https://www.sehk-wiki.org/api.php?action=feedcontributions&feedformat=atom&user=Ctol2 2026-05-25T06:08:19Z User contributions MediaWiki 1.43.0 https://www.sehk-wiki.org/index.php?title=Paracetamol&diff=2924 2022-04-05T10:42:06Z

<p>Ctol2: /* Drug Names */</p> <hr /> <div>[[Category: Drugs]] [[Category: Analgesic, antipyretic]]<br /> '''Paracetamol''' (中文: [[對乙酰氨基]])has analgesic and antipyretic properties. It is given orally or as a rectal suppository for mild to moderate pain and for fever. It may also be given by intravenous infusion for the short-term treatment of moderate pain, particularly after surgery, and of fever. It is often the analgesic or antipyretic of choice, especially in the elderly and in patients in whom salicylates or other anti-inflammatory drugs are contra-indicated. Such patients include asthmatics, those with a history of peptic ulcer and children.<br /> <br /> == Pronunciation ==<br /> === Paracetamol 500mg ===<br /> [[File: Paracetamol 500mg.mp3]]<br /> <br /> ==Drug Names==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Legal Classification 藥物分類<br /> |-<br /> |Paracetamol Tablet 500mg<br /> |PARA01<br /> |Non Poison<br /> |-<br /> !Brand Name 藥名<br /> !HK Reg Number 註冊代碼<br /> !Active Ingredients<br /> |-<br /> |ACEPHEN TAB 300MG<br /> |HK-38754<br /> |Paracetamol<br /> |}<br /> <br /> ==Mechanism of Action==<br /> *Non-opioid Analgesic<br /> *Antipyretic<br /> <br /> ==Dosage==<br /> Adult Oral dose: 0.5 - 1g every 4-6 hrs; max 4g per day<br /> It may be given as suppositories in a rectal dose of 0.5 to 1 g every 4 to 6 hrs, up to 4 times daily.<br /> Infusion dose based on body weight over 15 minutes:<br /> *Over 50 kg, single doses of 1g every 4 -6 hours, to a max of 4g daily<br /> *From 33 to 50 kg, single doses of 15mg/kg every 4 to 6 hours, to a max of 60mg/kg (up to 3 g) daily<br /> <br /> A maximum intravenous dose of 3 g daily should also not be exceed in patients with chronic alcoholism, chronic malnutrition, or dehydration, regardless of their body-weight.<br /> For doses in children, given according to age, every 4 to 6 hours if necessary up to a max of 4 doses in 24 hours, are:<br /> *3 to 6 months: 60 mg<br /> *6 months to 2 years: 120 mg<br /> *2 to 4 years: 180 mg<br /> *4 to 6 years: 240 mg<br /> *6 to 8 years: 240 or 250 mg<br /> *8 to 10 years: 360 or 375 mg<br /> *10 to 12 years: 480 or 500 mg<br /> *12 to 16 years: 480 or 750 mg<br /> <br /> ==Side Effects==<br /> Adverse effects of paracetamol are rare and usually mild, such as mild rashes occur occasionally.<br /> Overdosage with paracetamol (usually &gt;4g/day) can result in severe liver damage. <br /> no major side effect or drug interaction<br /> <br /> ==Pharmacokinetics==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Oral bioavailability<br /> |Paracetamol is readily absorbed from the gastrointestinal tract and is distributed into most body tissues.<br /> It also crosses the placenta and is present in breast milk.<br /> |-<br /> !style=&quot;text-align: left&quot;| Onset of action<br /> |The peak plasma concentrations occur about 10 to 60 minutes after oral doses.<br /> |-<br /> !style=&quot;text-align: left&quot;| Metabolism<br /> |It is metabolized in the liver <br /> |-<br /> !style=&quot;text-align: left&quot;| Elimination half-life<br /> |The elimination half-life varies from 1 to 3 hours.<br /> |}<br /> <br /> ==Drug Management==<br /> ===Monitoring===<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Efficiency<br /> |Management of Mild to Moderate Pain<br /> |-<br /> !style=&quot;text-align: left&quot;| Safety<br /> |Routine liver function test<br /> |-<br /> !style=&quot;text-align: left&quot;| Caution<br /> |Patient with chronic alcoholism, chronic malnutrition or dehydration. <br /> |}<br /> <br /> Overdosage with paracetamol (usually &gt;4g/day) can result in severe liver damage. Prompt treatment with acetylcysteine or methionine is essential.<br /> <br /> ===Drug interaction===<br /> no significant interaction with other medication,<br /> Use with caution when combine with medication that metabolize in the liver.<br /> <br /> ===Caution===<br /> Alcohol dependence, hepatocellular insufficiency, chronic malnutrition, chronic alcoholism and dehydration<br /> <br /> ===Hepatic impairment===<br /> Dose depend toxicity, avoid large dose.<br /> <br /> ===Renal impairment===<br /> Increase infusion dose interval<br /> <br /> ===Pregnancy===<br /> Not known to be harmful.<br /> <br /> ===Breast-feeding===<br /> Not known to be harmful.<br /> <br /> == FAQ ==<br /> === How should I take the tablet? ===<br /> *Follow the doctor's prescription.<br /> *Take with or without food.<br /> *Take the medication with plenty of water.<br /> *Can be crushed.<br /> <br /> === What should I avoid while taking? ===<br /> *Avoid alcohol consumption.<br /> *Avoid taking more than 4g of [[panadol]] per day.<br /> <br /> === What happens if I overdose? ===<br /> *Emergency situation, called 999 immediately.<br /> *Antidote: N-Acetylsysteine<br /> <br /> === What happen if I miss a dose? ===<br /> *Take it as soon as you remember. <br /> *If it is near the time of the next dose, skip the missed dose. <br /> *Take your next dose at the regular time. Do not double the dose to catch up.</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=Paracetamol&diff=2923 2022-04-04T06:54:16Z

