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Benzodiazepines, to varying degrees, have in common six major
pharmacologic effects: sedative, hypnotic, anxiolytic, amnestic,
anticonvulsant, and muscle relaxant.1,2 Benzodiazepines
are commonly used for the treatment of anxiety, insomnia, seizures,
and alcohol withdrawal.3–6 Midazolam,
a benzodiazepine with a short duration of action, is also used for procedural
sedation and general anesthesia (Table 177-1).
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During 2008, the American Association of Poison Control Centers
received reports of 78,443 exposures to benzodiazepines; 30,856
were single drug exposures to a benzodiazepine.7 Isolated
benzodiazepine overdose has a low mortality and death is rare.8,9
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Although the ingestion of benzodiazepines alone appears to result
in relatively few deaths, increased rates of morbidity do result
from mixed overdose. In addition, because of ...