March 22, 2023

NCLEX Review: Clonazepam (Benzodiazepine) – Mechanism of Action, Uses, Side effects, Contraindications, and Nursing considerations

Hi everyone this is nurse ryan and today we’re going to be talking about the drug clonazepam also known as clonopin or rivotril you can use the timestamps in the video description to jump ahead clonazepam belongs to the benzodiazepine drug classification sometimes just called benzos for short benzodiazepines work by enhancing the effects of the inhibitory

Neurotransmitter called gamma aminobutyric acid more commonly known as gaba that’s a lot to take in so let’s break down what all of that means so in our body we have neurons that transfer information throughout the entire brain and body and the way that this information gets from neuron to neuron is through electrical signals which we call action potentials

These action potentials are vital in the transfer of information throughout the body we also have neurotransmitters which influence these action potentials we have excitatory neurotransmitters and inhibitory neurotransmitters to simplify things we’ll say that these little yellowish red circles here are the excitatory neurotransmitters you can think of excitatory

Neurotransmitters as the ones that are excited the ones that are promoting or stimulating action potentials so they are exciting or encouraging whichever neurons that they’re acting on this means that information can travel more easily or more quickly from neuron to neuron and inhibitory neurotransmitters are the opposite they are kind of the downers the ones

That slow down or prevent action potentials the neurotransmitter called gaba is actually the main inhibitory neurotransmitter in the central nervous system again just to simplify things let’s say that gaba are these little green dots gaba reduces the excitability of neurons which slows down the transfer of information one more time let’s review all that so

Benzodiazepines like clonazepam work by enhancing gaba so clonazepam enhances the main downer of the nervous system which results in all sorts of inhibitory effects throughout the body this includes sedation drowsiness decreased anxiety muscle relaxing effects and more this is why you can think of clonazepam as a cns depressant alright now that we know how

Clonazepam works it’s a lot easier to work through what it’s used for clonazepam is used in the treatment of various seizure types including myoclonic seizures atonic seizures absent seizures in some cases lennox gaston syndrome which is a type of epilepsy and more seizures occur during the abnormal excitation of neurons in the brain so it makes sense that

Clonazepam a drug that inhibits neuron activity works to treat those excitable neurons again by slowing down the electrical activity of the brain clonazepam is also used for the treatment of panic disorder to reduce anxiety and help manage panic attacks off-label clonazepam is also used to treat generalized anxiety insomnia downbeat nystagmus restless leg syndrome

As a muscle relaxant and more many of clonazepam side effects relate to how benzos work which again is essentially as a central nervous system depressant cns depression may present as sedation dizziness weakness unsteadiness and more severe cns depression can eventually lead to loss of consciousness coma and even death there are many other possible side effects

Just some of which include hypotension possibly due to decreased anxiety respiratory depression due to the cns depression suicidal ideations which are very important to look out for tachycardia blurred vision and many more clonazepam is contraindicated in patients with hypersensitivity to benzodiazepines also avoid use in patients with narrow angle glaucoma as

Clonazepam may increase intraocular pressure in rare cases according to manufacturers clonazepam should also not be given to those with severe liver disease precautions should be used in patients with a history of addiction and patients with suicidal ideations clonazepam should not be given to patients with untreated depression also exercise caution in patients

With respiratory disease like copd or sleep apnea in patients with renal impairment and in elderly patients in all of these patients doses may have to be lowered always remember to assess and monitor for side effects of clonazepam assess the duration type and intensity of seizures be aware that there are many interactions with clonazepam which may increase or

Decrease its effectiveness other cns depressants especially like opioids and alcohol may increase the effects of sedation and respiratory depression which can be life-threatening when a patient first starts on clonazepam ensure that they have the proper support to assist with ambulation and other activities of daily living this will help with drowsiness and

Dizziness and will help reduce the risk of falls especially in elderly patients to avoid withdrawal symptoms do not discontinue clonazepam abruptly but instead gradually taper the dose according to the provider’s instructions lastly for the treatment of overdose a benzodiazepine antagonist such as flumazinil may be used as an antidote blocks or inhibits gaba

Receptors reducing the symptoms of overdose and that’s about it for the basics of clonazepam if you have any questions or would like me to cover a specific drug or topic please let me know in the comments and thanks for watching

Transcribed from video
Clonazepam (Klonopin/Rivotril) Nursing Drug Card (Simplified) – Pharmacology By Nurse Ryan