Benzodiazepines Flashcards
Benzo name endings + 2 that don’t follow name ending guide.
ending in “epam” or “olam” +Chlordiazepoxide, Clorazepate
Benzo’s used to Tx children
Chlordiazepxide, Clonazepam, Clorazepate, Diazepam have established PEDS dosage guides. Some others used with age and weight calc.
Benzodiazepines Actions
on lymbic system and the reticular activating system (RAS). enhance GABAs effects by increasing the frequency of the channel opening events
Treatment indications for Benzo’s
Anxiety disorders, Alcohol Withdrawal, Hyperexcitability/agitation, preoperative relief of anxiety/tension to ensure balanced anesthesia.
Specific benzo (s) usual for alcohol withdrawal
Chlordiazepoxide, Clorazepate, Diazepam, Oxazepam
Specific benzo (s) usual for Panic Disorder/Attack
Alprazolam, Clonazepam
Specific benzo (s) usual for Hypnotic Tx of Insomnia
Estazolam, Flurazepam, Quezepam, Temazepam, Triazolam
Specific benzo (s) usual for preoperative anxiolytic
Chlordiazepam, Diazepam, Lorazepam
Specific benzo (s) usual for seizures, partial seizures, and anti-epileptic
Clonazepam=seizure disorders, Clorazepate = partial seizure disorders. Diazepam= antiepileptic, antitetanus.
Benzo anxiolytic preferred for elderly
Oxazepam Tx of Anxiety and Alcohol withdrawal. Slow onset.
Benzo Anxiolytics to monitor injection sites after administration
Chlordiazepoxide, Diazepam, Lorazepam
Midazolam
Conscious sedation for short procedures, Sedation for intubation or ventilation. Don’t admin inter-arterially. Be prepared to breath for pt. May require a loading dose for in critical care
Specific Benzo (s) usual for restless leg syndrome
Clonazepam-monitor for suicidal ideation. (also for panic and seizure)
pharmacokinetics of Benzo (general)
well absorbed, well distributed, lipid soluble, crosses into placenta and BM. Onset 30-2 h. liver metabolized, urine excreted.
Benzo general contraidications
Allergy, acute narrow angle glaucoma, coma, acute alcohol intoxication. All can be exacerbated by depressed CNS effects. Pregnancy=cleft lip/palate, and other defects.
Benzo’s and African American
15-20% of African Americans predisposed to delayed metabolism causes build up and <adverse effects. Use smallest dose possible.
Benzo general adverse effects
Sedation, Drowsy, Depression, lethargy, blurred vision, HA, apathy, Light headed, amnesia, confusion, *mild paradoxical excitation, GI-dry mouth, C,N,V. HypoTN, HTN, Arrhythmia, Palpitation, respiratory distress, anemia, urinary retension, >libido, Withdrawal.
Diazepam Prototype Indications
Anxiety, Alcohol withdrawal, Muscle relaxer, Tx Tetanus, Antiepileptic in status epilepticus, preoperative anxiety and tension.
Benzo general DD interaction
Alcohol or other CNS Depressants, Cimetidine, oral contraceptive, Disulfiram= increased effects
Theophyllines or Ranitidine=Decreased effects
Diazepam Prototype Actions
Acts on Limbic System and RAS. May act of Spinal cord and supraspinal sites to relax muscles.
<effects of GABA (inhibitory NT)
Diazepam Prototype pharmacokinetics
routes: Oral-O=30-60 min, D=3h. Others=IM,IV,R
Liver in/Urine out in 20-80 h.
Diazepam Prototype Adverse effects
Drowsy, Depressed, Lethargic, Apathy, fatigue, restless, brady, tachy, GI=D,C. Incontinence/urinary retention, changed libido, withdrawal/dependence.
Benzo’s Nursing Implementations
No Intra-arterial admin, No mixed drug in solution IV, Oral forms preffered, push IV slowly to >risks, >narcotic analgesic to > risks, monitor L&K Fx., Taper after long term therapy.
Paradoxical Effect
Opposite reaction from desired effect
Can have for first 2 weeks of therapy: Insomnia, Rage, Excitation
