Benzodiazepines

Method of Administration

Capsule/tablet (common), intravenous, or intranasal

Mechanism of Action

1. Activation of the benzodiazepine receptors increases the frequency of the CI Channel opening *with GABA

Effects of Short-Term Use

CNS: Drowsiness lethargy, fatigue, and impaired thinking and memory

Breathing: Respiratory depression after rapid intravenous administration

Motor Coordination: Moderate doses can impair driving and large machiences

Effects of Long-Term Use

SID-MJ-IT: Effects can vary (some won’t even have)

1. Slurred speech

2. Incoordination

3. Disorientation

4. Memory Issues

5. Judgement Issues

6. Intoxication

7. Thinking Issues

Other Effects

Pregnant: If in the first trimester, result in small, but significant fetal abnormalities

• They’re secreted in the milk, exposing nursing infants to therapeutic or toxic doses, and can result in sedation or death.

Older Adults: Can produce cognitive dysfunction since they’re metabolised more slowly, often leading to over-sedation or death.

Misuse Potential

Low (Weaker reinforcer): Occurs in combination with alcohol

Inherent Harmfulness

LOW

• Does not depress respiration at therapeutic doses

• Rarely leads to death on its own

Tolerance

YES (But Low) 

• For sedative and hypnotic effects and incoordination, anxiety reduction, or euphoric effects 

• Magnitude does NOT produce clinical concerns 

• Cross-Tolerance occurs with other sedative hypnotics since all modulate CI channel 

Withdrawl

HAI - APSD (YES, but mild after therapeutic use)

1. Anxiety

2. Headache

3. Insomnia

YES (more pronounced after chronic use)

1. Agitation

2. Paranoia

3. Seizures

4. Delirium

*LESS frequent than barabiturates

Addiction 

YES (in some) 

• Depending on genetics and envrionment 

Therapeutic Use

SSS - AIA

1. Anxiety Prevention

2. Sedation for surgery

3. Insomnia Prevention

4. Seizures/epilepticus Prevention

5. Skeletal muscle relaxation

6. Alcohol withdrawal Prevention

*Minimal REM Sleep Suppression

Lethality And Treatment

No

• High therapeutic index

• Often involved in overdose, but deaths are rare

• Deaths occur after ingestion of large doses OR when taken with other drugs like alcohol

• **FLUMAZENIL: Blocks effects of benzodiazepine(antagonist)