Action: Decreases all levels of the CNS, including the limbic and reticular formation. Does this by facilitating the action of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter.
Use: Treat anxiety, panic and seizure disorders. Treat skeletal muscle spasm, acute alcohol withdrawal and used in conscious sedation.
Dental Considerations: Local anesthesia with vasoconstrictor ok. Significant dry mouth or sometimes increases in salivation. Orthostatic hypotension, tinnitus. Not compatible with pregnancy or breast-feeding.
Medical Considerations: >10%; drowsiness, ataxia, amnesia, slurred speech, light-headedness, phlebitis, pain with injection. 1-10%; confusion, dizziness.
Other adverse reactions; insomnia, hallucinations, EKG changes, tachycardia, hypotension, constipation, nausea, vomiting, anorexia, diarrhea, blurred vision, mydriasis, rash, dermatitis, itching. Don’t use with narrow-angle glaucoma, pre-existing CNS and respiratory depression, psychosis and severe uncontrolled pain. Use with caution in elderly, debilitated, hepatic and renal disease.
Dental Drug Interactions: CNS depressants (alcohol, barbiturates, opiods) enhance sedative and respiratory depressant effects of this medication. Increased effect of medication by erythromycin and antifungals.
Medical Drug Interactions: Increased medication effect with cimetidine, cisapride, valproic acid, antihistamines and selective serotonin reuptake inhibitors, oral contraceptives.
Alprazolam (Xanax) Headache, taste alteration.
Lorazepam (Ativan) Antiemetic, insomnia, psychogenic catatonia. Increased toxicity with MAO inhibitors, tricyclic antidepressants, phenothiazines.
Flurazepam (Dalmane) Short-term treatment of insomnia.
Triazolam (Halcion) Short-term treatment of insomnia, preoperative sedative.
Use: Treat petit mal and variant (Lennox-Gastaut), akinetic and myoclonic seizures, restless legs syndrome, neuralgia. Multifocal tic disorder, parkinsonian dysarthria, acute manic episodes, panic disorder and adjunct for schizophrenia.
Clonazepam Headache, blood dyscrasias.
Action: Interacts with a subunit of the GABA-benzodiazepine receptor. Same hypnotic and anxiolytic effects as benzodiazepines, but reduced effects on skeletal muscle relaxation and seizure activity.