Benzodiazepines: Therapeutical Indications and use in Patients with Renal Disease

Abstract

Benzodiazepines, consisting of a benzene ring joined to a diazepine ring and a phenyl radical, are a class of drugs mainly used for the treatment of anxiety symptoms. They increase the transmission of gamma-aminobutyric acid (a kind of endogenous anxiolytic) and, therefore, they have an anxiolytic, sleep-inducing or sedative, myorelaxing, anticonvulsive, and anesthetic effect. They have minimal interactions with other drugs, but too often they are used as a long-term therapy instead of being used only when they are really necessary. The Territorial Pharmacist can play an important role in solving this problem. In patients with renal disease it is important to consider that the pharmacokinetics of these drugs, and therefore the absorption, degradation, and excretion of both their active principles and their metabolites are altered factors in case of kidney failure. Patients with renal disease make use of benzodiazepines more than the general population; however in these patients it is necessary to reduce the dose of about one third of the maximum dose allowed in patients with normal renal function. Additional research is also needed to investigate the main reasons of benzodiazepines use by patients with kidney disease.