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Is your patient on benzodiazepines?

This Post is adapted from the Canadian Pharmacists Association (CPhA) Drug Monograph: Benzodiazepines

Benzodiazepines

Product Summary Information

Benzodiazepines

 

Indications

Benzodiazepines 2.

 

Contraindications

  • Patients with known hypersensitivity to this class of drugs or to any component of the product in question.
  • Patients with myasthenia gravis and acute angle-closure glaucoma, but they may be used in patients receiving appropriate therapy for open-angle glaucoma.

Warnings

  • Not recommended for use in patients with a major depressive disorder or psychosis in which anxiety is not a prominent feature.
  • Should be used with extreme caution in patients with severe pulmonary insufficiency or sleep apnea, especially the elderly or very ill patients, and those with limited pulmonary reserve.
  • Should be used with caution in severely depressed patients or those in whom there is any sign of impending depression with an associated anxiety disorder.
Precautions
 
  • Elderly or debilitated patients, children, and patients with liver disease or low serum albumin are most likely to experience CNS adverse effects.
  • Benzodiazepine therapy should be individualized and closely monitored in elderly patients.
  • Patients with compromised renal or hepatic function should be monitored and the dose carefully titrated to avoid accumulation of these agents.
Dosage
 
The dosage of benzodiazepines should be individualized and carefully titrated to avoid excessive sedation and mental or motor impairment. 
 Benzodiazepines 3

a. The dose is given for healthy younger adults. Elderly patients may be particularly sensitive to the CNS effects of benzodiazepines, and may have longer elimination half-lives due to decreased hepatic metabolism. In general, dosages of benzodiazepines for elderly patients tend to be approximately one-third to one-half of the recommended dose for younger adults.
b. Not recommended in elderly patients.

 
Source:
Canadian Pharmacists Association: Compendium of Pharmaceuticals and Specialties, online version (e-CPS), accessed on April 26, 2013

 

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