- Body system
- Mental health
- Name stem
- -azepam, -azolam
- Drug cards
- 1 in this guide
Drugs in this class
Other examples: Diazepam, Alprazolam, Midazolam, Clonazepam, Chlordiazepoxide.
How benzodiazepines work
Enhance the effect of GABA at the GABA-A receptor, increasing inhibition in the central nervous system.
Uses
- Anxiety and panic disorder
- Status epilepticus and seizure clusters
- Alcohol withdrawal
- Procedural sedation
- Insomnia (short term)
- Muscle spasm (diazepam)
Adverse effects
- Drowsiness and impaired coordination
- Respiratory depression, especially with other depressants
- Confusion and falls in older adults
- Dependence, tolerance and withdrawal
Nursing considerations
- Monitor respiratory rate, oxygen saturation and level of sedation, especially with IV use.
- Keep flumazenil and resuscitation equipment available for procedural sedation.
- Use fall precautions; avoid in older adults when possible (Beers criteria).
Patient teaching
- Avoid alcohol, opioids and other sedatives.
- Do not drive until you know the effect.
- Do not stop suddenly after regular use: seizures can occur. The dose is tapered.
Benzodiazepines NCLEX practice questions
Answer each question to see the rationale.
3 questions. Choose an answer to see the rationale.
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What is the reversal agent for a benzodiazepine overdose?
Show answer
Answer D: Flumazenil Flumazenil is a benzodiazepine receptor antagonist. Naloxone reverses opioids.
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Which combination poses the greatest risk of fatal respiratory depression?
Show answer
Answer B: Lorazepam and an opioid Benzodiazepines and opioids together carry a boxed warning for profound sedation, respiratory depression, coma and death.
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A patient has taken alprazolam daily for a year and wants to stop. What is the best advice?
Show answer
Answer D: Taper slowly under the provider's direction Abrupt withdrawal after long-term use can cause rebound anxiety, insomnia and seizures; a supervised taper is needed.
Frequently asked questions
What are benzodiazepines?
Benzodiazepines calm anxiety, stop seizures and sedate. Respiratory depression (especially with opioids or alcohol), falls and dependence are the main risks; flumazenil is the reversal agent.
How do benzodiazepines work?
Enhance the effect of GABA at the GABA-A receptor, increasing inhibition in the central nervous system.
What are examples of benzodiazepines?
Lorazepam, Diazepam, Alprazolam, Midazolam, Clonazepam and Chlordiazepoxide.
What are the nursing considerations for benzodiazepines?
Monitor respiratory rate, oxygen saturation and level of sedation, especially with IV use. Keep flumazenil and resuscitation equipment available for procedural sedation.