<p>Ctol2: /* Breast-feeding */</p> <hr /> <div>[[Category: Drugs]] [[Category: Analgesic, antipyretic]]<br /> '''Paracetamol''' (中文: [[對乙酰氨基]])has analgesic and antipyretic properties. It is given orally or as a rectal suppository for mild to moderate pain and for fever. It may also be given by intravenous infusion for the short-term treatment of moderate pain, particularly after surgery, and of fever. It is often the analgesic or antipyretic of choice, especially in the elderly and in patients in whom salicylates or other anti-inflammatory drugs are contra-indicated. Such patients include asthmatics, those with a history of peptic ulcer and children.<br /> <br /> == Pronunciation ==<br /> === Paracetamol 500mg ===<br /> [[File: Paracetamol 500mg.mp3]]<br /> <br /> ==Drug Names==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name藥名<br /> !HA Code藥物代碼<br /> !Legal Classification藥物分類<br /> |-<br /> |Paracetamol Tablet 500mg<br /> |PARA01<br /> |Non Poison<br /> |-<br /> !Brand Name藥名<br /> !HK Reg Number註冊代碼<br /> !Active Ingredients<br /> |-<br /> |ACEPHEN TAB 300MG<br /> |HK-38754<br /> |Paracetamol<br /> |}<br /> <br /> ==Mechanism of Action==<br /> *Non-opioid Analgesic<br /> *Antipyretic<br /> <br /> ==Dosage==<br /> Adult Oral dose: 0.5 - 1g every 4-6 hrs; max 4g per day<br /> It may be given as suppositories in a rectal dose of 0.5 to 1 g every 4 to 6 hrs, up to 4 times daily.<br /> Infusion dose based on body weight over 15 minutes:<br /> *Over 50 kg, single doses of 1g every 4 -6 hours, to a max of 4g daily<br /> *From 33 to 50 kg, single doses of 15mg/kg every 4 to 6 hours, to a max of 60mg/kg (up to 3 g) daily<br /> <br /> A maximum intravenous dose of 3 g daily should also not be exceed in patients with chronic alcoholism, chronic malnutrition, or dehydration, regardless of their body-weight.<br /> For doses in children, given according to age, every 4 to 6 hours if necessary up to a max of 4 doses in 24 hours, are:<br /> *3 to 6 months: 60 mg<br /> *6 months to 2 years: 120 mg<br /> *2 to 4 years: 180 mg<br /> *4 to 6 years: 240 mg<br /> *6 to 8 years: 240 or 250 mg<br /> *8 to 10 years: 360 or 375 mg<br /> *10 to 12 years: 480 or 500 mg<br /> *12 to 16 years: 480 or 750 mg<br /> <br /> ==Side Effects==<br /> Adverse effects of paracetamol are rare and usually mild, such as mild rashes occur occasionally.<br /> Overdosage with paracetamol (usually &gt;4g/day) can result in severe liver damage. <br /> no major side effect or drug interaction<br /> <br /> ==Pharmacokinetics==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Oral bioavailability<br /> |Paracetamol is readily absorbed from the gastrointestinal tract and is distributed into most body tissues.<br /> It also crosses the placenta and is present in breast milk.<br /> |-<br /> !style=&quot;text-align: left&quot;| Onset of action<br /> |The peak plasma concentrations occur about 10 to 60 minutes after oral doses.<br /> |-<br /> !style=&quot;text-align: left&quot;| Metabolism<br /> |It is metabolized in the liver <br /> |-<br /> !style=&quot;text-align: left&quot;| Elimination half-life<br /> |The elimination half-life varies from 1 to 3 hours.<br /> |}<br /> <br /> ==Drug Management==<br /> ===Monitoring===<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Efficiency<br /> |Management of Mild to Moderate Pain<br /> |-<br /> !style=&quot;text-align: left&quot;| Safety<br /> |Routine liver function test<br /> |-<br /> !style=&quot;text-align: left&quot;| Caution<br /> |Patient with chronic alcoholism, chronic malnutrition or dehydration. <br /> |}<br /> <br /> Overdosage with paracetamol (usually &gt;4g/day) can result in severe liver damage. Prompt treatment with acetylcysteine or methionine is essential.<br /> <br /> ===Drug interaction===<br /> no significant interaction with other medication,<br /> Use with caution when combine with medication that metabolize in the liver.<br /> <br /> ===Caution===<br /> Alcohol dependence, hepatocellular insufficiency, chronic malnutrition, chronic alcoholism and dehydration<br /> <br /> ===Hepatic impairment===<br /> Dose depend toxicity, avoid large dose.<br /> <br /> ===Renal impairment===<br /> Increase infusion dose interval<br /> <br /> ===Pregnancy===<br /> Not known to be harmful.<br /> <br /> ===Breast-feeding===<br /> Not known to be harmful.<br /> <br /> == FAQ ==<br /> === How should I take the tablet? ===<br /> *Follow the doctor's prescription.<br /> *Take with or without food.<br /> *Take the medication with plenty of water.<br /> *Can be crushed.<br /> <br /> === What should I avoid while taking? ===<br /> *Avoid alcohol consumption.<br /> *Avoid taking more than 4g of [[panadol]] per day.<br /> <br /> === What happens if I overdose? ===<br /> *Emergency situation, called 999 immediately.<br /> *Antidote: N-Acetylsysteine<br /> <br /> === What happen if I miss a dose? ===<br /> *Take it as soon as you remember. <br /> *If it is near the time of the next dose, skip the missed dose. <br /> *Take your next dose at the regular time. Do not double the dose to catch up.</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=Paracetamol&diff=2922 2022-04-04T06:54:07Z

