Benzos

Question 1

What is the principle pharmacologic effect of benzodiazepines?

Answer 1

• Sedation
• Anxiolysis
• Hypnotic
• Anticonvulsant
• Spinal cord (mediated skeletal muscle relaxation)

Question 2

How do the different benzos potencies compare?

Answer 2

Lorazepam (5x more than)> Midazolam (5x more than) > Diazepam

Question 3

What is the induction dose of versed?

Answer 3

0.1-0.2 mg/kg
may precede dose with fentanyl 50-100mcg

Question 4

What is the onset of midazolam?

Answer 4

induction dose: 30-60sec
other: 1-5min

Question 5

What is the duration of midazolam?

Answer 5

inducation dose: 5-10 min
other: 15-80min (shortest)

Question 6

What is the dose of diazepam? IV and PO

Answer 6

0.1mg/kg IV
0.2mg/kg PO

Question 7

What is diazepam onset?

Answer 7

1-5 min

Question 8

What is diazepam duration?

Answer 8

2-6 hours

Question 9

What is Lorazepam dose?

Answer 9

0.04 mg/kg

Question 10

What is ativan onset?

Answer 10

1-5min

Question 11

What is ativan duration?

Answer 11

6-10 hours (longest)

Question 12

What is sedative dose of midazolam?

Answer 12

1-5mg (0.05mg/kg)

Question 13

What are the respiratory effects of benzodiazepines?

Answer 13

• Dose dependent respiratory depression
• Depresses airway reflexes and ability to swallow (at higher doses)

Question 14

Why do we need to be careful giving benzos to pts with chronic COPD, OSA, and morbid obesity?

Answer 14

These drugs will depress their drive to breath
These patient use oxygen/hypoxia to trigger breathing (not CO2) and benzos depress hypoxic drive to breath

Question 15

Can midazolam cause apnea?

Answer 15

Yes! Any dose, Any patient…need to monitor closely!

Question 16

Do benzos blunt SNS response to intubation?

Answer 16

No

Question 17

Are we concerned about resp depression with PO diazepam and lorazepam?

Answer 17

No especially not when its used alone (Bzds are synergistic with opioids)