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| Format: | Recurso digital |
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Zenodo
2026
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| Online Access: | https://doi.org/10.5281/zenodo.20347289 |
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Table of Contents:
- <p class="MsoNormal"><span>Benzodiazepines represent a cornerstone pharmacotherapeutic class within contemporary medical practice, exerting their primary effects through positive allosteric modulation of gamma-aminobutyric acid type A (GABA-A) receptors in the central nervous system. This manuscript provides a comprehensive, academically rigorous examination of benzodiazepine pharmacology, spanning FDA-approved and off-label indications, molecular mechanisms of action, detailed pharmacokinetic profiles, evidence-based administration protocols across diverse patient populations, and systematic approaches to adverse effect monitoring and toxicity management. Particular emphasis is placed on the clinical nuances of specific agents—including alprazolam, lorazepam, diazepam, midazolam, and the novel agent remimazolam—with attention to their distinctive pharmacokinetic properties that inform agent selection in specific clinical contexts such as status epilepticus, alcohol withdrawal syndrome, procedural sedation, and insomnia. The review critically examines contraindications, including angle-closure glaucoma and hypersensitivity reactions, and highlights the FDA-mandated boxed warning regarding concomitant opioid use. Furthermore, this article elucidates the essential role of the interprofessional healthcare team—encompassing prescribing clinicians, pharmacists, nurses, anesthesiologists, neurologists, intensivists, and psychiatrists—in optimizing therapeutic outcomes while minimizing risks of tolerance, physical dependence, misuse, and life-threatening respiratory depression. By integrating current evidence from clinical practice guidelines, including those from the American Epilepsy Society, American Society of Addiction Medicine, and American Academy of Sleep Medicine, this review offers a practical yet scholarly framework for the safe, individualized, and effective use of benzodiazepines across the continuum of care.</span></p> <p class="MsoNormal"><strong><span>Keywords:</span></strong><span> Benzodiazepines; GABA-A receptors; status epilepticus; alcohol withdrawal syndrome; procedural sedation; insomnia; flumazenil; drug-drug interactions; interprofessional healthcare team; substance use disorder</span></p>