* promote sleep

* ↓ anxiety

* treat epilepsy

*relax muscle spasms

*moderate sedation

-pam

-lam

* ↑ inhibitory effects of GABA

*cause sedation (which helps promote sleep)

*drowsiness

*dizziness

*confusion

*anxiety

*tolerance (over weeks)

*withdrawal (requires taper)

*can have paradoxical effects in older adults

*oversee nighttime ambulation, esp. older adults

*watch for toxicity

*monitor for paradoxical reactions, esp. older adults

*monitor for tolerance

*taper to avoid withdrawal

*weakness

*slurred speech

*ataxia

*uncoordinated muscle movements

*respiratory depression

*30 minutes before bed, ensure 8 hours for sleep

*do not take alcohol or other CNS depressants

*notify provider of paradoxical reactions

*pregnancy

*glaucoma

*children

*renal or hepatic impairment

*SIHI

*alcohol

*neuromuscular disorders

*chronic respiratory disorders

*sleep apnea

*CNS depressants (alcohol, opioids, etc)

*kava kava and valerian ( ↑ sedation)

*Cimetidine (↑ benzo level)

*smoking (↓ benzo effects)