Kiezen voor de juiste benzodiazepine: werkingsmechanisme en farmacokinetiek

Translated title of the contribution: Choosing the correct benzodiazepine: mechanism of action and pharmacokinetics

Christiaan H Vinkers, Joeri K Tijdink, Jurjen J Luykx, Roeland Vis

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

There is a discrepancy between the recommendation for caution and daily practice in the prescription of benzodiazepines. Although there is heterogeneity in the registered indications, all benzodiazepine agonists have almost the same mechanism of action. There are, however, substantial pharmacokinetic differences between individual benzodiazepine agonists. During short-term use of benzodiazepines, the elimination half-life is no measure of duration of action. Benzodiazepine lipophilicity determines the speed of action. If a rapid effect is desired, for instance in acute anxiety or agitation, then regarding oral medication the use of a lipophilic benzodiazepine such as diazepam is a rational choice. An accumulation factor can be used to estimate benzodiazepine accumulation during chronic use. In theory, accumulation does not occur with once-daily dosage of benzodiazepines that have an elimination half-life markedly shorter than 24 h, such as oxazepam, temazepam, and lorazepam.

Original languageDutch
Pages (from-to)A4900
JournalNederlands Tijdschrift voor Geneeskunde
Volume155
Issue number35
Publication statusPublished - 2012

Cite this

Vinkers, C. H., Tijdink, J. K., Luykx, J. J., & Vis, R. (2012). Kiezen voor de juiste benzodiazepine: werkingsmechanisme en farmacokinetiek. Nederlands Tijdschrift voor Geneeskunde, 155(35), A4900.