<p>Ctol2: /* Pregnancy */</p> <hr /> <div>[[Category: Drugs]] [[Category: Analgesic, antipyretic]]<br /> '''Paracetamol''' (中文: [[對乙酰氨基]])has analgesic and antipyretic properties. It is given orally or as a rectal suppository for mild to moderate pain and for fever. It may also be given by intravenous infusion for the short-term treatment of moderate pain, particularly after surgery, and of fever. It is often the analgesic or antipyretic of choice, especially in the elderly and in patients in whom salicylates or other anti-inflammatory drugs are contra-indicated. Such patients include asthmatics, those with a history of peptic ulcer and children.<br /> <br /> == Pronunciation ==<br /> === Paracetamol 500mg ===<br /> [[File: Paracetamol 500mg.mp3]]<br /> <br /> ==Drug Names==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name藥名<br /> !HA Code藥物代碼<br /> !Legal Classification藥物分類<br /> |-<br /> |Paracetamol Tablet 500mg<br /> |PARA01<br /> |Non Poison<br /> |-<br /> !Brand Name藥名<br /> !HK Reg Number註冊代碼<br /> !Active Ingredients<br /> |-<br /> |ACEPHEN TAB 300MG<br /> |HK-38754<br /> |Paracetamol<br /> |}<br /> <br /> ==Mechanism of Action==<br /> *Non-opioid Analgesic<br /> *Antipyretic<br /> <br /> ==Dosage==<br /> Adult Oral dose: 0.5 - 1g every 4-6 hrs; max 4g per day<br /> It may be given as suppositories in a rectal dose of 0.5 to 1 g every 4 to 6 hrs, up to 4 times daily.<br /> Infusion dose based on body weight over 15 minutes:<br /> *Over 50 kg, single doses of 1g every 4 -6 hours, to a max of 4g daily<br /> *From 33 to 50 kg, single doses of 15mg/kg every 4 to 6 hours, to a max of 60mg/kg (up to 3 g) daily<br /> <br /> A maximum intravenous dose of 3 g daily should also not be exceed in patients with chronic alcoholism, chronic malnutrition, or dehydration, regardless of their body-weight.<br /> For doses in children, given according to age, every 4 to 6 hours if necessary up to a max of 4 doses in 24 hours, are:<br /> *3 to 6 months: 60 mg<br /> *6 months to 2 years: 120 mg<br /> *2 to 4 years: 180 mg<br /> *4 to 6 years: 240 mg<br /> *6 to 8 years: 240 or 250 mg<br /> *8 to 10 years: 360 or 375 mg<br /> *10 to 12 years: 480 or 500 mg<br /> *12 to 16 years: 480 or 750 mg<br /> <br /> ==Side Effects==<br /> Adverse effects of paracetamol are rare and usually mild, such as mild rashes occur occasionally.<br /> Overdosage with paracetamol (usually &gt;4g/day) can result in severe liver damage. <br /> no major side effect or drug interaction<br /> <br /> ==Pharmacokinetics==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Oral bioavailability<br /> |Paracetamol is readily absorbed from the gastrointestinal tract and is distributed into most body tissues.<br /> It also crosses the placenta and is present in breast milk.<br /> |-<br /> !style=&quot;text-align: left&quot;| Onset of action<br /> |The peak plasma concentrations occur about 10 to 60 minutes after oral doses.<br /> |-<br /> !style=&quot;text-align: left&quot;| Metabolism<br /> |It is metabolized in the liver <br /> |-<br /> !style=&quot;text-align: left&quot;| Elimination half-life<br /> |The elimination half-life varies from 1 to 3 hours.<br /> |}<br /> <br /> ==Drug Management==<br /> ===Monitoring===<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Efficiency<br /> |Management of Mild to Moderate Pain<br /> |-<br /> !style=&quot;text-align: left&quot;| Safety<br /> |Routine liver function test<br /> |-<br /> !style=&quot;text-align: left&quot;| Caution<br /> |Patient with chronic alcoholism, chronic malnutrition or dehydration. <br /> |}<br /> <br /> Overdosage with paracetamol (usually &gt;4g/day) can result in severe liver damage. Prompt treatment with acetylcysteine or methionine is essential.<br /> <br /> ===Drug interaction===<br /> no significant interaction with other medication,<br /> Use with caution when combine with medication that metabolize in the liver.<br /> <br /> ===Caution===<br /> Alcohol dependence, hepatocellular insufficiency, chronic malnutrition, chronic alcoholism and dehydration<br /> <br /> ===Hepatic impairment===<br /> Dose depend toxicity, avoid large dose.<br /> <br /> ===Renal impairment===<br /> Increase infusion dose interval<br /> <br /> ===Pregnancy===<br /> Not known to be harmful.<br /> <br /> ===Breast-feeding===<br /> not known to be harmful.<br /> <br /> == FAQ ==<br /> === How should I take the tablet? ===<br /> *Follow the doctor's prescription.<br /> *Take with or without food.<br /> *Take the medication with plenty of water.<br /> *Can be crushed.<br /> <br /> === What should I avoid while taking? ===<br /> *Avoid alcohol consumption.<br /> *Avoid taking more than 4g of [[panadol]] per day.<br /> <br /> === What happens if I overdose? ===<br /> *Emergency situation, called 999 immediately.<br /> *Antidote: N-Acetylsysteine<br /> <br /> === What happen if I miss a dose? ===<br /> *Take it as soon as you remember. <br /> *If it is near the time of the next dose, skip the missed dose. <br /> *Take your next dose at the regular time. Do not double the dose to catch up.</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=Paracetamol&diff=2921 2022-04-04T06:46:45Z

<p>Ctol2: /* side effects */</p> <hr /> <div>[[Category: Drugs]] [[Category: Analgesic, antipyretic]]<br /> '''Paracetamol''' (中文: [[對乙酰氨基]])has analgesic and antipyretic properties. It is given orally or as a rectal suppository for mild to moderate pain and for fever. It may also be given by intravenous infusion for the short-term treatment of moderate pain, particularly after surgery, and of fever. It is often the analgesic or antipyretic of choice, especially in the elderly and in patients in whom salicylates or other anti-inflammatory drugs are contra-indicated. Such patients include asthmatics, those with a history of peptic ulcer and children.<br /> <br /> == Pronunciation ==<br /> === Paracetamol 500mg ===<br /> [[File: Paracetamol 500mg.mp3]]<br /> <br /> ==Drug Names==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name藥名<br /> !HA Code藥物代碼<br /> !Legal Classification藥物分類<br /> |-<br /> |Paracetamol Tablet 500mg<br /> |PARA01<br /> |Non Poison<br /> |-<br /> !Brand Name藥名<br /> !HK Reg Number註冊代碼<br /> !Active Ingredients<br /> |-<br /> |ACEPHEN TAB 300MG<br /> |HK-38754<br /> |Paracetamol<br /> |}<br /> <br /> ==Mechanism of Action==<br /> *Non-opioid Analgesic<br /> *Antipyretic<br /> <br /> ==Dosage==<br /> Adult Oral dose: 0.5 - 1g every 4-6 hrs; max 4g per day<br /> It may be given as suppositories in a rectal dose of 0.5 to 1 g every 4 to 6 hrs, up to 4 times daily.