Benzodiazepines
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Benzodiazepines are tranquillizers used to treat anxiety disorders (Low et al, 2000, 131-134). Benzodiazepine receptors are found throughout the central nervous system linked to gamma amino butyric acid (GABA) receptors, an inhibitory neurotransmitter in the CNS (Longo and Johnson, 2122). It enhances the affinity of the recognition site for GABA by inducing a conformational change. The GABA receptor complex also binds barbiturates and other sedative-hypnotics such as alcohol. Low et al have shown that they react with the alpha2-GABAA receptors, which are expressed mostly in the limbic system. They demonstrated the localization in two mouse lines, one of which had the alpha2 GABAA receptors obliterated and one of which had the alpha 3 GABAA receptors obliterated. The alpha3 GABAA receptors predominate in the reticular activating system. Benzodiazepines are widely prescribed for a variety of conditions, but particularly for anxiety and insomnia (Longo and Johnson, 2000, 2121). These drugs rapidly replaced barbiturates as sedative-hypnotic, and they cause significantly less respiratory depression than barbiturates so they are relatively safe, and even in cases of overdose, rarely result in death. However, they can be addicting when used chronically, and are often taken in combination with other drugs by patients with addiction disorders, so must be prescribed with care. Benzodiazepines act synergistically with other central nervous system depressants, includin
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n older people whose metabolism has slowed (Longo and Johnson, 2000, 2123). Benzodiazepines can also cause anterograde amnesia, which gives beneficial effects to midazolam (Versed) used for presurgical medication, an effect which appears to be separate from sedation effects. Episodic memory is particularly impaired. Benzodiazepines also cause a paradoxical inhibition, leading to excitement, irritability, aggression, hostility, and impulsivity in some patients, particularly children, the elderly, and those with developmental disabilities. Sometimes there is depression and emotional blunting. Tolerance to the drug can develop to varying degrees, and physiologic and psychologic dependence can occur. There can be withdrawal symptoms when benzodiazepines are stopped.
Benzodiazepines are rarely used alone as a drug of abuse (Longo and Johnson, 2000, 2124). They are usually used along with heroin or methadone, alcohol, or cocaine. The short-acting benzodiazepines are most favored because they begin to act immediately. Problems with benzodiazepine dependence, tolerance, withdrawal, revound, and abuse limit their use for long-term treatment of anxiety disorders in patients with alcohol or drug addictions. More effective drugs
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Approximate Word count = 1493
Approximate Pages = 6 (250 words per page)
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