oxazepam (redirected from Serestra)

oxazepam /ox·az·e·pam/ (ok-saz´ĕ-pam) a benzodiazepine tranquilizer, used as an antianxiety agent and as an adjunct in the treatment of acute alcohol withdrawal symptoms.

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ox·az·e·pam (k-sz-pm)

n.

A tranquilizing drug related to benzodiazepine and used especially in the treatment of insomnia and alcohol withdrawal.

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oxazepam

[oksā′zəpam]

a benzodiazepine tranquilizer.

indications It is prescribed to relieve anxiety and nervous tension and manage ethanol withdrawal, and it has unlabeled use for treatment of simple partial seizures.

contraindications Acute narrow-angle glaucoma, psychotic disorders, or known hypersensitivity to this drug prohibits its use.

adverse effects Among the more serious adverse effects are withdrawal symptoms resulting from discontinuation of treatment. Dizziness and fatigue commonly occur.

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oxazepam (oksaz´pam),

n brand name: Serax;
drug class: benzodiazepine (Controlled Substance Schedule IV);
action: produces central nervous system depression by interacting with a benzodiazepine receptor to facilitate the action of the inhibitory neurotransmitter λ-aminobutyric acid (GABA);
uses: anxiety, alcohol withdrawal.

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oxazepam

a benzodiazepine tranquilizer. See also diazepam.

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oxazepam

Apo-Oxazepam (CA), Novoxapam (CA), Serax

Pharmacologic class: Benzodiazepine

Therapeutic class: Anxiolytic, sedative-hypnotic

Controlled substance schedule IV

Pregnancy risk category D

Action

Suppresses CNS stimulation at limbic and subcortical levels by potentiating effects of gamma-aminobutyrate, an inhibitory neurotransmitter. This suppression reduces anxiety and diminishes alcohol withdrawal symptoms.

Availability

Capsules: 10 mg, 15 mg, 30 mg

Tablets: 15 mg

⊘Indications and dosages

➣ Mild to moderate anxiety

Adults: 10 to 15 mg P.O. three to four times daily

➣ Severe anxiety; alcohol withdrawal symptoms

Adults: 15 to 30 mg P.O. three to four times daily

Dosage adjustment

• Elderly patients

Off-label uses

• Insomnia

Contraindications

• Hypersensitivity to drug or tartrazine (some products)

Precautions

Use cautiously in:
• hepatic dysfunction, severe chronic obstructive pulmonary disease, myasthenia gravis, CNS depression, uncontrolled severe pain
• history of suicide attempt or drug abuse
• concurrent use of other benzodiazepines
• elderly or debilitated patients
• pregnant or breastfeeding patients.

Administration

• Administer with or without food.
• Taper dosage after long-term therapy.

Route	Onset	Peak	Duration
P.O.	45-90 min	3 hr	6-12 hr

Adverse reactions

CNS: dizziness, drowsiness, headache, confusion, poor memory, hangover effect, slurred speech, depression, paradoxical stimulation

CV: orthostatic hypotension, hypotension, ECG changes, tachycardia

EENT: blurred vision, mydriasis, tinnitus

GI: nausea, vomiting, constipation, diarrhea

GU: urinary retention, urinary incontinence

Hematologic: leukopenia

Hepatic: jaundice, hepatitis

Respiratory: respiratory depression

Skin: rash, dermatitis, itching

Other: physical and psychological drug dependence, drug tolerance, withdrawal symptoms

Interactions

Drug-drug. Azole antifungals: increased oxazepam blood level, greater risk of toxicity

Hormonal contraceptives, phenytoin: decreased oxazepam efficacy

Levodopa: decreased levodopa efficacy

Other CNS depressants (including antidepressants, antihistamines, other benzodiazepines, sedative-hypnotics, opioids): additive CNS depression

Theophylline: decreased sedative effect of oxazepam

Drug-diagnostic tests. Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, lactate dehydrogenase: increased levels

Hematocrit, thyroid uptake of sodium iodide ¹²³I and ¹³¹I, white blood cells: decreased values

Drug-food. Cabbage: decreased drug blood level

Drug-herbs. Chamomile, hops, kava, valerian, skullcap: increased CNS depression

Drug-behaviors. Alcohol use: increased CNS depression

Patient monitoring

☞ Monitor liver function tests and watch for signs and symptoms of hepatitis.
• Check vital signs. Stay alert for respiratory depression, orthostatic hypotension, and tachycardia.
• Monitor neurologic status. As needed, take measures to prevent injury.
• Watch for signs and symptoms of psychological or physical dependence.
• When tapering, watch for withdrawal symptoms.

Patient teaching

• Tell patient he may take with or without meals, but should avoid cabbage.
• Advise patient to take exactly as prescribed. Tell him drug can cause dependence, and emphasize importance of following tapering instructions to avoid withdrawal symptoms.
☞ Urge patient to immediately report unusual tiredness, nausea, appetite loss, or yellowing of skin or eyes.
• Tell patient to change position slowly to avoid blood pressure decrease.
• Instruct patient to report severe dizziness, weakness, persistent drowsiness, palpitations, or visual changes.
• Advise patient not to drink alcohol.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects vision, cognition, and balance.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, foods, herbs, and behaviors mentioned above.

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oxazepam

Neuropharmacology A benzodiazepine anxiolytic/sedative/hypnotic Therapeutic range 0.2–1.4 mg/L; 200-1400 µg/L Toxic range Not defined