Benzodiazepines

Question 0

Benzos have analgesia properties

Answer 0

NO

Question 1

What are benzos used for?

Answer 1

(Primarily Anxiolytic, sedation, anxiolysis,) anticonvulsant effects, spinal-cord mediated muscle relaxation, and anterograde amnesia and at high doses unconsciousness and respiratory depression

Question 2

Therapeutic index

Answer 2

High 100s

Benzo + narcotic = t.i. <10

Question 3

Benzo site receptor

Answer 3

GABA-A
2a & 2b
Enhanced opening of Cl channel
Hyper polarization of post synaptic membrane
Post synaptic neurons resistant to excitation

Question 4

Reversal agent

Answer 4

Flumazenil

Question 5

Flumazenil

Answer 5

Exclusive BZD competitive antagonist with high affinity for the BZD receptor

Question 6

Flumazenil How it reverse

Answer 6

In a dose dependent manner

Question 7

Flumazenil Quick or slow reversal?

Answer 7

Not abrupt reversal like narcotic reversal

Question 8

Flumazenil Onset of action

Answer 8

30 seconds to 2 mins

Question 9

Flumazneil redistribution 1/2 life

Answer 9

7-15 mins may need to redose

Question 10

Flumazenil dosing

Answer 10

0.2 mg IV over 15 seconds
Wait 45 secs
Re-dose 0.2 mg increments over 15 seconds

Question 11

Max dose of flumazenil

Answer 11

3 mg per hour

Question 12

Other causes of patient seeming like BZD overdose to look at

Answer 12

Incomplete reversal of muscle relaxation
Residual anesthetic 
Narcotic 
Hypodermic
Hyper apnea
Surgical complication

Question 13

Other reversal of BZD

Answer 13

Physostigmine

Question 14

Physostigmine

Answer 14

Tertiary amine

Cholinesterase inhibitor that causes build-up of ACh in the brain tissue

Question 15

Aminoonyline

Answer 15

1mg/kg may antagonize the sedative effects and adenosine in the CNS