Drug Presentation On

Clonazepam

PREPARED BY:
MANISHA THAPA
LEEZA SHRESTHA
Introduction 1

 Clonazepam, sold under the tradename CLONAZ, KLOZEP is a medication used

to prevent and treat seizures, panic disorder, and the movement disorder known as
akathisia. It is a tranquilizer of the benzodiazepine class. It is taken by mouth. It
begins having an effect within 1 hour and lasts between 6 and 12 hours.
Molecular Formula: C15H10ClN3O3
Excretion: Kidney

2
Bio-availability: 90%
Onset Of Action: Within an hour
Molar Mass: 315.715 g/mol

Structural Formula
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MECHANISM OF ACTION

Clonazepam’s primary mechanism of action is the modulation of GABA function in

the brain, by the benzodiazepine receptor, located on GABA receptors, which in turn,
leads to enhanced GABAergic inhibition of neuronal firing.
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INDICATIONS

 For the alternative treatment of absence seizures, petit mal variant (Lennox-
Gastaut syndrome), and akinetic and myoclonic seizures (myoclonia). ...
 For the treatment of panic disorder with or without agoraphobia.
 For the treatment of restless legs syndrome.
 For the treatment of insomnia.
PREPARATION
Tablet : 0.125 mg ,0.25 mg , 0.5 mg, 1mg, 2mg
 
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USUAL DOSE AND ROUTE

 Adult (by PO) : 1mg (Elderly 0.5 mg ) initially at night for 4 nights , increased
according to response over 2 – 4 weeks ;
 Maintenance dose 4 -8 mg at night (may be given 3 -4 divided doses if
necessary ) 
 Infant and children < 10 years : 0.01 – 0.03 mg /kg in 2 - 3 divided doses.
 Doses may be increased up to 0.5 mg increment at 3 days interval until seizures
are controlled .Do not exceed 0.2 mg /kg daily
 
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SIDE EFFECTS

 Clonazepam can cause dangerous central nervous system depression, leading to

markedly impaired alertness and slowed bodily functions, especially when taken
recreationally or in doses higher than recommended.
 There are a number of side effects of clonazepam, especially if taken for a long
period of time or at high doses, one may experience:
 CNS : Vertigo ,sedation, weakness , dizziness, ataxia ,decreased minor
performance , confusion .
 Ocular : double or blurred vision.
 Skin : urticaria, rash , photosensitivity .
 GI : change in weight dry mouth , constipation .
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SIDE EFFECTS
 CNS : when used in combination with other CNS depressant , may lead to death
 CN : tachycardia to cardiovascular collapse .
In addition, clonazepam is reported to increase suicidal ideation, or suicidal thoughts
in some people taking the drug. If felt depressed, restless or suicidal soon after
starting clonazepam, the person should immediately alert the doctor. It is important
not to drive or operate machinery due to these effects, as one could significantly
endanger themselves and others.
CONTRAINDICATIONS 8

 Antianxiety drugs in a person with hypersensitivity to any of the drugs in the

classification and following conditions .
 Acute narrow angle glaucoma .
 Untreated open- angled glaucoma .
 During or within 14 days of MAO ( Monoamine oxidase inhibitors ) inhibitor
therapy .
 Depressed or psychotic patients in the absence of anxiety
 First trimester of pregnancy and lactation ( breastfeeding ).
 Shock of coma .
 Acute alcoholic intoxication .
NURSING CONSIDERATIONS 9
CLINICAL ALERT! Name confusion has occurred between Klonopin
(clonazepam) and clonidine; use caution.

Assessment
 History: Hypersensitivity to benzodiazepines; psychoses; acute
narrow-angle glaucoma; shock; coma; acute alcoholic intoxication;
pregnancy; lactation; liver or renal impairment, debilitation.
 Physical: Skin color, lesions; T; orientation, reflexes, affect,
ophthalmologic examination; P, BP; R, adventitious sounds; liver
evaluation, abdominal examination, bowel sounds, normal output;
CBC, LFTs, renal function tests.
INTERVENTIONS 10

 Monitor addiction-prone patients carefully because of their predisposition to

habituation and drug dependence.
 Monitor liver function and blood counts periodically in patients on long-term
therapy.
 WARNING: Taper dosage gradually after long-term therapy, especially in patients
with epilepsy; substitute another antiepileptic.
 Monitor patient for therapeutic drug levels: 20–80 ng/mL.
 If the patient has epilepsy, arrange for patient to wear medical alert identification
indicating patient has epilepsy and is receiving drug therapy.
TEACHING POINTS 11

 Take drug exactly as prescribed; do not stop taking drug (long-term therapy) without consulting
health care provider.
 Avoid alcohol, sleep-inducing, or over-the-counter drugs.
 Avoid pregnancy; serious adverse effects can occur. Using barrier contraceptives is advised while
taking this drug.
 It would be advisable to wear or carry a medical alert identification indicating your diagnosis and
drug therapy.
 You may experience these side effects: Drowsiness, dizziness (may become less pronounced;
avoid driving or engaging in other dangerous activities); GI upset (take drug with food); fatigue;
dreams; crying; nervousness; depression, emotional changes; bed-wetting, urinary incontinence.
 Report severe dizziness, weakness, drowsiness that persists, rash or skin lesions, difficulty
voiding, palpitations, swelling in the extremities.