Benzodiapines include-

Alprozolam, Chlordiazepoxide, Clonazepam, Clorazepate,Diazepam, Halazepam, Lorazepam,Oxazepam, Prazazepam

Refer Diazepam

Alcohol potentiates chlordiazepoxide & concurrent use of both can be potentially dangerous.

Cimetidine increases half-life of chlodiazpoxide.

Absorption is impaired by mag trisilicate, morphine, pethidine & atropine.

Absorption enhanced by metoclopramide & alum hydrox.

Potentiates action of major neuroleptics,can be used in useful combination.

Anxiety disorders.

Amongst the safest drug available.

May rarely cause hypoplastic or haemolytic anaemia.

Physical & psychological dependence, withdrawal syndrome, impairs psychomotor performance, more accident prone,

Aggression(in predisposed individuals especially in combination with alcohol),

sedation and mild skin rashes.

Jaundice.

Myasthemia gravis,  acute pulmonary insufficiency and respiratory depression. Hypersensitivity to benzodiapiness.

Depression, 3rd trimester of pregnancy

 Special precautions:

Alcohol.Handling of machinary & driving vehicles.

Sedation, dependence,

pregnancy, lactation.

Elderly & debilitated patients.

Date of Approval -   1973

Indications:

Anxiety disorders.

Dosage:

Mild to moderate anxiety- 5 to 10mg 3 times/day

Severe anxiety - 20 to 25mg 3 or 4 times/day.

Geriatric patients - 5mg 2 or 3 times/day.

Porphyria exacerbation- 

Porphyrias are a group of clinically heterogenous diseases associated with inherited or acquired disturbances in heme boisynthesis. Porphyrins are tetrapyrrole pigments that serve as intermediates in the pathway.

They are formed from the precursors akph- aminolevilinic acid ( ALA ) and porphobilinogen. Heme the ferrous iron complex of protoporphrrins IX , functions as a prosthetic group and mitochondrial cytochromes, catalase,tryptophan oxygenase and others.

Drugs causing adverse reactions-

1. Barbiturates

2. Chlordiazepoxide

3. Meprobamate

4. Sulfonamides

5. Estrogens

6. Oral contraceptives

7. Chlorpropamide

8. Phenytoin

9. Glutethimide

10. Griseofluvin

11. Rifampicin

Benzodiapines include-

Alprozolam, Bromozepam, Chlordiazepoxide, Clonazepam, Clorazepate,Diazepam, Estazolam, Flurazepam, Halazepam, ketazolam,Lorazepam,Nitrazepam, Oxazepam, Prazepam, Quazepam, Temazepam, Triazolam

Refer Diazepam

1.May cause drowsiness; avoid driving or other tasks requiring alertness.

2.Alcohol and other CNS depresants.

3.May be taken with food or water if stomach upset occurs.

4.Patients on long term use make experience withdrawal syndrome. Do not discontinue the therapy abpruptly.

Refer - Diazepam

Take with or without food

Pregnancy:

Avoid using the drug during pregnancy.

Lactation:

Drug excreted in breast milk,and accumulation of the drug or its metabolites to toxic levels is possible.