Anterograde amnesia

Amnesia (anterograde) Drowsiness, stupor, coma Dykinesia, dystonia Incoordination Transient ischemic attacks (TIAs) CNS Seizures... 

The definition of desired therapeutic and side effects in the case of the benzodiazepines very much depends on the clinical problem in question. The sedative and hypnotic actions are desired effects in the treatment of insomnia, but undesired effects in the treatment of anxiety disorders. Effects that are usually undesired include daytime drowsiness, potentiation of the sedative effects of ethanol, and anterograde amnesia. They are mediated via the benzodiazepine site of GABAa receptors, since they can be antagonized with flumazenil. 

Inquire about carryover sedation and anterograde amnesia from therapy. 

Anterograde amnesia A condition in which events that occurred after the onset of amnesia cannot be recalled and new memories cannot be formed. 

The most common side effect of BZs is CNS depression. Tolerance usually develops to this effect. Other side effects are disorientation, psychomotor impairment, confusion, aggression, excitement, and anterograde amnesia. 

Anterograde amnesia has been reported with most benzodiazepines. Using the lowest dose possible minimizes amnesia. 

GABA-boosting medications are in general well tolerated but not without side effects. They cause sedation and drowsiness, anterograde amnesia, and impaired motor coordination. Some of these effects provide an excellent example of how a side effect in one setting can be beneficial in another. For example, anterograde... 

Triazolam (ti/2 of elimination -1.5-5.5 h) is especially likely to impair memory (anterograde amnesia) and to cause rebound anxiety or insomnia and daytime confusion. The severity of these and other adverse reactions (e.g., rage, violent hostility, hallucinations), and their increased frequency in the elderly, has led to curtailed or suspended use of triazolam in some countries (UK). 

Benzodiazepines have the capacity to produce a calming effect and to cause anterograde amnesia, in which the patient cannot recall events that took place for some time after the drug was administered. Benzodiazepine-induced sedation and amnesia are deemed useful in the preparation of patients for anesthesia, surgery, and other frightening or unpleasant medical and dental procedures and diagnostic tests. Midazolam is a frequently used anesthetic benzodiazepine (see Chapter 25). 

A 54-year-old man is scheduled for an elective colonoscopy that will take approximately 20 minutes. Which of the following drugs would be most likely to produce the desired anesthesia and anterograde amnesia ... 

C. Midazolam, like all benzodiazepines given in sufficient dose, has the capacity to produce anterograde amnesia. It is also available in an injectable form and frequently is used as an anesthetic agent during short procedures. 

Clinicians should be aware of a few drug interactions with Zolpidem. Flumazenil acts as an antagonist to the hypnotic effects of zolpidem. There is decreased alertness when zolpidem is combined with cimetidine. There is an increase in anterograde amnesia in volunteers treated with a combination of imipramine and zolpidem. Haloperidol, ranitidine, chlorpromazine, warfarin, and digoxin, along with cimetidine and flumazenil, do not alter the pharmacokinetics of zolpidem (Salva and Costa, 1995). 

Mendelson SD, Quartermain D, Francisco T, et al S-HTj agonists induce anterograde amnesia in mice through a post synaptic mechanism. Eur J Pharmacol 236 177-182, 1993... 

Benzodiazepines are associated with anterograde amnesia, especially when they are administered intravenously and in high doses. 

Deterioration of performance decreased concentration and decreased physical capacity anterograde amnesia (see Chapter 7)... 

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