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Benzodiazepine Poisoning

Benzodiazepine Poisoning is a topic covered in the 5-Minute Emergency Consult.

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  • Potentiates the activity of γ-aminobutyric acid (GABA), the major inhibitory neurotransmitter, by binding to its own specific site
  • Also facilitates GABA binding to its site
  • Results in chloride influx, membrane hyperpolarization, and inhibition of cellular excitation:
    • Benzodiazepines (BZDs) increase the frequency of chloride channel opening.
    • Depresses spinal reflexes and reticular activating system
  • Rapidly absorbed from GI tract:
    • Highly protein bound
    • Large Vd
    • Hepatic metabolism
    • Duration of action is inversely proportional to lipophilicity with highly lipophilic drugs penetrating the CNS more rapidly.
    • Duration of lorazepam > diazepam > midazolam.
    • Synergistic with other sedative–hypnotic medications (e.g., ethanol, barbiturates, propofol)

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Rosen, Peter, et al., editors. "Benzodiazepine Poisoning." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307515/all/Benzodiazepine_Poisoning.
Benzodiazepine Poisoning. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307515/all/Benzodiazepine_Poisoning. Accessed April 25, 2019.
Benzodiazepine Poisoning. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307515/all/Benzodiazepine_Poisoning
Benzodiazepine Poisoning [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 25]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307515/all/Benzodiazepine_Poisoning.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Benzodiazepine Poisoning ID - 307515 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307515/all/Benzodiazepine_Poisoning PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -