Let's talk about benzodiazepines. You may hear them referred to as anxiolytics or anti-anxiety agents, which means to relieve the body of anxiety. The medication class is very easy to recognize because we are saved by the suffix.
The suffix of benzodiazepines are zepam and zolam. Examples of these are alprazolam, trade name Xanax, lorazepam, trade name Ativan, diazepam trade name Valium, and clonazepam trade name Colopin. Okay, let's dive into the mechanism of action of benzodiazepines. When the medication enters the body, it binds to GABA receptors in the brain. Well, what is GABA?
GABA is an inhibitory neurotransmitter which slows and mediates the activity of the brain. When the medication binds to these neurotransmitters, GABA inhibitory actions are enhanced. This means a calming effect sets in, leading to central nervous system depression and a more settled state of mind and body.
Let's look at why and when benzodiazepines are used. Benzodiazepines are most commonly used for anxiety and panic disorders. And with the overall ability to ease the body's muscles, they may also be used for seizure activity. They also help decrease muscle tension, which is why they may be referred to as muscle relaxants.
It's also important to note that lorazepam, brand name Ativan, is often used for symptoms of alcohol dependence and withdrawal. You can remember this by the memory trick, Ativan, think alcohol withdrawal. Okay, let's review some of the must-know side effects of benzodiazepines. Since these drugs depress the central nervous system, we also need to watch for depressed activity everywhere else in the body.
So, you can remember the effects of this drug by thinking. Benzos think low and slow. This includes a decreased respiratory rate, also called bradypnea.
It also can sometimes lead to respiratory depression. We also have a decrease in blood pressure or hypotension, a decrease in GI motility, which can lead to constipation, a decrease in energy levels, which can lead to sedation, and a decrease in secretions in the mouth causing dry mouth. Okay, let's review some patient education.
You need to educate your patient to change positions slowly. Benzodiazepines can cause dizziness or falls if you get up too quickly. You also should instruct your patient to not drive or operate heavy machinery until the body has adapted.
This can take several weeks. You also want to educate them to not drink any alcohol, take illicit drugs, or any unprescribed CNS depressants. This can lead to sedation or even respiratory depression.
You also need to educate your patient to not abruptly stop the medication. Benzodiazepines must be tapered. This means that you need to decrease the dosage gradually.
You also want to educate that benzos are not for long-term treatment. This can lead to tolerance or dependence of the drug. Okay, let's look at some nursing considerations for this drug class.
You always want to monitor your patient's vital signs, especially their respiratory rate. Remember, this medication puts your patient at risk for respiratory depression. You also want to monitor for any mental status changes such as confusion.
You as a nurse should implement falls risk precaution since these drugs can cause dizziness or unsteadiness. And finally, you as a nurse need to know the antidote for benzodiazepines just in case a patient becomes unresponsive or experience severe respiratory depression. The antidote for benzodiazepines is flumazenil.
You can remember this by the memory trick, I flew fast in my Mercedes-Benz, like benzodiazepines. Okay, let's review by going over some of the most commonly tested on topics for benzodiazepines. These drugs are central nervous system depressants, so you need to monitor those vital signs for signs of respiratory depression. The antidote for benzodiazepines is flumazenil. And finally, lorazepam, brand name Ativan, is included for alcohol withdrawal protocols to ease negative symptoms.
If you want more information like this, you can find it in the Complete Pharmacology flashcards. It covers everything you need to know in your pharmacology class, but it's presented in a fun and condensed way. No more textbook fluff.
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