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benzo indications
at lower dosage → reduce anxiety
at high dose → produce sedation and sleep
anticonvulsants
anesthetics
anxiety disorders
GAD
OCD
Panic disorder
PTSD
social anxiety
benzo meds
•Diazepam (Valium)
•Alprazolam (Xanax)
•Clorazepate (Tranzene)
•Lorazepam (Ativan)
•Midazolam (Versed)
•Temazepam (Restoril)
•Clonazepam (Klonopin)
•Chlordiazepoxide (Librium)
•Flurazepam (Dalmane)
•Triazolam (Halcion)
•Oxazepam
benzodiazepine
SCHEDULE IV → may physiologic dependence
DO NOT discontinue abruptly
may have additive effects w/ CNS depressants
benzo effects
dizzy, drowsy, confusion, resp. Depression, visual disturb, nausea, constipation, dry mouth
benzo contraindications
COPD, sleep apnea, renal and hepatic failure, pregnancy and lactation
ETOH and substance abuse
flumazenil
reversal agent for overdose of benznodiazpene
Lunesta
eszopiclone
SCHEULE IV
used for CHRONIC INSOMNIA
may cause behavioral changes/memory
DO NOT take with high fat meals, grapefruit juice, CYP-450 meds or other CNS depressants
Sonata
Zaleplon
SCHEDULE IV
used for SHORT TERM INSOMNIA
may cause depression, dizzy, drowsy, amnesia
DO NOT take with high fat meals, cimetidine, or other CNS depress
DOES NOT interact with CYP 450 meds
Ambien
Zolpidem
SCHEUDLE IV
used for SHORT TERM INSOMIA→ cause rebound insomnia, withdrawal symptoms
DO NOT take with other CNS depressants
rozerem
ramelteon
NOT A CONTROLLED SUBSTANCE
works on melatonin receptors
used for LONG TERM INSOMNIA
may cause dizzy, joint pain, altered taste
DO NOT take with high fat meals or other CNS
Kava
herbal
used to treat anxiety and insomnia
may lead to liver failure if taken with ETOH
may cause pulm. hypertension and decreased platelets and lymphocytes
interacts with other CNS depress. anti platelet meds and parkinson’s meds
SHOULD NOT be used by pregnant. lactating and children under age of 12
melatonin
used for insomnia
contraindication in CV disease and neurological disorders
may interact with other CNS depress.
valerian
used for insomnia
SHOUDL NOT be used in hepatic failure, pregnancy and lactation
may interact with other CNS depress