QUAZEPAM

QUAZEPAM
(qua'ze-pam)
Doral
Classifications: benzodiazepine; anxiolytic; sedative-hypnotic;
Therapeutic: antianxiety; sedative-hypnotic
Prototype: Lorazepam
Pregnancy Category: X
Controlled Substance: Schedule IV

Availability

15 mg tablets

Action

Believed to potentiate gamma-aminobutyric acid (GABA) neuronal inhibition in the limbic, neocortical, and mesencephalic reticular systems.

Therapeutic Effect

Significantly decreases sleep latency and total wake time and significantly increases sleep time. REM sleep is essentially unchanged.

Uses

Insomnia characterized by difficulty in falling asleep, frequent nocturnal awakenings, or early morning awakenings.

Contraindications

Hypersensitivity to quazepam or benzodiazepines; sleep apnea; pregnancy (category X), lactation.

Cautious Use

Impaired liver and kidney function; compromised respiratory function; history of seizures; elderly; debilitated clients. Safety and effectiveness in children <18 y are not established.

Route & Dosage

Insomnia
Adult: PO 7.5–15 mg h.s.

Administration

Oral

Initial dose is usually 15 mg but can often be effectively reduced after several nights of therapy.
Use lowest effective dose in older adults as soon as possible.

Adverse Effects (≥1%)

CNS: Drowsiness, headache, fatigue, dizziness, dry mouth. GI: Dyspepsia.

Interactions

Drug: Alcohol, cns depressants, anticonvulsants potentiate CNS depression; cimetidine increases quazepam plasma levels, increasing its toxicity; may decrease antiparkinsonism effects of levodopa; may increase phenytoin levels; smoking decreases sedative effects of quazepam. Herbal: Kava, valerian may potentiate sedation.

Pharmacokinetics

Absorption: Readily from GI tract. Onset: 30 min. Peak: 2 h. Distribution: Crosses placenta; distributed into breast milk. Metabolism: In liver to active metabolites. Elimination: In urine and feces. Half-Life: 39 h.

Nursing Implications

Assessment & Drug Effects

Monitor for respiratory depression in patients with chronic respiratory insufficiency.
Monitor for suicidal tendencies in previously depressed clients.
Daytime drowsiness is more likely to occur in older adult clients.

Patient & Family Education

Inform physician about any alcohol consumption and prescription or nonprescription medication that you take. Avoid alcohol use since it potentiates CNS depressant effects.
Inform physician immediately if you become pregnant. This drug causes birth defects.
Do not drive or engage in potentially hazardous activities until response to drug is known.
Do not increase the dose of this drug; inform physician if the drug no longer works.
This drug may cause daytime sedation, even for several days after drug is discontinued.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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