Benzodiazepines Flashcards
(52 cards)
MOA of benzos
- bind to GABA receptors in the synapse
- decrease the excitability of neurons by increasing efficiency of GABA
metabolism of benzos
CYP450
side effects of benzos
- MC: sedation, impaired concentration
- dizziness, ataxia, muscle twitching
what side effects of benzos should you be alert to?
disinhibition with paradoxical agitation and/or aggression
overdose sx of benzos
respiratory depression (esp if combined with ETOH)
what determines the severity of withdrawal symptoms from benzos
the faster the serum levels of the drug falls, the worse the sx
which benzo is known for its withdrawal?
xanax
symptoms of withdrawal from benzos
increased anxiety, tremor or shakiness, muscle twitching, sweating, tachycardia, HTN, zeizures
pros of long acting benzos
provide less symptom fluctuation and less severe withdrawal
cons of long acting benzos
higher potential for drug accumulation and therefore sedation
how should you start dosing benzos?
LOW and go SLOW
how long until a patient can develop tolerance/dependence from benzos?
3 weeks
what is the biggest mistake when it comes to benzos?
continuing them indefinitely
safest and efficient strategy of benzos
- start with a short/intermediate acting benzo at a low dose to begin, then titrate up
- continue for 2-6 weeks followed by a 1-2 week taper
- during those 6 weeks, start SSRI
alprazolam
xanax
indications for xanax
panic d/o, GAD, social phobia
onset of xanax
fast
how many times is xanax taken a day?`
can be multiple
why is there an abuse potential with xanax?
fast euphoria commonly reported
how sedating is xanax?
less than other benzos`
diazepam
valium
indications for valium
anxiety, ETOH w/d, adjunct tx of muscle spasm and movement disorders
half-life of valium
a really really long time (100 hours)
downside of valium
longer half life leads to accumulation of active metabolites, especially in elderly
