benzodiazepines

Question 1

what are the 3 benzodiazepines?

Answer 1

• diazepam
• alprazolam
• clonazepam

Question 2

alprazolam: indication

Answer 2

• generalized anxiety disorder
• anxiety

Question 3

diazepam: indication

Answer 3

• generalized anxiety disorder
• seizures
• muscle spasm, spasticity
• alcohol withdrawal
• anesthesia induction/preanesthesia

Question 4

clonazepam: indications

Answer 4

• seizures
• anxiety

Question 5

benzodiazepines: MOA

Answer 5

• potentiate the effects of GABA–inhibitory NT in the CNS
  
  • enhance action by binding to receptor called GABA receptor chloride channel
• b/c they act by amplifying endogenous GABA, there is a limit to how much CNS depression benzos can produce
  
  • why they are safer than barbiturates

Question 6

benzodiazepines: SE

Answer 6

• CNS depression: drowsiness, lightheadedness, incoordination, difficulty concentrating, confusion
• anterograde amnesia

Question 7

benzodiazepines: ADRs

Answer 7

• sleep related behaviors: driving, eating, calling ppl
  
  • more common if drug combined with other depressants
  • taper dose slowly
• paradoxical insomnia, excitation, euphoria, heightened anxiety, rage
• respiratory depression (especially if given by IV)
• abuse
• risk of congenital malformation in fetus (cleft lip, hernia, heart anomalies)
  *

Question 8

benzodiazepines: contraindications

Answer 8

• Hypersensitivity;
• Cross-sensitivity with other benzodiazepines may exist;
• Pre-existing CNS depression;
• Severe uncontrolled pain;
• Obstructive sleep apnea or pulmonary disease;
• pregnant or breast feeding

Question 9

benzodiazepines: nursing implications

Answer 9

• need to use caution if administering IV b/c can cause severe respiratory depression
• caution pt in using other respiratory depressants like alcohol and other benzos
• do not d/c abruptly
• DO NOT use grapefruit juice
• monitor CBC, liver/renal function during long term therapy
• take w/ food if GI upset occurs
• instruct pt to notify provider if sleep related behaviors occur or if paradoxical effects occur