Benzo overdose
Started by AlbertConstable
There is this widely used graph that compares benzos and barbiturates, and I wish I had a copy.
Basically the Y-axis starts with sedation and moves on to hypnosis, then respiratory depression and finally death at the top. The X-axis is dose. Barbiturates move linearly up through respiratory depression to death with increased dose, while benzos level off at hypnosis and never reach respiratory depression. They are a safer alternative to barbiturates.
I also remember reading that this phenomenon has something to do with the receptor subtypes.
Basically the Y-axis starts with sedation and moves on to hypnosis, then respiratory depression and finally death at the top. The X-axis is dose. Barbiturates move linearly up through respiratory depression to death with increased dose, while benzos level off at hypnosis and never reach respiratory depression. They are a safer alternative to barbiturates.
I also remember reading that this phenomenon has something to do with the receptor subtypes.
barbiturates are more dangerous because they can kill you due to inhibitiing NADH DEHYDROGENASE COMPLEX 1 in the inner membrane of the Electron transport chain, If you have an overdose of barbiturates, the only ATP you can generate will be via through the FADH2. Both will give you respiratory depression, but barbs can kill you.
sure, the main consequence is respiratory depression. That's not a real important point to know though. Im not sure why children would be affected any differently in terms of what symptoms to expect.
If a question is asked on benzo od, the question would almost certainly deal with flumenazil being what to use as it is a comp antagonist at the benzo receptor. I can't imagine anything else they could ask you(maybe something dealing with why benzos have a higher safety margin than barbituates, but I doubt it)
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Well I've seen a question twice that goes along the lines of "Child finds benzo pills in purse, finishes them all and is found a little while later" What is the most likely consequence?
Choices include respiratory depression and 4 other things that are along those lines. I just wasn't sure if there is any other consequences besides being "out of it" and possibly respiratory depression?
Choices include respiratory depression and 4 other things that are along those lines. I just wasn't sure if there is any other consequences besides being "out of it" and possibly respiratory depression?
I remember that question, wasn't it NBME #3 and an empty bottle of Valium?
Well, I'm almost certain it's respiratory depression, especially since it's a child.
Flumazenil would be the DOC.
While BZDs are safer when used alone due to their greater margin of safety when compared to barbiturates, a BZD-naive child would still be at risk of respiratory depression. Barbiturates also directly affect the respiratory center in the medulla, so we're not comparing apples to apples here. Different mechanisms are in play. NADH Dehydrogenase inhibition is one I hadn't heard about (or don't remember), that's interesting.
In terms of subtypes, the only differentiation I'm aware of is when you compare the traditional BZDs (Valium, Ativan, Xanax, Klonopin) to the omega-1 selective benzodiazepine receptor agonists such as Ambien, Lunesta, and Sonata.
http://www.emedicine.com/EMERG/topic58.htm
http://www.emedicine.com/EMERG/topic52.htm
I remember seeing a similar question. While both can cause respiratory depression, I think the effect is greater with barbiturates than benzos...so if I had to guess which drug was given in a patient that didn't have respiratory depression, I'd pick benzos
http://www.emedicine.com/EMERG/topic52.htm
I remember seeing a similar question. While both can cause respiratory depression, I think the effect is greater with barbiturates than benzos...so if I had to guess which drug was given in a patient that didn't have respiratory depression, I'd pick benzos
Benzos increase the firing frequency of GABA neurons by altering Cl- channels. There is essentially a max firing rate, which limits toxicity. Barbituates also alter Cl- channels, but they increase the release of GABA with each stimulation. There is essentially no limitation on GABA release with barbituates, and patients will die due to respiratory depression before they deplete GABA.
