DRUG NAME MECHANISM OF ACTION INDICATIONS AND SIDE EFFECTS AND ADVERSE NURSING CONSIDERATIONS

CONTRAINDICATIONS
Generic Name:
- Chlordiazepoxide
Brand Name:
- Librium
Dosage/Frequency:
- For mild to moderate
anxiety, 5 mg or 10 mg, 3 or 4
times daily. For severe
anxiety, 20 mg or 25 mg, 3 or
4 times daily.
Route:
- PO or IV
Classification:
- Benzodiazepines
REACTIONS
- Chlordiazepoxide binds to
stereospecific benzodiazepine
(BZD) binding sites on GABA
(A) receptor complexes at
several sites within the central withdrawal symptoms of acute
nervous system, including the
limbic system and reticular
formation. This results in an
increased binding of the
inhibitory neurotransmitter
GABA to the GABA(A)
receptor. BZDs, therefore,
enhance GABA-mediated
chloride influx through GABA
receptor channels, causing
membrane hyperpolarization.
The net neuro-inhibitory
effects result in the observed
sedative, hypnotic, anxiolytic,
Indications:
- For the management of anxiety
disorders or for the short-term
relief of symptoms of anxiety,
alcoholism, and preoperative
apprehension and anxiety.
Contraindications:
- Contraindicated in patients with
known hypersensitivity to the
drug. Concomitant use of
benzodiazepines, including
Librium, and opioids may result in
profound sedation, respiratory
depression, coma, and death.
CNS: Dizziness, drowsiness,
hangover, headache, mental
depression, paradoxical
excitation, sedation.
EENT: Blurred vision
GI: Constipation, diarrhea,
nausea, vomiting, weight gain.
SKIN: Rashes
LOCAL: Pain at IM site.
MISC: Physical dependence,
psychologic dependence,
tolerance.
- Monitor daytime drowsiness and,
“hangover” symptoms (headache,
nausea, irritability, dysphoria). Repeated
or excessive symptoms may require
change in dose or medication.
- Assess dizziness that might affect gait,
balance, and other functional activities
(See Appendix C). Report balance
problems and functional limitations to
the physician, and caution the patient
and family/caregivers to guard against
falls and trauma.
- Report any behavioral or personality
changes such as decreased mental acuity
or excessive excitation.
- Periodically assess body weight and
other anthropometric measures (body
mass index, body composition). Report a
rapid or unexplained weight gain or
and muscle relaxant increased body fat.
properties. - Monitor IM injection site for pain,
swelling, and irritation. Report
prolonged or excessive injectionsite
reactions to the physician.