Name of Drug Dosage/ Route/ Mechanism of Indications Contraindication Side effects/ Adverse Effect Nursing Responsibility

frequency Action
alprazolam  Anxiety  Exact  Management of  Contraindicated  CNS: Transient, mild CLINICAL ALERT!
(al prah' zoe lam) disorders: mechanisms of anxiety disorders, with drowsiness initially; sedation,
Alprazolam Initially, action not short-term relief of hypersensitivity depression, lethargy, apathy,  Name confusion has occurred
Intensol, Apo- 0.25–0.5 mg understood; symptoms of to fatigue, light-headedness, among Xanax (alprazolam),
Alpraz (CAN), PO tid; adjust main sites of anxiety; anxiety benzodiazepines disorientation, anger, Celexa (citalopram), and Cerebyx
Niravam, Novo- to maximum action may be associated with , psychoses, hostility, episodes of mania (fosphenytoin), and between
Alprazol (CAN), daily dose of the limbic depression. acute narrow- and hypomania, restlessness, alprazolam and lorazepam; use
Nu-Alpraz 4 mg/day in system and  Treatment of panic angle glaucoma, confusion, crying, delirium, caution.
(CAN), Xanax, divided doses reticular attacks with or shock, coma, headache, slurred speech,
Xanax TS (CAN), or extended- formation; without acute alcoholic dysarthria, stupor, rigidity, Assessment
Xanax XR release form increases the agoraphobia intoxication with tremor, dystonia, vertigo,
once per day effects of  Unlabeled uses: depression of euphoria, nervousness,  History: Hypersensitivity to
Pregnancy in the AM GABA, an Social phobia, vital signs, difficulty in concentration, benzodiazepines; psychoses;
Category D once dosage inhibitory premenstrual pregnancy vivid dreams, psychomotor acute narrow-angle glaucoma;
is established neurotransmitter syndrome, (crosses the retardation, extrapyramidal shock; coma; acute alcoholic
Controlled (immediate ; anxiety depression placenta; risk of symptoms; mild paradoxical intoxication with depression of
Substance C-IV release, blocking effects congenital excitatory reactions during vital signs; labor and delivery;
intensol occur at doses malformations, first 2 wk of treatment lactation; impaired liver or kidney
    Drug classes solution). well below those neonatal  CV: Bradycardia, tachycardia, function; debilitation
 Panic necessary to withdrawal CV collapse, hypertension,  Physical: Skin color, lesions; T;
 Benzodiazepin disorder: cause sedation, syndrome), labor hypotension, palpitations, orientation, reflexes, affect,
e Initially, 0.5 ataxia. and delivery edema ophthalmologic examination; P,
 Anxiolytic mg PO tid; ("floppy infant"  Dermatologic: Urticaria, BP; liver evaluation, abdominal
increase dose syndrome), pruritus, rash, dermatitis examination, bowel sounds,
at 3- to 4-day lactation  EENT: Visual and auditory normal output; CBC, LFTs, renal
intervals in (secreted in disturbances, diplopia, function tests
increments of breast milk; nystagmus, depressed
no more than infants become hearing, nasal congestion Interventions
1 mg/day; lethargic and  GI: Constipation, diarrhea,
ranges of 1– lose weight). dry mouth, salivation, nausea,  Arrange to taper dosage gradually
10 mg/day  Use cautiously anorexia, vomiting, difficulty after long-term therapy, especially
have been with impaired in swallowing, gastric
needed; liver or kidney disorders, hepatic impairment
extended- function,  GU: Incontinence, changes in
release form debilitation. libido, urinary retention,
once per day menstrual irregularities
in AM once  Hematologic: Elevations of
dosage is blood enzymes—LDH,
established alkaline phosphatase, AST,
(Xanax ALT; blood dyscrasias—
products, agranulocytosis, leukopenia
Niravam).  Other: Hiccups, fever,
diaphoresis, paresthesias,
muscular disturbances,
gynecomastia. Drug
dependence with withdrawal
syndrome when drug is
discontinued; more common
with abrupt discontinuation of
higher dosage used for longer
than 4 months
 not be stopped suddenly.
in epileptic patients.
 Do not administer with grapefruit
juice.
 Taper drug slowly; decrease by no
more than 0.5 mg every 3 days.
Teaching points
 Take this drug exactly as
prescribed; take extended-release
form once a day in the morning;
place rapidly disintegrating tablet
on top of tongue, where it will
disintegrate and can be swallowed
with saliva.
 Do not drink grapefruit juice
while on this drug.
 Do not stop taking drug (in long-
term therapy) without consulting
health care provider; drug should
 Avoid alcohol, sleep-inducing, or
over-the-counter drugs.
 You may experience these side
effects: Drowsiness, dizziness
(these effects will be less
pronounced after a few days,
avoid driving a car or engaging in
other dangerous activities if these
occur); GI upset (take drug with
food); fatigue; depression;
dreams; crying; nervousness.
 Report severe dizziness,
weakness, drowsiness that
persists, rash or skin lesions,
difficulty voiding, palpitations,
swelling in the extremities.