Test One medications
Type of Substance Treatment Withdrawal and Detoxification
Benzodiazepines- effects, • When taken in overdose, rarely • Withdrawal sx. depend on half-
symptoms and intoxication fatal lethargic & confused of the drug.
and withdrawal similar to
• Tx gastric lavage; followed by • Sx. opposite of the acute eff
alcohol – relaxing, sedation,
activated charcoal & saline of drug :
drowsiness, reduce anxiety
cathartic; dialysis if sx. severe
• Increase pulse; BP; RR and
• Flumazenil (Romazicon) IV temperature
• Tremors, insomnia, anxiety, nau
psychomotor agitation
• Seizures and hallucinations are
Benzodiazepines: (anti-anxiety) Benzodiazepines are used for safe withdrawal of
alcohol.
-Treats acute anxiety, sedation/muscle relaxant, seizures, alcohol withdrawal
-alprazolam/Xanax, lorazepam/Ativan, diazepam/valium,
clonazepam/klonopin
-ANTIDOTE: flumazenil (I FLU fast in my Mercedes BENZ)
-Adverse reactions: (risk for) hypotension, respiratory arrest, apnea, airway
occlusion
-Patient education: Not meant for long term use (dependence), tolerance can
be built, must be tapered, take at bedtime because benzos cause sedation
-Alprazolam (Xanax)
Class: anxiolytic, benzodiazepine
Indication: Management of anxiety disorders, short-term relief of anxiety symptoms,
anxiety associated with depression, panic disorder
ADJUST DOSES: elderly patients, advanced hepatic disease, debilitation
Side effects: anger, apathy, confusion, constipation, crying, CV collapse, diarrhea,
disorientation, drug dependence (WITHDRAWAL syndrome when drug is
discontinued), dry mouth, fatigue, hostility lethargy, light-headedness, restlessness,
sedation
Interactions: alcohol, grapefruit juice, digoxin, hormonal contraceptives
Patient teaching: taper gradually when discontinuing. Patient should avoid alcohol
and grapefruit juice. Take safety measures with CNS effects.
-Chlordiazepoxide (Librium)
Class: anxiolytic, benzodiazepine
, Indication: Management of anxiety disorders, Preop apprehension, alcohol
withdrawal
ADJUST DOSES: Elderly patients, debilitating disease
Side Effects: apathy, confusion, constipation, CV collapse, depression, diarrhea,
disorientation, drowsiness, drug dependence with withdrawal, fatigue, incontinence,
lethargy, light-headiness, urine retention
Interactions: alcohol, smoking, hormonal contraceptives
Patient teaching: Taper gradually after long term use. Not for use in pregnancy
(barrier contraceptives advised) Use caution with breastfeeding. Patient should take
safety precautions with CNS effects
-Clonazepam (Klonopin)
Class: Antiepileptic, benzodiazepine
Indication: Treatment of Lennox-Gastaut syndrome: akinetic and myoclonic seizures,
treatment of panic disorder with or without agoraphobia
Side effects: agranulocytosis, apathy, confusion, constipation, CV collapse,
depression, diarrhea, disorientation, drowsiness, drug dependence with withdrawal,
fatigue, incontinence, lethargy, light-headedness, restlessness, suicidality, urine
retention
Interactions: alcohol, digoxin, hormonal contraceptives,
Patient teaching: Monitor suicidal and addiction-prone patients closely. Taper
gradually after long term treatment. Not for use in pregnancy and breastfeeding,
avoid alcohol wear or carry medical alert notice, take safety precautions with CNS
effects
-Clorazepate dipotassium (Gen-Xene, Tranxene)
Class: Antiepileptic, anxiolytic, benzodiazepine
Indications: Management of anxiety disorder, Adjunct to antiepileptics, acute alcohol
withdrawal
Adjust dose: Elderly patients, debilitating disease
Side effect: agranulocytosis, apathy, CV collapse, constipation, depression, diarrhea,
disorientation, dizziness, drowsiness, dry mouth, lethargy, light headedness
Interactions: alcohol, CNS depressants, digoxin, hormonal contraceptives
Patient teaching: Taper gradually after long term use, monitor for suicidality,
encourage use of medical alert tag, nor for use in pregnancy, patient should avoid
alcohol, take safety precautions for CNS effects
-Diazepam (Valium)
Class: antiepileptic, anxiolytic, benzodiazepine
Indication: Treatment of anxiety disorders, skeletal muscle spasm, seizure disorders
Adjust dose: elderly patients, debilitating diseases
Side effects: apathy, bradycardia, confusion, constipation, cv collapse, depression,
diarrhea, disorientation, fatigue, incontinence, lethargy, libido changes, light-
headedness, tachycardia, urine retention
Interactions: alcohol, hormonal contraceptives
Patient teaching: taper dose after long-term, suggest medical alert tag, not for use
in pregnancy (barrier contraceptive advised), Patient should take safety precautions
with CNS effects
-Estazolam
Type of Substance Treatment Withdrawal and Detoxification
Benzodiazepines- effects, • When taken in overdose, rarely • Withdrawal sx. depend on half-
symptoms and intoxication fatal lethargic & confused of the drug.
