<p><strong>Diazepam</strong> and <strong>Lorazepam</strong> both belong to the <em><strong>benzodiazepine</strong></em> class. They act as positive allosteric modulators of the GABA-A receptor in the Central Nervous System where they produce their depressant effects. They work by enhancing GABA, the main inhibitory neurotransmitter in the brain, reducing excessive neuronal firing.</p><h1><strong>ONSET OF ACTION</strong></h1><p><strong>Diazepam (Valium) </strong>has a very <strong><em>fast onset</em></strong> because it is highly lipid-soluble, allowing it to easily cross the blood-brain barrier.</p><p><strong>Lorazepam (Ativan) </strong>has a <strong><em>slower onset</em></strong> because it is less lipid-soluble. It has more stable and predictable absorption.
</p><h1><strong>DURATION OF ACTION & METABOLISM
</strong></h1><p><strong>Diazepam</strong> has a very <strong><em>long half-life</em></strong> of 20 to 50 hours. It is metabolised by the liver cytochrome enzymes, producing active metabolites that can last up to 100 hours.
</p><p><strong>Lorazepam</strong> has a <strong><em>short-to-intermediate half-life</em></strong> of 10 to 20 hours. It is metabolised by glucuronidation and has no active metabolites.
</p><h1><strong>CLINICAL USES
</strong></h1><p><strong>Diazepam</strong> is preferred for acute seizures, alcohol withdrawal, muscle spasms, procedural anxiety, and rapid sedations.
</p><p><strong>Lorazepam</strong> is used for generalized anxiety disorder, pre-procedure sedation, severe agitation in psychiatric emergencies, status epilepticus, and liver disease.
</p><p>Both drugs can cause sedation, respiratory depression, cognitive impairment, and dependence and addiction.
</p><p>The choice between <strong>Diazepam</strong> and <strong>Lorazepam</strong> depends on the specific condition being treated, the desired speed and duration of action, and individual factors like age, other medications being taken, and liver function.
</p><p>Both drugs are powerful <strong><em>benzodiazepines</em></strong> but each shines in a different clinical scenario.
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