<br /> Infusion dose based on body weight over 15 minutes:<br /> *Over 50 kg, single doses of 1g every 4 -6 hours, to a max of 4g daily<br /> *From 33 to 50 kg, single doses of 15mg/kg every 4 to 6 hours, to a max of 60mg/kg (up to 3 g) daily<br /> <br /> A maximum intravenous dose of 3 g daily should also not be exceed in patients with chronic alcoholism, chronic malnutrition, or dehydration, regardless of their body-weight.<br /> For doses in children, given according to age, every 4 to 6 hours if necessary up to a max of 4 doses in 24 hours, are:<br /> *3 to 6 months: 60 mg<br /> *6 months to 2 years: 120 mg<br /> *2 to 4 years: 180 mg<br /> *4 to 6 years: 240 mg<br /> *6 to 8 years: 240 or 250 mg<br /> *8 to 10 years: 360 or 375 mg<br /> *10 to 12 years: 480 or 500 mg<br /> *12 to 16 years: 480 or 750 mg<br /> <br /> ==Side Effects==<br /> Adverse effects of paracetamol are rare and usually mild, such as mild rashes occur occasionally.<br /> Overdosage with paracetamol (usually &gt;4g/day) can result in severe liver damage. <br /> no major side effect or drug interaction<br /> <br /> ==Pharmacokinetics==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Oral bioavailability<br /> |Paracetamol is readily absorbed from the gastrointestinal tract and is distributed into most body tissues.<br /> It also crosses the placenta and is present in breast milk.<br /> |-<br /> !style=&quot;text-align: left&quot;| Onset of action<br /> |The peak plasma concentrations occur about 10 to 60 minutes after oral doses.<br /> |-<br /> !style=&quot;text-align: left&quot;| Metabolism<br /> |It is metabolized in the liver <br /> |-<br /> !style=&quot;text-align: left&quot;| Elimination half-life<br /> |The elimination half-life varies from 1 to 3 hours.<br /> |}<br /> <br /> ==Drug Management==<br /> ===Monitoring===<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Efficiency<br /> |Management of Mild to Moderate Pain<br /> |-<br /> !style=&quot;text-align: left&quot;| Safety<br /> |Routine liver function test<br /> |-<br /> !style=&quot;text-align: left&quot;| Caution<br /> |Patient with chronic alcoholism, chronic malnutrition or dehydration. <br /> |}<br /> <br /> Overdosage with paracetamol (usually &gt;4g/day) can result in severe liver damage. Prompt treatment with acetylcysteine or methionine is essential.<br /> <br /> ===Drug interaction===<br /> no significant interaction with other medication,<br /> Use with caution when combine with medication that metabolize in the liver.<br /> <br /> ===Caution===<br /> Alcohol dependence, hepatocellular insufficiency, chronic malnutrition, chronic alcoholism and dehydration<br /> <br /> ===Hepatic impairment===<br /> Dose depend toxicity, avoid large dose.<br /> <br /> ===Renal impairment===<br /> Increase infusion dose interval<br /> <br /> ===Pregnancy===<br /> not known to be harmful.<br /> <br /> ===Breast-feeding===<br /> not known to be harmful.<br /> <br /> == FAQ ==<br /> === How should I take the tablet? ===<br /> *Follow the doctor's prescription.<br /> *Take with or without food.<br /> *Take the medication with plenty of water.<br /> *Can be crushed.<br /> <br /> === What should I avoid while taking? ===<br /> *Avoid alcohol consumption.<br /> *Avoid taking more than 4g of [[panadol]] per day.<br /> <br /> === What happens if I overdose? ===<br /> *Emergency situation, called 999 immediately.<br /> *Antidote: N-Acetylsysteine<br /> <br /> === What happen if I miss a dose? ===<br /> *Take it as soon as you remember. <br /> *If it is near the time of the next dose, skip the missed dose. <br /> *Take your next dose at the regular time. Do not double the dose to catch up.</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=Diazepam&diff=2732 2020-10-20T06:54:42Z

<p>Ctol2: /* Drug Management */</p> <hr /> <div>[[Category: Drugs]][[Category:benzodiazepine]]<br /> '''Diazepam''' (中文: [[地西泮]]) is a long-acting benzodiazepine with anticonvulsant, anxiolytic, sedative, muscle relaxant properties. It is used:<br /> *In the short-term treatment of severe anxiety disorders;<br /> *As a hypnotic in the short-term treatment of insomnia;<br /> *As a sedative<br /> *As an anticonvulsant (particularly in the management of status epilepticus and febrile convulsions)<br /> *In the control of muscle spasms<br /> *In the management of alcohol, or benzodiazepine withdrawal syndrome.<br /> <br /> ==Pronunciation==<br /> ===Diazepam 2mg===<br /> [[File:Diazepam 2mg.mp3]]<br /> <br /> ===Diazepam 5mg===<br /> [[File:Diazepam 5mg.mp3]]<br /> <br /> ==Drug Names==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification藥物分類<br /> |-<br /> |Diazepam Tablet 2 mg<br /> |DIAZ01<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |-<br /> |Diazepam Tablet 5 mg<br /> |DIAZ02<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |-<br /> |Diazepam Rectal Solution 2mg/ml (2.5ml/tube)<br /> |DIAZ10<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |-<br /> |Diazepam Rectal Solution 4mg/ml (2.5ml/tube)<br /> |DIAZ11<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |}<br /> <br /> ==Mechanism of Action==<br /> *Diazepam is a benzodiazepine. <br /> *Gama-Aminobutyric acid (GABA) is an inhibitory neurotransmitter, acting on the GABA receptors in the central nervous system (CNS), thus inhibiting the nerve impulses. <br /> *It acts on the benzodiazepine receptors in the brain and the spinal cord. Benzodiazepine receptors in the CNS are linked with GABA receptors as a complex. <br /> *Diazepam by binding to the benzodiazepine receptors results in activation of the GABA-benzodiazepine receptor complex, resulting in inhibition of nerve impulses, overall depression of brain and spinal cord.