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14 Cards in this Set
- Front
- Back
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What are the four benzodiazepines we need to worry about?
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- Diazepam
- Midazolam - Larazepam - Flumazenil |
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MoA of Diazepam
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Bind to BZ receptor on GABA
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MoA of Midazolam
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Bind to BZ receptor on GABA
- 2x more potent than Diazepam |
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MoA of Larazepam
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Bind to BZ receptor on GABA
- 10x more potent than diazepam |
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MoA of Flumazenil
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Competitively binds to BZ to block other benzodiazepines from binding
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List the 3 benzodiazepines that act as agonists in order of potency (least --> most)
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Diazepam --> Midazolam --> Larazepam
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4 general adverse effects of benzodiazepines
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- Vocalization
- Excitement - Fasciculations - Ataxia |
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2 adverse effects of diazepam
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- Hepatic failure in cats
- Exacerbation of fear driven aggression |
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Which benzodiazepines are controlled?
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Schedule IV
- Diazepam - Midazolam - Lorazepam |
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3 general contraindications of benzodiazepines
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- Benzodiazepine hypersensitivity
- Hepatic dysfunction - Acute glaucoma |
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What does binding to the BZ receptor of GABA do?
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Increases frequency of Cl- channel opening, which hyperpolarizes the post-synaptic neuron, producing decreased neuronal transmission
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5 general therapeutic goals of benzodiazepines
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- Muscle relaxation
- Decrease in seizures - Decrease in anxiety - Sedation - Induction of sleep Does *not* induce analgesia |
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When do withdrawal symptoms from Diazepam start?
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24 hours after being taken off
- All benzodiazepines require tapering (except flumazenil probably) |
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Two contraindications of flumazenil
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- Don’t use in patients treated chronically with BZDs or OD of TCA since it can cause seizures.
- Arrhythmias and death in patients receiving both TCAs and BZDs |
