium, respiratory arrest)
• decreased clearance of food/drugs that inhibit CYP3A = enhanced effects

Question 5

which anxiety medication to take that has less sedation, less memory impairment, and minimal withdrawal effect? but sadly can take 2-4 weeks to provide relief

Answer 5

buspar over benzos but buspar is slow acting

Question 6

which benzo best option for lactation?

Answer 6

Lorazepam bc shorter half life

Question 7

benzos in elderly?

Answer 7

NEVARRRR!
bc of reduced liver size and kidney size, blood flow and clearance and metabolism is slower, CNS more sensitive to effects of sedating meds and more sensitive to delirium and fall

Question 8

benzo monitoring

Answer 8

worsen depression
behavior changes
suicide thoughts
LFT/CBC for long term use
digoxin/TCA lvls

short term use only (max 4 weeks)