<br /> *Thus, Diazepam helps to promote muscle relaxation, reduce anxiety, control of convulsions and promote sleep.<br /> <br /> ==Dosage==<br /> *Diazepam is administered orally, rectally, and parenterally with the risk of dependence very much influencing the dose and duration of treatment.<br /> *Courses of treatment should be short, not normally exceeding 4 weeks, with diazepam being withdrawal gradually.<br /> *Elderly and debilitated patients should be given not more than one-half the usual adult dose<br /> <br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Anxiety<br /> |By ''mouth<br /> ADULT: <br /> *2 mg three times a day, then increased if necessary, to<br /> *15 – 30 mg daily in divided doses.<br /> ELDERLY: <br /> *1 mg three times a day, then increased if necessary to<br /> *7.5 – 15 mg daily in divided doses.<br /> Debilitated patients: use elderly dose<br /> |-<br /> !style=&quot;text-align: left&quot;| Insomnia associated with anxiety<br /> |By ''mouth<br /> ADULT: <br /> <br /> 5 – 15mg daily, to be taken at bedtime<br /> |-<br /> !style=&quot;text-align: left&quot;| For premedicationbefore general anaesthesia <br /> | By ''mouth<br /> ADULT: <br /> <br /> 5 – 10mg, to be given 1-2 hours before procedure<br /> ELDERLY: <br /> 2.5 – 5 mg, to be given 1-2 hours before procedure<br /> Debilitated patients: use elderly dose<br /> |-<br /> !style=&quot;text-align: left&quot;| For sedation during minor surgery<br /> |By ''mouth<br /> ADULT: <br /> <br /> Up to 20mg, to be given 1-2 hours before procedure<br /> |-<br /> !style=&quot;text-align: left&quot;| Status epilepticus<br /> <br /> Febrile convulsions<br /> <br /> Convulsions due to poisoning<br /> | By ''rectum<br /> CHILD 1 month – 1 years: 5 mg, then 5 mg after 10 minutes if required.<br /> <br /> CHILD 2 – 11 years: 5 – 10 mg, the 5 – 10 mg after 10 minutes if required.<br /> <br /> CHILD 12 – 17 years: 10 – 20 mg, then 10 – 20 mg after 10 minutes if required<br /> ADULT: <br /> <br /> 10 – 20 mg, then 10 – 20 mg after 10 – 15 minutes if required<br /> ELDERLY: <br /> 10mg, then 10 mg after 10 – 15 minutes if required<br /> |-<br /> !style=&quot;text-align: left&quot;| Dyspnoea associated with anxiety in palliative care<br /> | By ''mouth<br /> ADULTS:<br /> 5 – 10mg daily<br /> |-<br /> !style=&quot;text-align: left&quot;| Pain of muscle spasm in palliative care<br /> | By ''mouth<br /> ADULTS:<br /> 5 – 10mg daily<br /> |-<br /> !style=&quot;text-align: left&quot;| Muscle spasm<br /> | By ''mouth<br /> ADULTS:<br /> 2 – 15mg daily in divided doses, then increased if necessary to 60 mg daily.<br /> |-<br /> !style=&quot;text-align: left&quot;| Alcohol withdrawal syndrome<br /> | By ''mouth<br /> ADULTS:<br /> *5 to 20 mg, repeated if necessary after 2 to 4 hours;<br /> *Or 10 mg three or four times on the first day, reducing to<br /> *5 mg three or four times daily as required.<br /> |}<br /> <br /> Diazepam is rarely used for the long-term treatment of epilepsy because tolerance to its anticonvulsant effects usually develops within 6 to 12 months of treatment. Effectively rendering it useless for that purpose.<br /> <br /> ==Side Effects==<br /> <br /> Sedative drugs, including alprazolam, have been associated with an increased risk of death.<br /> <br /> Possible side effects include:<br /> <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Very common (&gt;10% of incidence) <br /> or Common(1-10% of incidence)<br /> |<br /> *Shakiness and unsteady walk (especially in the elderly)<br /> *Trembling, and other problems with muscle control or coordination<br /> *Confusion (especially in the elderly)<br /> *Amnesia<br /> *Drowsiness the next day<br /> *sedation<br /> *Muscle weakness<br /> *Paradoxical increase in aggression<br /> |-<br /> !style=&quot;text-align: left&quot;| Infrequent (0.1 -1% of incidence)<br /> |<br /> *Dysarthria<br /> *Gastro-intestinal disturbances<br /> *Gynaecomastia<br /> *Low blood pressure<br /> *Incontinence<br /> *Urinary retention<br /> *Slurred speech<br /> *Tremor<br /> *Vertigo<br /> *Visual disturbances<br /> |-<br /> !style=&quot;text-align: left&quot;| Rare (&lt;0.1% of incidence)<br /> |<br /> *Apnoea<br /> *Blood disorders<br /> *Jaundice<br /> *Respiratory depression<br /> *hypersensitivity reactions<br /> *suicidal ideation<br /> |}<br /> <br /> '''Overdosage''' can produce CNS depression and coma.<br /> <br /> '''Paradoxical reactions (the opposite of what is to be expected) may occur'''. Symptoms include<br /> *aggression, rage<br /> *mania, agitation, and restlessness<br /> *hallucinations, inappropriate behavior<br /> *twitches and tremor<br /> <br /> ==Pharmacokinetics==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Oral bioavailability<br /> |Diazepam is well absorbed after oral doses.<br /> |-<br /> !style=&quot;text-align: left&quot;| Onset of action<br /> |Peak plasma concentrations occur between 30 and 90 minutes after an oral dose; and after 10 to 30 minutes when given as a rectal solution.<br /> |-<br /> !style=&quot;text-align: left&quot;| Metabolism<br /> |Diazepam is metabolized in the liver by the cytochrome P450 enzyme system. It has several active metabolites. Because of these active metabolites, the serum diazepam levels alone are not useful in predicting the effects of the drug. <br /> |-<br /> !style=&quot;text-align: left&quot;| Elimination half-life<br /> |<br /> Diazepam is excreted in the urine. <br /> The half-life of diazepam in general is 30 – 56 hours.