Anti-Anxiety Pharmacology: Benzodiazepines & Barbiturates

Let’s settle this confusion once and for all – benzodiazepines versus barbiturates. How are these two anti-anxiety medications the same and how are they different?

The Similarities

Benzodiazepines and barbiturates are given for the same things:

  • Reduction of client’s anxiety
  • Decreases blood pressure
  • Decreases heart rate
  • Decreases respiratory rate
  • Acts on the central nervous system (CNS)

Take note: benzodiazepines and barbiturates are not opioid receptor pain blockers. Therefore, they do not necessarily block pain.

The Differences

Benzodiazepines and barbiturates mechanism of actions are entirely different. How?

  • Benzodiazepines – acts fast, has a quick half-life, and is excreted from the body quickly
  • Barbiturates – longer duration, has high concentration, stays in the body for two to three days; sometimes, it extends up to five days

Take note: Regarding addiction, clients have a higher propensity to get addicted to barbiturates than benzodiazepines.

How does one identify benzodiazepines from barbiturates?

Benzodiazepines

Think of benzodiazepines as a Mercedes Benz – flashy, high-end, fast car. When you have a Benz, you’re typically living a high-profile life with two women riding the fast life – Pam and Lam. This is how you remember the basics of benzodiazepines.

“-Pam” and “-Lam” are usually the two suffixes of benzodiazepines with medications like:

  • Lorazepam (Ativan)
  • Alprazolam (Xanax)
  • Clonazepam (Klonopin)
  • Diazepam (Valium)

So remember:

Benzodiazepines = Mercedes Benz = fast life with two women (Pam and Lam)

Benzodiazepines are usually given to clients with high anxiety or those who come in having a seizure. Lorazepam (Ativan) will act on the neurotransmitters and sedates the brain.

Barbiturates

Barbiturates act on the central nervous system (CNS), specifically on the GABA alpha receptors.

Barbie behind bars = Barbie is for your “-barbital” while bars or jail is for your time span since barbiturates have a longer duration (three to five days) before it gets expelled from the system. Overdosing and addiction are primary concerns for this kind of medication.

“-Barbital” is the known suffix of barbiturates with medications like:

  • Phenobarbital
  • Amobarbital
  • Pentobarbital

So remember:

            Barbiturates (-barbital) = Barbie behind bars = long duration

GABA the Controller

A little bit about GABA and how it is primarily involved in your benzodiazepines and barbiturates. Basically, you just have to remember this:

GABA receptor = controls conscious thoughts (rational thinking)

Barbiturates act on the GABA alpha receptors the same way alcohol does. Alcohol affects GABA because it is considered as a depressant; affecting the neurotransmitters that excites and inhibits. On the other hand, benzodiazepines acts on the same GABA receptors but at a different receptor site.

What We’ve Learned So Far

  1. Benzodiazepines and barbiturates act as CNS depressants, so you have to be mindful of your blood pressure, heart rate, and respiratory rate.
  2. Benzodiazepines (Mercedes Benz) live a fast life with Pam and Lam (suffixes).
  3. Barbiturates (Barbie behind bars) has “-barbital” as a suffix and last three to five days.
  4. Clients taking barbiturates have a higher propensity to addiction and toxicity.

Hopefully, this helped straighten out your confusion between these two medications.

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