Podcast
Questions and Answers
What is the preferred type of benzodiazepine for patients with hepatic impairment?
What is the preferred type of benzodiazepine for patients with hepatic impairment?
- Short-acting benzodiazepines (correct)
- Non-benzodiazepine anxiolytics
- Any benzodiazepine
- Long-acting benzodiazepines
Which of the following is a common withdrawal symptom of benzodiazepines?
Which of the following is a common withdrawal symptom of benzodiazepines?
- Increased appetite
- Dizziness
- Tremors (correct)
- Euphoria
What is the recommended action when treating benzodiazepine overdose?
What is the recommended action when treating benzodiazepine overdose?
- Use naloxone
- Administer flumazenil (correct)
- Increase the dose of benzodiazepines
- Provide immediate dialysis
Which drug class is primarily indicated for chronic anxiety treatment?
Which drug class is primarily indicated for chronic anxiety treatment?
What can increase sedation when taking benzodiazepines?
What can increase sedation when taking benzodiazepines?
Flashcards
Benzodiazepines
Benzodiazepines
A class of medications used to treat anxiety, particularly in acute situations. They work by enhancing the effects of GABA, a neurotransmitter that has calming effects.
Short-acting benzodiazepines
Short-acting benzodiazepines
Short-acting benzodiazepines such as lorazepam and oxazepam are preferred in patients with liver problems and older adults. They also come with a higher risk of withdrawal symptoms.
Long-acting benzodiazepines
Long-acting benzodiazepines
Long-acting benzodiazepines like diazepam, alprazolam, and chlordiazepoxide can be problematic, especially for patients with liver issues. They can lead to prolonged sedation and potentially coma.
Benzodiazepine withdrawal
Benzodiazepine withdrawal
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Flumazenil
Flumazenil
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Study Notes
Anxiety Treatment
- Acute Anxiety: Benzodiazepines
- Chronic Anxiety: SSRIs (sertraline, citalopram, escitalopram, fluoxetine), and Propranolol (alleviates physical symptoms).
Benzodiazepines
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Hepatic Coma: Long-acting benzodiazepines (diazepam, alprazolam, chlordiazepoxide hydrochloride, clobazam) can induce hepatic coma, especially in long-term use.
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Short-acting preferred: Short-acting benzodiazepines (lorazepam and oxazepam) are often preferred in patients with impaired liver function or age. Warning: Risk of withdrawal symptoms higher with short-acting.
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Paradoxical Effects: Benzodiazepines can sometimes cause paradoxical effects, including aggression, hostility, excessive talkativeness, and excitation.
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Sedation: Benzodiazepines can increase sedation when combined with alcohol or other CNS depressants. Avoid if driving or operating machinery (some, like Clonazepam, Lorazepam, Diazepam, Flunitrazepam, and Temazepam are on a legal driving limit list)
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Enzyme Considerations: Some drugs can interact with the metabolism of benzodiazepines
Benzodiazepine Withdrawal
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Withdrawal symptoms: Anxiety, sweating, weight loss, tremors, loss of appetite.
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Tapering: Tapering is essential to avoid withdrawal symptoms and should be done carefully. (gradually decrease the dose daily).
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Dosage reduction: Convert all medications to a once-nightly dose of diazepam. Gradually reduce by 1-2 mg (or 1/10th of a larger initial dosage) every 2-4 weeks. ONLY reduce further if withdrawal symptoms have resolved. Final dose reductions should be done very very incrementally (0.5mg).
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Overdose Treatment: Flumazenil is used to treat benzodiazepine overdose.
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Description
This quiz covers various treatments for anxiety, focusing on both acute and chronic conditions. Specific medications like benzodiazepines and SSRIs are discussed, along with their effects, preferences, and risks associated with usage. Test your knowledge on how different treatments impact anxiety management.