<br /> Diazepam has a biphasic half-life of about 1 to 2 days, and 2 to 5 days for its principal active metabolite. <br /> The elimination half-life of diazepam and also the active metabolite increases significantly in the elderly, which may result in prolonged action and accumulation of the drug in the body. <br /> |}<br /> <br /> ==Drug Management==<br /> ====Monitoring====<br /> *Blood pressure, pulse and respiratory rate are recommended<br /> *Elderly may be sensitivity to diazepam’s effects. Impairment of memory, cognitive function, and psychomotor performance and behavior disinhibition may be common. Long-term use commonly exacerbates underlying dementia in elderly patients.<br /> *Diazepam may make elderly patients feel dizzy, increasing risk of falls, so fall prevention is needed<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended<br /> *changes in mood, the development or worsening depression, and/or any thoughts or behaviour of suicide.<br /> <br /> ===Dependence and Withdrawal===<br /> *One-third of individuals treated with benzodiazepines for longer than 4 weeks develop a dependence on the drug and experience a withdrawal syndrome on cessation.<br /> *Withdrawal symptoms can range from insomnia and anxiety to more serious symptoms, including seizures and psychosis.<br /> *Diazepam should therefore be withdrawn by tapering the dose to minimize occurrence of withdrawal symptoms. <br /> *Tolerance develops to the anticonvulsant effects of diazepam. <br /> <br /> ===Drug interaction===<br /> Medicines that interact with diazepam may either <br /> *Decrease its effect<br /> *Affect how long it works for<br /> *Increase side effects<br /> <br /> Common medications that may interact with diazepam include:<br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Drugs given with diazepam<br /> !style=&quot;text-align: left&quot;| Potential Effect<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *Alcohol, <br /> *Hypnotics / sedative (e.g. [[barbiturates]])<br /> *Antidepressants (e.g. [[fluoxetine]], [[amitriptyline]])<br /> *Sedative histamines (e.g. [[promethazine]])<br /> *Antipsychotic (e.g. [[chlorpromazine]], [[clozapine]])<br /> |May worsens the side effects such as drowsiness , dizziness and respiratory depression<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *[[Cimetidine]]<br /> *[[Omeprazole]]<br /> *[[Oxcarbazepine]], [[Topiramate]], [[Valproate]]<br /> *[[Ketoconazole]]<br /> *[[Itraconazole]]<br /> *[[Isoniazid]]<br /> *[[Erythromycin]], [[Ciprofloxacin]]<br /> *[[Propranolol]]<br /> *[[Fluoxetine]]<br /> |'''Prolong the action''' of diazepam by inhibiting its elimination<br /> |-<br /> |style=&quot;text-align: left&quot;| Alcohol <br /> |May cause a synergistic enhancement of the hypotensive effect of diazepam and alcohol<br /> |-<br /> |style=&quot;text-align: left&quot;| Oral contraceptives<br /> |Oral contraceptives significant decrease the elimination of diazepam, so '''prolong the action of diazepam'''<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *[[Rifampicin]]<br /> *[[Phenytoin]]<br /> *[[Carbamazepine]]<br /> *[[Phenobarbitone]]<br /> |All these drugs increase the metabolism of diazepam, thus decreasing drug levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *Steroid (e.g. [[Dexamethasone]])<br /> *St John’s wort<br /> |Increase the metabolism of diazepam, thus decreasing diazepam plasma levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| [[Theophylline]]<br /> |May inhibit the action of diazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| [[Levodopa]] (e.g. [[Sinemet]])<br /> |Diazepam may block the action of levodopa used in the treatment of Parkinson’s disease.<br /> |-<br /> |style=&quot;text-align: left&quot;|<br /> Foods that acidify the urine <br /> <br /> Food that alkalinize the urine<br /> |Can lead to faster absorption and elimination of diazepam, reducing drug levels and effects.<br /> Can lead to slower absorption and elimination of diazepam, increasing the diazepam plasma levels and effects.<br /> |}<br /> <br /> ===Caution===<br /> *particular care in pregnancy, <br /> *elderly, due to increased susceptibility to side-effects, especially loss of coordination and drowsiness<br /> *in patients with hepatic or renal impairment, who may require reduced doses<br /> *people with history of alcohol dependence or abuse<br /> *people with history of drug dependence or abuse<br /> *people with psychiatric disorders<br /> *avoid prolonged use and abrupt withdrawal thereafter<br /> <br /> ===Contra-indications===<br /> Use of diazepam should be avoided, when possible, in individuals with: <br /> *severe hepatic impairment<br /> *sleep apnoea <br /> *chronic obstructive airways disease (COPD) <br /> *Myasthenia gravis<br /> *Acute narrow-angle glaucoma<br /> *Chronic schizophrenia<br /> <br /> ===Hepatic impairment===<br /> *Start with smaller initial doses or reduce dose.<br /> *Can precipitate coma.<br /> *Avoid in severe impairment.<br /> <br /> ===Renal impairment===<br /> *Start with small doses in severe impairment.<br /> <br /> ===Pregnancy===<br /> Possible adverse effects of use of benzodiazepines such as diazepam during pregnancy include: miscarriage, malformation, intrauterine growth retardation, and function deficits. <br /> <br /> ===Breast-feeding===<br /> Use during breast feeding is not recommended.