Title Prednosti i mane korištenja benzodiazepina Title (english) Benefits and drawbacks of benzodiazepine use Author Darija Ćutuk Mentor Neven Henigsberg (mentor)Committee member Miroslav Herceg (predsjednik povjerenstva)Committee member Dražen Begić (član povjerenstva)Committee member Neven Henigsberg (član povjerenstva)Granter University of Zagreb Defense date and country 2020-07-17, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Benzodiazepini (BZ) su jedni od najpropisivanijih lijekova u svijetu. Spadaju u skupinu lijekova koji djeluju na središnji živčani sustav, a njihovo ciljno mjesto je GABAA receptor. GABA receptor funkcionira kao kloridni kanal koji se otvara vezanjem GABA
neurotransmitora te uzrokuje inhibiciju na postsinaptičkom neuronu. Benzodiazepini ne mogu samostalno otvoriti kloridni kanal nego potenciraju djelovanje GABA-e, odnosno povećavaju učestalost otvaranja kanala.Otkad je sredinom prošlog stoljeća otkriven prvi BZ, klordiazepoksid, do danas je sintetizirano mnogo BZ-a koji se međusobno razlikuju po farmakokinetici te će o brzini apsorpcije i eliminacije pojedinog BZ-a ovisiti izbor lijeka za određenu indikaciju. Postoji više podjela BZ-a. Prema poluvijeku eliminacije mogu se podijeliti na dugodjelujuće, srednjedugodjelujuće i kratkodjelujuće, prema potentnosti na visokopotentne i niskopotentne, a prema kliničkoj primjeni na anksiolitike i hipnotike.Osim u liječenju anksioznih poremećaja i nesanice, koriste se i za liječenje epilepsije, alkoholnog apstinencijskog sindroma i mišićnih spazama, a korisni su i u premedikaciji i indukciji anestezije. Prednosti su im što se dobro podnose i manje su toksični od većine drugih lijekova koji se koriste za iste indikacije. Rijetko dovode do depresije središnjeg živčanog sustava, a do toga dolazi uglavnom kada se kombiniraju s drugim depresorima SŽS-a. Najčešće nuspojave kod primjene BZ-a su pretjerana sedacija, pospanost i mišićna slabost, što je posebno izraženo kod starijih osoba kod kojih može doći do padova. Značajna nuspojava je i anterogradna amnezija koja je u nekim indikacijama poželjna (anestezija). Kod dijela pacijenata razvije se tolerancija i ovisnost o BZ-ima te se zbog toga BZ-i nikad ne bi smjeli primjenjivati duže od nekoliko tjedana. Kod naglog prekida uzimanja BZ-a pojavljuje se sindrom sustezanja sa simptomima koji mogu biti životno ugrožavajući pa zbog toga terapiju treba postupno ukidati.
Abstract (english) Benzodiazepines are one of the most prescribed medications worldwide. They accomplish their effects in central nervous system by binding to GABAA receptor which functions as a chloride channel. The channel opens when GABA neurotransmitter is bind to its receptor and the role of benzodiazepines is to enhance that inhibitory effect of GABA on the postsynaptic neuron. They cannot open the channel on their own, when GABA is absent. Since the first BZ, chlordiazepoxide, was discovered, many BZ have been synthesized. They differ in their pharmacokinetics so the time of the absorption and elimination of each BZ will determine their main indication.BZ can be classified based on their half-life into long-acting, intermediate-acting and short-acting, based on their potency into drugs with high or low potency and based on their clinical application into anxiolytics and hypnotics. Besides the treatment of anxiety disorders and insomnia, BZ can also be used when treating epilepsy, alcohol withdrawal syndrome and muscle spasms as well as before and during anaesthesia. Advantages of BZ therapy are that they are well tolerated and less toxic than some of the other medications used for the same indications. They rarely cause respiratory depression and even when they do, it usually occurs when combined with other CNS depressants. The most common side effects include sedation, drowsiness and muscle relaxation and the older adults are at higher risk of developing them so caution is needed in order to avoid falls and consequently bone fractures. Significant side effect is anterograde amnesia which is in some indications (anesthesia) desirable. Some patients may develop tolerance and dependence so BZ should never be used for more than a few weeks. If therapy is ceased abruptly, the symptoms of withdrawal syndrome may occur and sometimes can be life threatening so BZ should always be gradually excluded from therapy.
Keywords
anksioznost
benzodiazepini
nesanica
nuspojave
Keywords (english)
benzodiazepines
insomnia
side effects
Language croatian URN:NBN urn:nbn:hr:105:169579 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2021-03-26 11:49:06
