/reference/drugs/benzos-reversal
Midazolam, lorazepam, diazepam, flumazenil
Short-acting benzodiazepine
GABA-A potentiation at benzodiazepine receptor.
Benzodiazepine receptor antagonist (GABA-A α-subunit competitive)
Competitively binds benzodiazepine site on GABA-A receptor → displaces benzo agonists → reverses sedation, respiratory depression, amnesia.
Intermediate-acting benzodiazepine
Allosteric positive modulator at GABA-A receptors → ↑frequency of Cl⁻ channel opening → membrane hyperpolarization. Hypnotic, anxiolytic, anticonvulsant, anterograde amnesia. Glucuronidated only — no CYP metabolism — useful in liver disease.
Long-acting benzodiazepine
Allosteric positive modulator at GABA-A. Hypnotic, anxiolytic, anticonvulsant, skeletal-muscle relaxant. Produces highly lipid-soluble + active metabolites (desmethyldiazepam, oxazepam, temazepam) → very long total duration in elderly + chronic dosing.