<br /> <br /> ===Driving and skilled tasks===<br /> May impair judgment and increase reaction time, and so affect ability to drive or operate machinery. Patients should be warned not to operate dangerous machinery or motor vehicles until it is known that they do not become drowsy from diazepam therapy.<br /> <br /> == FAQ ==<br /> === How should I take the tablet? ===<br /> May be taken with or without food. Swallow whole with a glass of water.<br /> === What should I avoid while taking? ===<br /> Do not eat grapefruit or drink grapefruit juice as it may increase blood levels of diazepam. <br /> <br /> Avoid drinking alcohol while taking diazepam because it may enhance the side effects of sedation and respiratory depression. <br /> <br /> Avoid driving or hazardous activity until you know how diazepam will affect you. <br /> ==== What happen if I overdose? ====<br /> Contact your primary care doctor.<br /> If emergency situation, call 999<br /> ==== What happen if I miss a dose? ====<br /> Take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=Nitrazepam&diff=2719 2020-10-20T06:33:21Z

<p>Ctol2: /* What happen if I overdose? */</p> <hr /> <div>[[Category: Drugs]][[Category: benzodiazepine]]<br /> '''Nitrazepam''' (中文:[[硝西泮]]) is a long-acting benzodiazepine. It is used as a hypnotic in the short-term management of insomnia. It is reported to act in 30 to 60 minutes to produce sleep lasting for 6 to 8 hours.<br /> <br /> ==Drug Names==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam Tablet 5 mg<br /> |NITR01<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |}<br /> <br /> ==Mechanism of Action==<br /> *Nitrazepam is a benzodiazepine. <br /> *Gama-Aminobutyric acid (GABA) is an inhibitory neurotransmitter, acting on the GABA receptors in the central nervous system (CNS), inducing sleepiness, muscular relaxation, and control of anxiety and seizures.<br /> *Nitrazepam acts on the benzodiazepine receptors in the brain and the spinal cord. Benzodiazepine receptors in the CNS are linked with GABA receptors as a complex. <br /> *Nitrazepam by binding to the benzodiazepine receptors results in activation of the GABA-benzodiazepine receptor complex.<br /> *Thus, Nitrazepam helps to promote muscle relaxation, reduce anxiety, control of convulsions and promote sleep.<br /> <br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Insomnia (short-term use)<br /> |''Oral''<br /> *ADULT: 5 – 10 mg daily, to be taken at bedtime.<br /> *ELDERLY: 2.5 – 5 mg daily, to be taken at bedtime.<br /> |}<br /> <br /> Benzodiazepines are sometimes used in the management of epilepsy, but their long-term use is limited by problems of sedation, dependence, and tolerance to the antiepileptic effects. <br /> <br /> Nitrazepam has been used in the treatment of infantile spasms (as for example in West’s syndrome) and the so-called infantile myoclonic seizures.<br /> <br /> Usual oral dose: 0.3 to 1 mg/kg daily in 3 divided doses.<br /> <br /> ==Side Effects==<br /> Nitrazepam is an unsuitable hypnotic for the elderly as it causes:<br /> <br /> *Impairments in body balance and standing steadiness in individuals who wake up at night; <br /> *As a result, leading to falls and hip fractures;<br /> *It induces general mental deterioration;<br /> *Inability to walk;<br /> *Incontinence;<br /> *Confusion and disorientation.<br /> <br /> The nitrazepam-induced symptoms can lead to a misdiagnosis of dementia. <br /> <br /> Elderly are more likely to experience sedation and decreased coordination. The lowest effective dose of nitrazepam should be used for the shortest possible length of time. <br /> <br /> Possible side effects include: <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Very common (&gt;10% of incidence) <br /> or '''Common'''(1-10% of incidence)<br /> |<br /> *Shakiness and unsteady walk (especially in the elderly)<br /> *Trembling, , impairment of muscle functions or coordination<br /> *Confusion (especially in the elderly)<br /> *Amnesia(impairment of memory)<br /> *Drowsiness the next day<br /> *Numbed emotions<br /> *Reduced alertness<br /> *Muscle weakness<br /> *Paradoxical increase in aggression<br /> |-<br /> !style=&quot;text-align: left&quot;| Infrequent (0.1 -1% of incidence)<br /> |<br /> *Dysarthria<br /> *Hypotension<br /> *hypothermia<br /> *Gastro-intestinal disturbances<br /> *Gynaecomastia<br /> *Low blood pressure<br /> *Incontinence<br /> *Drooling, impaired swallowing and aspiration pneumonia<br /> *Slurred speech<br /> *Tremor<br /> *Vertigo<br /> *Visual disturbances<br /> |-<br /> !style=&quot;text-align: left&quot;| Rare (&lt;0.1% of incidence)<br /> |<br /> *Apnoea<br /> *Blood disorders<br /> *Jaundice<br /> *Respiratory depression<br /> *hypersensitivity reactions<br /> |}<br /> <br /> '''Overdosage''' can produce CNS depression and coma.<br /> <br /> '''Paradoxical reactions (the opposite of what is to be expected) may occur'''. Symptoms include<br /> *Aggression, rage;<br /> *Mania, agitation, and restlessness;<br /> *Hallucinations, inappropriate behavior;<br /> *Twitches and tremor.<br /> <br /> ==Pharmacokinetics==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Oral bioavailability<br /> |Nitrazepam is well absorbed after oral doses.<br /> |-<br /> !style=&quot;text-align: left&quot;| Onset of action<br /> |Peak plasma concentrations occur about 2 to 3 hours after ingestion.<br /> |-<br /> !style=&quot;text-align: left&quot;| Metabolism<br /> |Nitrazepam is metabolized in the liver, mediated by the cytochrome P450 system. <br /> |-<br /> !style=&quot;text-align: left&quot;| Elimination half-life<br /> |<br /> Nitrazepam is excreted in the urine. Up to about 20% of an oral dose is found in the faeces.