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Re: Klonopin: interfear with your breathing patte

Posted by notfred on October 4, 2006, at 23:11:00

In reply to Klonopin: interfear with your breathing patterns?, posted by qbsbrown on October 4, 2006, at 22:46:11

I know that benzos slow breathing, but this seems to make it more irregular.
>
> Brian


Nope, alone they do not slow breathing to a degree that is clinically significant. That is one of the major advantages to benzos, no respiratory
depression vs. barbiturates.


By injection there can be partial airway obstruction (ie airway blockage) but it
is a corner case or happens in concert with
the meds for general anesthesia.


PARTIAL AIRWAY OBSTRUCTION MAY OCCUR IN HEAVILY SEDATED PATIENTS. INTRAVENOUS LORAZEPAM, WHEN GIVEN ALONE IN FAR GREATER THAN THE RECOMMENDED DOSE, OR AT THE RECOMMENDED DOSE AND ACCOMPANIED BY OTHER DRUGS USED DURING THE ADMINISTRATION OF ANESTHESIA, MAY PRODUCE HEAVY SEDATION; THEREFORE, EQUIPMENT NECESSARY TO MAINTAIN A PATENT AIRWAY AND TO SUPPORT RESPIRATION/VENTILATION SHOULD BE AVAILABLE.


Benzodiazepines: Benzodiazepines are weak respiratory depressants, much safer for monotherapy than barbiturates, and are indicated for anxiolysis and sedation. 12 For example, when diazepam is administered as monotherapy, respiratory depression is not detectable until a 0.2 mg/kg (14 mg dose for a 70 kg person) dose is administered. 28 Additionally, the resulting increase in CO2 is slight, not clinically significant, and attributable to a decreased tidal volume. 28 However, benzodiazepine-induced respiratory depression can be clinically significant when used in combination with other respiratory depressants, when consumed in overdose, or if allowed to accumulate to toxic levels. 2,5,12 Elderly patients are at particular risk from longer acting agents such as flurazepam (50–100 hours), diazepam (20–50 hours) and prazepam (36–70 hours). 12,28 Patients taking cimetidine are more likely to exhibit accumulation of benzodiazepines as a result of impaired metabolism via the cytochrome P-450 system. 28) However, lorazepam, oxazepam and temazepam are the only benzodiazepines eliminated primarily by glucuronidation, which is less dependent on microsomal enzymes, and are unlikely to be influenced by hepatic dysfunction, increasing age or cimetidine administration. These drugs do not have active metabolites and have elimination half-lives from 5 hours (oxazepam) to 15 hours (lorazepam, temazepam). 28


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poster:notfred thread:691968
URL: http://www.dr-bob.org/babble/20061003/msgs/691979.html