and withdrawal similar to
• Tx gastric lavage; followed by • Sx. opposite of the acute eff
alcohol – relaxing, sedation,
activated charcoal & saline of drug :
drowsiness, reduce anxiety
cathartic; dialysis if sx. severe
• Increase pulse; BP; RR and
• Flumazenil (Romazicon) IV temperature
• Tremors, insomnia, anxiety, nau
psychomotor agitation
• Seizures and hallucinations are
Benzodiazepines: (anti-anxiety) Benzodiazepines are used for safe withdrawal of
alcohol.
-Treats acute anxiety, sedation/muscle relaxant, seizures, alcohol withdrawal
-alprazolam/Xanax, lorazepam/Ativan, diazepam/valium,
clonazepam/klonopin
-ANTIDOTE: flumazenil (I FLU fast in my Mercedes BENZ)
-Adverse reactions: (risk for) hypotension, respiratory arrest, apnea, airway
occlusion
-Patient education: Not meant for long term use (dependence), tolerance can
be built, must be tapered, take at bedtime because benzos cause sedation
-Alprazolam (Xanax)
Class: anxiolytic, benzodiazepine
Indication: Management of anxiety disorders, short-term relief of anxiety symptoms,
anxiety associated with depression, panic disorder
ADJUST DOSES: elderly patients, advanced hepatic disease, debilitation
Side effects: anger, apathy, confusion, constipation, crying, CV collapse, diarrhea,
disorientation, drug dependence (WITHDRAWAL syndrome when drug is
discontinued), dry mouth, fatigue, hostility lethargy, light-headedness, restlessness,
sedation
Interactions: alcohol, grapefruit juice, digoxin, hormonal contraceptives
Patient teaching: taper gradually when discontinuing. Patient should avoid alcohol
and grapefruit juice. Take safety measures with CNS effects.
-Chlordiazepoxide (Librium)
Class: anxiolytic, benzodiazepine
, Indication: Management of anxiety disorders, Preop apprehension, alcohol
withdrawal
ADJUST DOSES: Elderly patients, debilitating disease
Side Effects: apathy, confusion, constipation, CV collapse, depression, diarrhea,
disorientation, drowsiness, drug dependence with withdrawal, fatigue, incontinence,
lethargy, light-headiness, urine retention
Interactions: alcohol, smoking, hormonal contraceptives
Patient teaching: Taper gradually after long term use. Not for use in pregnancy
(barrier contraceptives advised) Use caution with breastfeeding. Patient should take
safety precautions with CNS effects
-Clonazepam (Klonopin)
Class: Antiepileptic, benzodiazepine
Indication: Treatment of Lennox-Gastaut syndrome: akinetic and myoclonic seizures,
treatment of panic disorder with or without agoraphobia
Side effects: agranulocytosis, apathy, confusion, constipation, CV collapse,
depression, diarrhea, disorientation, drowsiness, drug dependence with withdrawal,
fatigue, incontinence, lethargy, light-headedness, restlessness, suicidality, urine
retention
Interactions: alcohol, digoxin, hormonal contraceptives,
Patient teaching: Monitor suicidal and addiction-prone patients closely. Taper
gradually after long term treatment. Not for use in pregnancy and breastfeeding,
avoid alcohol wear or carry medical alert notice, take safety precautions with CNS
effects
-Clorazepate dipotassium (Gen-Xene, Tranxene)
Class: Antiepileptic, anxiolytic, benzodiazepine
Indications: Management of anxiety disorder, Adjunct to antiepileptics, acute alcohol
withdrawal
Adjust dose: Elderly patients, debilitating disease
Side effect: agranulocytosis, apathy, CV collapse, constipation, depression, diarrhea,
disorientation, dizziness, drowsiness, dry mouth, lethargy, light headedness
Interactions: alcohol, CNS depressants, digoxin, hormonal contraceptives
Patient teaching: Taper gradually after long term use, monitor for suicidality,
encourage use of medical alert tag, nor for use in pregnancy, patient should avoid
alcohol, take safety precautions for CNS effects
-Diazepam (Valium)
Class: antiepileptic, anxiolytic, benzodiazepine
Indication: Treatment of anxiety disorders, skeletal muscle spasm, seizure disorders
Adjust dose: elderly patients, debilitating diseases
Side effects: apathy, bradycardia, confusion, constipation, cv collapse, depression,
diarrhea, disorientation, fatigue, incontinence, lethargy, libido changes, light-
headedness, tachycardia, urine retention
Interactions: alcohol, hormonal contraceptives
Patient teaching: taper dose after long-term, suggest medical alert tag, not for use
in pregnancy (barrier contraceptive advised), Patient should take safety precautions
with CNS effects
-Estazolam
