Benzodiazepines

definition

Benzodiazepine is a medicinal substance that works in the CNS and, in addition to anxiolytic (anxiolytic) also a drowsy, calming (sedating) Has an effect.

effect

Stimulating and inhibiting nerve fibers and nerve cells coexist in the CNS. The associated messenger substances (transmitters) also have an exciting or inhibiting effect. The main carrier of the inhibitory nerve fibers is GABA (Gamma aminobutyric acid). This substance binds to special points (GABA receptors) on a nerve cell and thus inhibits its activity.

The GABA receptors in turn have a binding site for benzodiazepines. If a benzodiazepine binds to a GABA receptor, it is activated more strongly, consequently the inhibitory effect of the GABA is also increased. Inhibiting fibers have calming and anxiety-relieving effects in the human body, so a benzodiazepine is able to intensify these effects. Benzodiazepines are therefore also called GABA receptor agonists (Amplifier).

Benzodiazepines belong to the group of muscle relaxants. Find out more about these muscle relaxers below: Muscle relaxants

Active ingredients

Within the group of Benzodiazepines Is there a Variety of individual active ingredientsthat have different effects and such many areas of application exhibit.
Benzodiazepines act as either Sedatives (Tranquilizer, sedative), anti-anxiety agent (Anxiolytic), Sleeping pills (Hypnotic) or antispasmodic (Anti-epileptic).

Sedatives are for example that Bentazepam or the Lopralozam. To the anti-anxiety agents belong that Etizolam or that Clotiazepam. Nitrazepam and Temazepam will be as Sleeping pills effective. Clonazolam and Clonazepam Act antispasmodic.
Some of the benzodiazepines not only have one effect, they do several things at the same time. The diazepam, probably the best known Benzodiazepine, has next to his Antispasmodic also an anxiolytic and calming Effect.

The various active ingredients differ greatly in their respective ones Half-life, i.e. the time after which only half of the originally administered amount of medication is left in the body. she therefore all act for different lengths of time, the effect can be very different fail.

Areas of application

Benzodiazepines are widely used in almost all areas, but especially in anesthesia to induce anesthesia. Here one makes the calming (sedating) and anti-anxiety (anxiolytic) Use the effect of this class of substances. The anti-anxiety component of benzodiazepines also plays an important role in psychotherapy in the treatment of anxiety and restlessness. Epileptic seizures can be broken or prevented thanks to the anticonvulsant effect. Benzodiazepines also serve their purpose as a means of falling asleep or sleeping through the night. For muscle cramps (Spasms) relax (relax) the muscles.

Learn more about the use of benzodiazepines in the Twilight sleep anesthesia or spastic cerebral palsy.

Dosage forms

Benzodiazepines are prescription only. They are most common in Tablet form offered. As tablets, they mainly play as Sedatives or as a sleep aid a role. Intravenously through an indwelling venous cannula or by injection, the Benzodiazepines in the hospital, for Preparation for surgery or in emergency medicine, for example in the case of an epileptic seizure administered.

Risks

Risks in taking from Benzodiazepines are side effects like Fatigue, lack of drive, headache, muscle weakness and drowsiness. It comes to reduced ability to react and perceive, driving vehicles or operating machines is when taking Benzodiazepines not recommended. Furthermore, the long-term intake of Benzodiazepines risky as it is used to Tolerance development can come. It is not uncommon for tolerance to develop into one Dependency. Yes, do Benzodiazepines not as dependent as for example Barbiturates, nevertheless longer intake should be carefully considered and discussed with the doctor. Dependence leads to the development of Withdrawal symptoms, how Headache, tremors, restlessness and nervousness. With very strong Finally, withdrawal symptoms can include cramps occur.

Intoxication

Intoxications, so poisoning, with Benzodiazepines result from either accidental or deliberate incorrect use of the drug. Accidentally incorrectly taken medication, either too much at once or in combination with alcohol increases the effect of the Benzodiazepines enormously. Even the deliberately wrong ingestion in suicidal intent occurs though itself Benzodiazepines not suitable for suicide (suicide) to commit as they no inhibitory effect on the respiratory center exercise. Symptomatically occur in one Poisoning with Benzodiazepines Impaired consciousness, Nausea and vomiting. Later it comes to complete loss of consciousness, The patients no longer show protective reflexes and do not react to painful stimuli.

Therapeutic measures are primarily those Securing the airways Of the patients. Since all protective reflexes fail, those affected are for example unable to cough. Perhaps Vomit is simply swallowed, gets into the lungs, there is a risk of pneumonia (pneumonia). In the clinic, the airways are secured by means of a hose (Tube), which is pushed into the windpipe.

As first aid measure is recommended to secure breathing stable side position. The Airways are kept open, Vomit and secretions can run out of the sideways mouth.
In the clinic, further measures such as gastric lavage or the use of water-drawing drugs (Diuretics).

antagonist

A Another possibility of poisoning with benzodiazepines to treat is that Gift of an antidote (Antidote). Flumazenil is one such antidote. It's a so-called Benzodiazepine antagonist (Attenuator), that is, the Substance blocks the binding sites for benzodiazepines on the GABA receptor. Benzodiazepines can then no longer develop their effect. Flumazenil is broken down very quickly by the body. In case of poisoning with high doses Benzodiazepine the antidote must be given accordingly often in order to achieve treatment success.

Not Flumazenil should be given to patients who are dependent on benzodiazepines are. If the action of the benzodiazepines is stopped as abruptly as the action of flumazenil would occur massive withdrawal symptoms on. The application of flumazenil as Benzodiazepine antagonist is consequently with caution to be enjoyed and must not be done until it is clear whether the patient has been taking benzodiazepines for a long time.