Chlordiazepoxide - Wikipedia
Benzodiazepines (BZD, BDZ, BZs), sometimes called "benzos", are a class of psychoactive drugs whose core chemical structure is There is controversy concerning the safety of benzodiazepines in pregnancy. While they .. Additionally, an altered perception of self, environment and relationships may occur. Compared to. form a cylindrical structure with a chloride channel as a center .. Benzodiazepines and Respiratory. Function. ◇Benzodiazepine use is risk factor for pulmonary aspiration in during pregnancy. (Laegreid et al, J relationship Librium. I. Prenatal exposure to lorazepam in mice alters open-field activity and GABA . Relationship between benzodiazepine ingestion during pregnancy and oral.
However, it lacks the hypnotic effects of barbiturates. Forty-two hospital patients admitted for acute and chronic alcoholism, and various psychoses and neuroses were treated with chlordiazepoxide.Karol Kaltenbach, PhD: Benzodiazepines and the Pregnant Patient: Special Challenges
In a majority of the patients, anxietytensionand motor excitement were "effectively reduced. It was reported that ulcers and dermatologic problems, both of which involving emotional factors, were reduced by chlordiazepoxide.
It assisted persons burdened by compulsive behavior who, amongst other behaviors, felt compelled to count the slats on venetian blinds upon entering a room.
Sleep-related problems were treated with nitrazepam Mogadonwhich was introduced intemazepam Restorilwhich was introduced inand flurazepam Dalmanewhich was introduced in Benzodiazepine drug misuse InCarl F. He mentioned a day study of chlordiazepoxide, which concluded that the automobile accident rate among 68 users was 10 times higher than normal. Particular care should be taken with drugs that potentiate the effects of diazepam, such as barbiturates, phenothiazinesopioidsand antidepressants.
No evidence would suggest diazepam alters its own metabolism with chronic administration. These interactions would be expected to be most significant with long-term diazepam therapy, and their clinical significance is variable. The euphoriant effects of opioids may be increased, leading to increased risk of psychological dependence. Other classical benzodiazepines include chlordiazepoxideclonazepamlorazepamoxazepamnitrazepamtemazepamflurazepambromazepamand clorazepate.
This has been found by measuring sodium-dependent high-affinity choline uptake in mouse brain cells in vitro, after pretreatment of the mice with diazepam in vivo.
This may play a role in explaining diazepam's anticonvulsant properties. Binding of benzodiazepines to this receptor complex promotes binding of GABA, which in turn increases the total conduction of chloride ions across the neuronal cell membrane. This increased chloride ion influx hyperpolarizes the neuron's membrane potential. As a result, the difference between resting potential and threshold potential is increased and firing is less likely.
How do benzodiazepines work? | Reconnexion - Anxiety, panic, depression, benzodiazepine dependancy
As a result, the arousal of the cortical and limbic systems in the central nervous system is reduced. Benzodiazepine drugs including diazepam increase the inhibitory processes in the cerebral cortex. Sustained repetitive firing seems limited by benzodiazepines' effect of slowing recovery of sodium channels from inactivation. The onset of action is one to five minutes for IV administration and 15—30 minutes for IM administration.
The duration of diazepam's peak pharmacological effects is 15 minutes to one hour for both routes of administration. The half-life of diazepam in general is 30—56 hours. The distribution half-life of diazepam is two to 13 minutes.
If used in pregnancy, those benzodiazepines with a better and longer safety record, such as diazepam or chlordiazepoxideare recommended over potentially more harmful benzodiazepines, such as temazepam  or triazolam.
Using the lowest effective dose for the shortest period of time minimizes the risks to the unborn child. Adverse effects on cognition can be mistaken for the effects of old age. The benefits of withdrawal include improved cognition, alertness, mobility, reduced risk incontinence, and a reduced risk of falls and fractures.
The success of gradual-tapering benzodiazepines is as great in the elderly as in younger people. Benzodiazepines should be prescribed to the elderly only with caution and only for a short period at low doses.
Benzodiazepine - Wikipedia
The high potency benzodiazepines alprazolam and triazolam and long-acting benzodiazepines are not recommended in the elderly due to increased adverse effects. Nonbenzodiazepines such as zaleplon and zolpidem and low doses of sedating antidepressants are sometimes used as alternatives to benzodiazepines. However, like antidepressantsthey have little evidence of effectiveness, although antipsychotics have shown some benefit. Benzodiazepines were ranked in this graph 7th in dependence, physical harm, and social harm.
They include drowsinessdizziness, and decreased alertness and concentration. Lack of coordination may result in falls and injuries, in particular, in the elderly.
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Depression and disinhibition may emerge. Hypotension and suppressed breathing hypoventilation may be encountered with intravenous use. Cases of liver toxicity have been described but are very rare.
Feelings of turmoil, difficulty in thinking constructively, loss of sex-drive, agoraphobia and social phobia, increasing anxiety and depression, loss of interest in leisure pursuits and interests, and an inability to experience or express feelings can also occur. Not everyone, however, experiences problems with long-term use. This included hospitalization, patient transfer, or death, and visits involving a combination of benzodiazepines and non-benzodiapine receptor agonists had almost four-times increased odds of a serious health outcome.
One view is that many of the short-term effects continue into the long-term and may even worsen, and are not resolved after stopping benzodiazepine usage. Another view maintains that cognitive deficits in chronic benzodiazepine users occur only for a short period after the dose, or that the anxiety disorder is the cause of these deficits.
While the definitive studies are lacking, the former view received support from a meta-analysis of 13 small studies. Some of the other impairments reported were decreased IQ, visiomotor coordination, information processing, verbal learning and concentration. The authors of the meta-analysis  and a later reviewer  noted that the applicability of this meta-analysis is limited because the subjects were taken mostly from withdrawal clinics; the coexisting drug, alcohol use, and psychiatric disorders were not defined; and several of the included studies conducted the cognitive measurements during the withdrawal period.
Paradoxical effects[ edit ] Paradoxical reactionssuch as increased seizures in epileptics,  aggressionviolence, impulsivityirritability and suicidal behavior sometimes occur.
Most reports of disinhibition involve high doses of high-potency benzodiazepines.