DRUG NAME CLASS/FAMILY MECHANISM OF ACTION INDICATIONS WHY IS YOUR PATIENT GETTING THIS MEDICINE ROUTES PATIENT DOSAGE

COMMON DOSAGE

Generic: alprazolam Trade Name: Xanax, Niravam ANXIOLYTIC; SEDATIVE-HYPNOTIC; BENZODIAZEPINE A CNS depressant that appears to act at the limbic, thalamic, and hypothalamic levels of the CNS. Has antianxiety and sedative effects with addictive potential. Management of anxiety disorders or for short-term relief of anxiety symptoms. Also used as adjunct in management of anxiety associated with depression and agitation, and for panic disorders, such as agoraphobia. anxiety PO 0.5 PO BID Anxiety Disorders Adult: PO 0.250.5 mg t.i.d. (max: 4 mg/day) Geriatric: PO 0.1250.25 mg b.i.d. Panic Attacks Adult: PO 12 mg t.i.d. (max: 8 mg/day); sustained release: Initiate with 0.51 mg once/day. Depending on the response, the dose may be increased at intervals of 3 to 4 days in increments of no more than 1 mg/day. Target range 36 mg/day (max: 10 mg/day). Hepatic Impairment Dosage Adjustment Reduce dose by 50% in hepatic impairment. Do not discontinue abruptly. Peak: 12 h. n/a

ONSET, PEAK, DURATION FOR IV MEDS, COMPATIBILITY WITH IV DRIPS AND OR SOLUTIONS LAB VALUE ALTERATIONS CAUSE BY THIS MED CONTRAINDICATIONS/ PRECAUTIONS

n/a Sensitivity to benzodiazepines; acute narrow angle glaucoma; pulmonary disease; use alone in primary depression or psychotic disorders, bipolar disorders, organic brain disorders; myasthenia gravis; pregnancy ( category D), lactation; children younger than 18 y. Impaired hepatic function; history of alcoholism; renal impairment, hepatic disease; geriatric and debilitated patients. Effectiveness for longterm treatment (greater than 4 mo) not established. Drug: Alcohol and other CNS DEPRESSANTS, ANTICONVULSANTS, ANTIHISTAMINES, BARBITURATES, NARCOTIC ANALGESICS, BENZODIAZEPINES compound CNS depressant effects; cimetidine, disulfiram, fluoxetine, TRICYCLIC ANTIDEPRESSANTS increase alprazolam levels (decreased metabolism); ORAL CONTRACEPTIVES may

INTERACTIONS

increase or decrease alprazolam effects. Herbal: Kava, valerian may potentiate sedation; St. John's wort decreases serum level of alprazolam. Cigarette smoking may decrease serum level of alprazolam by 50%. CNS: Drowsiness, sedation, light-headedness, dizziness, syncope, depression, headache, confusion, insomnia, nervousness, fatigue, clumsiness, unsteadiness, rigidity, tremor, restlessness, paradoxical excitement, hallucinations. CV: Tachycardia, hypotension, ECG changes. Special Senses: Blurred vision. Respiratory: Dyspnea. Monitor for S&S of drowsiness and sedation, especially in older adults or the debilitated; they may require supervised ambulation and/or side rails. Lab tests: Monitor periodic blood counts, urinalyses, and blood chemistry studies, particularly during continuing therapy. Adverse reactions may occur during early high-dose therapy. These usually disappear with continuing therapy, but dosage adjustments may be indicated. Make position changes slowly and in stages to prevent dizziness. Do not use alcohol, other CNS depressants, or OTC medications containing antihistamines (e.g., sleep aids, cold, hay fever, or allergy remedies) without consulting physician. Do not drive or engage in potentially hazardous activities until response to drug is known. Taper dosage following continuous use; abrupt discontinuation of drug may cause withdrawal symptoms: Nausea, vomiting, abdominal and muscle cramps, sweating, confusion, tremors, convulsions.

ADVERSE/SIDE EFFECTS

IMP NURS RESPONSIBILITIES

PT/FAMILY TEACHING