Benzodiazepines

Specific Agents: 

Midazolam (Versed)

Diazepam (Valium)

 

  • Most widely used drugs for Sedation.

 

  • Probably work in the limbic system and amygdala of the brain, where fear, anxiety and apprehension arise.

 

  • Attach to receptor sites in the cerebral cortex, enhancing gamma-aminobutyric acid (GABA) and inhibiting excitatory impulses:  anxiolysis…reduction of anxiety, amnesiac…reduces ability to recall events surrounding administration, anti-convulsive …stops seizures, skeletal muscle relaxation, sedative …hypnotic in large doses.

 

  • Patients who chronically take cimetidine (Tagamet) or ranitidine (Zantac) are especially susceptible to benzodiazepine overdose…these H-2 blocking drugs may dramatically increase the sedative effect of even small doses of benzodiazepines.

 

  • Narcotics (when given in conjunction with benzodiazepines are great potentiators of respiratory depression (great synergistic effect).

 

Reversal

Flumazenil (Romazicon)

 

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