BIOMEDICINE – PSYCHIATRIC: 06.02 – Benzodiazepines
ACTION: Depresses all levels of CNS by enhancing action of GABA. Produces anxiolytic effect, elevates seizure threshold, produces skeletal muscle relaxation.
INDICATIONS: Short-term relief of anxiety symptoms, relief of acute alcohol withdrawal. Adjunct for relief of acute musculoskeletal conditions, treatment of seizures
OFF-LABEL: Treatment of panic disorder. Short-term treatment of spasticity in children with cerebral palsy. Sedation for mechanically vented pts in ICU.
SIDE EFFECTS:
Frequent: Pain with IM injection, drowsiness, fatigue, ataxia.
Occasional: Slurred speech, orthostatic hypotension, headache, hypo-activity, constipation, nausea, blurred vision.
Rare: Paradoxical CNS reactions (hyperactivity/ nervousness in children, excitement/restlessness in elderly/debilitated) generally noted during first 2 wks of therapy, particularly in presence of uncontrolled pain.
ADVERSE EFFECTS/TOXIC REACTIONS: IV route may produce pain, swelling, thrombophlebitis, carpal tunnel syndrome. Abrupt or too-rapid withdrawal may result in pronounced restlessness, irritability, insomnia, hand tremor, abdominal/muscle cramps, diaphoresis, vomiting, seizures. Abrupt withdrawal in pts with epilepsy may produce increase in frequency/severity of seizures. Overdose results in drowsiness, confusion, diminished reflexes, CNS depression, coma.
Antidote: Flumazenil
INTERACTIONS:
DRUG: Alcohol, CNS depressants may increase CNS depression. CYP3A4 inducers (e.g., carbamazepine, rifampin) may decrease concentration. CYP3A4 inhibitors (e.g., itraconazole, ketoconazole) may increase concentration.
HERBAL: Gotu kola, kava kava, St. John’s wort, valerian may increase CNS depression. St. John’s wort may decrease concentration/effects.
FOOD: Grapefruit products may increase concentration/effects.
LAB VALUES: None significant.
(Valium)
TCM – Chapter 16: Substances that Extinguish Wind & Stop Tremors
Enters: LV, GB, SJ, PC
Temperature: cool
Taste: slightly bitter
ACTION: Sedate Shen, subdue Liv fire, settle Liver Wind, expel exterior Wind, stop Spasms
INDICATIONS: Anxiety d/t Liver-Heat or Fire, Seizures d/t Liver-Wind, Spasms d/t deficient heat
Tongue: red.
Pulse: fast, wiry,
RATIONALE: Its is heavy and strongly anchors mind, its bitter taste clears Liver Fire and cool temperature cools blood, this actions in turn settle Liver Wind.
CAUTION: Ht Qi deficiency, excess cold.
NOTE: Overuse may disperse Qi excessively causing fatigue and prevent clear Yang from rising causing drowsiness and ataxia. It is addresses only manifestations and does not affect root causes
MODIFICATIONS: To nourish Liv blood add Dang Gui