Benzodiazepines on the NCLEX
Benzos for NCLEX: -pam/-lam endings, antidote flumazenil, withdrawal, indications.
Benzos end in -pam or -lam. Bind GABA receptors. Used for anxiety, seizures, alcohol withdrawal, procedural sedation. The NCLEX tests reversal, respiratory depression, and elderly cautions.
Common drugs
Lorazepam (Ativan), diazepam (Valium), alprazolam (Xanax), midazolam (Versed), clonazepam (Klonopin), temazepam (Restoril).
Uses
Anxiety (short-term). Seizure rescue (lorazepam IV). Alcohol withdrawal (CIWA-driven). Procedural sedation (midazolam). Insomnia (temazepam).
Antidote
Flumazenil (Romazicon). Reverses respiratory depression. Caution in chronic benzo users, can precipitate seizures.
Side effects
Sedation, ataxia, anterograde amnesia, respiratory depression (especially with opioids), paradoxical agitation in elderly.
Withdrawal
Seizures possible in chronic users. Don't stop abruptly. Taper slowly. Withdrawal can be fatal, unlike opioid withdrawal.
Frequently asked
Elderly and benzos?
Beers Criteria flag. Fall risk, confusion. Use cautiously and at lower doses.
Alcohol withdrawal seizure prophylaxis?
Lorazepam or chlordiazepoxide, CIWA-driven dosing.
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