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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.3–6Midazolam, a benzodiazepine with a short duration of action, is also used for procedural sedation and general anesthesia (Table 177-1).

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Table 177-1 Benzodiazepines 
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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 the varying pharmacologic profiles, with some agents having more profound sedative or hypnotic effects, there is evidence that ...

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