NEURO: BENZODIAZEPINES Flashcards Preview

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Flashcards in NEURO: BENZODIAZEPINES Deck (6)
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1
Q

BENZOs - LORAZEPAM: INDICATIONS

A
  • 1st line = seizures, status epilepticus, alcohol withdrawl rxns
  • Common Choice = Sedation of interventional procedures (eg general anaesthesia)
  • ST Tx = anxiety, insomnia
2
Q

BENZOs - LORAZEPAM: MOA

A
  • Target is GABAa, choloride channel that opens in reponse to binding with GABA
  • GABA is the main inhibitory NT, TF opening of channel = more chloride into cell and cell more resistant to depolarisation
  • Benzos enhance the binding of GABA to GABAa receptor = widespread depressant effect on synaptic transmission
  • Clinical effects = reduced anxiety, sleepiness, sedation and anti convulsive effects
3
Q

BENZOs - LORAZEPAM: ADVERSE EFFECTS

A
  • Dose dependent drowsiness, sedation and coma
  • Little cardiorespiratory depression
  • Loss of reflexes = AWO and death
  • Dependence
  • Abrupt cessation = withdrawl rxn
4
Q

BENZOs - LORAZEPAM: WARNINGS

A
  • Elderly
  • Patients with respiratory impairment or NMDx
  • Avoid in Liver failure because can precipitate ENCEPHALOPATHY
  • If use is essential, Lorazepam is the best choice, as less dependent on liver for its elimination
5
Q

BENZOs - LORAZEPAM: IMPORTANT INTERACTIONS

A
  • Additive to those sedating drugs = alcohol and opioids
  • Most dependent on cytochrome p450 enzymes for elimination
  • So concurrent use with cytochrome p450 inhibitors (amiodarone, macroclides, flucanazole etc) may increase their effects
6
Q

BENZOs - LORAZEPAM: EXAMPLES

A
  • Lorazepam
  • Chlordiazepoxide
  • ‘am’

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