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Benzodiazepines differ by the methods they can be given, time of onset, action duration, mechanism of metabolism, and presence of active metabolites.

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The duration of action is about 30 minutes, although sedation may be prolonged in elderly patients. It is an intermediate-acting benzodiazepine; its effects begin within 3-5 minutes and peak at 20-30 minutes. Lorazepam has a few advantages over midazolam: first, metabolism occurs by means of conjugation, which makes it more suitable than other benzodiazepines for use in the presence of renal or hepatic failure.

In addition, this class of drugs produces amnesia and has anticonvulsant actions. Their most significant adverse effect is respiratory depression and subsequent hypoxemia.

Therefore, exercise caution when administering this medication to patients with underlying chronic obstructive pulmonary disease (COPD).

Sedatives typically have more than one of these actions, although one may predominate.

The ideal sedative would exhibit all of the above qualities; most do not.

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