<br /> <br /> The half-life of nitrazepam is between 16.5 and 48.3 hours. In young people, nitrazepam has a half-life of about 29 hours, and a much longer half-life of 40 hours in the elderly.<br /> <br /> Nitrazepam’s half-life in the cerebrospinal fluid, 68 hours, indicates its extremely slow elimination from the cerebrospinal fluid.<br /> |}<br /> <br /> ==Drug Management==<br /> ====Monitoring====<br /> *Blood pressure, pulse and respiratory rate are recommended.<br /> *Elderly may be sensitivity to nitrazepam’s effects. Impairment of memory, cognitive function, and psychomotor performance and behavior disinhibition may be common. Long-term use commonly exacerbates underlying dementia in elderly patients.<br /> *Nitrazepam may make elderly patients feel dizzy, increasing risk of falls, so fall prevention is needed.<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended.<br /> *changes in mood, the development or worsening depression, and/or any thoughts or behaviour of suicide.<br /> <br /> ===Dependence and Withdrawal===<br /> *One-third of individuals treated with benzodiazepines for longer than 4 weeks develop a dependence on the drug and experience a withdrawal syndrome on cessation.<br /> *Withdrawal symptoms can range from insomnia and anxiety to more serious symptoms, including seizures and psychosis.<br /> *Nitrazepam should therefore be withdrawn by tapering the dose to minimize occurrence of withdrawal symptoms. <br /> *Tolerance to the sleep-inducing effects of nitrazepam occurs after 7 days. <br /> <br /> ===Drug interaction=== <br /> Medicines that interact with nitrazepam may either <br /> *Decrease its effect<br /> *Affect how long it works for<br /> *Increase side effects<br /> <br /> Common medications that may interact with nitrazepam include:<br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Drugs given with nitrazepam<br /> !style=&quot;text-align: left&quot;| Potential Effect<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *Alcohol, <br /> *Hypnotics / sedative (e.g. [[barbiturates]])<br /> *Antidepressants (e.g. [[fluoxetine]], [[citalopram]], [[paroxetine]], [[sertraline]], [[amitriptyline]])<br /> *Sedative histamines (e.g. [[chlorpheniramine]], [[dimenhydrinate]], [[diphenhydramine]])<br /> *Antipsychotic (e.g. [[chlorpromazine]], [[clozapine]], [[haloperidol]], [[clozapine]], [[quetiapine]], [[risperidone]])<br /> |May worsens the side effects such as drowsiness , dizziness and respiratory depression<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *[[Cimetidine]]<br /> *[[Omeprazole]]<br /> *[[Oxcarbazepine]], [[Topiramate]], [[Valproate]]<br /> *[[Ketoconazole]]<br /> *[[Itraconazole]]<br /> *[[Isoniazid]]<br /> *[[Erythromycin]], [[ciprofloxacin]]<br /> *[[Propranolol]]<br /> *[[Fluoxetine]]<br /> |Prolong the action of nitrazepam by inhibiting its elimination<br /> |-<br /> |style=&quot;text-align: left&quot;| Alcohol <br /> |May cause a synergistic enhancement of the hypotensive effect of nitrazepam and alcohol<br /> |-<br /> |style=&quot;text-align: left&quot;| Oral contraceptives<br /> |Oral contraceptives significant decrease the elimination of nitrazepam, so prolong the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *[[Rifampicin]]<br /> *[[Phenytoin]]<br /> *[[Carbamazepine]]<br /> *[[Phenobarbitone]]<br /> |All these drugs increase the metabolism of nitrazepam, thus decreasing drug levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *Steroid (e.g. [[Dexamethasone]])<br /> *St John’s wort<br /> |Increase the metabolism of nitrazepam, thus decreasing nitrazepam plasma levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| [[Theophylline]]<br /> |May inhibit the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| [[Levodopa]] (e.g. [[Sinemet]])<br /> |nitrazepam may block the action of levodopa used in the treatment of Parkinson’s disease.<br /> |}<br /> <br /> ===Caution=== <br /> *Particular care in pregnancy, <br /> *Elderly, due to increased susceptibility to side-effects, especially loss of coordination and drowsiness<br /> *In patients with hepatic or renal impairment, who may require reduced doses<br /> *People with history of alcohol dependence or abuse<br /> *People with history of drug dependence or abuse<br /> *People with psychiatric disorders<br /> *Avoid prolonged use and abrupt withdrawal thereafter<br /> <br /> ===Contra-indications===<br /> Use of nitrazepam should be avoided, when possible, in individuals with: <br /> *Severe hepatic impairment<br /> *Sleep apnoea <br /> *Chronic obstructive airways disease (COPD) <br /> *Myasthenia gravis<br /> *Acute narrow-angle glaucoma<br /> *Chronic schizophrenia<br /> Nitrazepam is recommended to be avoided in patients who drive or operate machinery, as it can impaired driving skills up to 17 hours after dosing.<br /> <br /> ===Hepatic impairment===<br /> *Start with smaller initial doses or reduce dose.<br /> *Can precipitate coma.<br /> *Avoid in severe impairment.<br /> <br /> ===Renal impairment===<br /> Start with small doses in severe impairment.<br /> <br /> ===Pregnancy===<br /> Possible adverse effects of use of benzodiazepines during pregnancy include: miscarriage, malformation, intrauterine growth retardation, and function deficits. <br /> <br /> ===Breast-feeding===<br /> Use during breast feeding is not recommended.<br /> <br /> ===Driving and skilled tasks===<br /> May impair judgment and increase reaction time, and so affect ability to drive or operate machinery. Moreover the hangover effects of a night dose may impair driving on the following day.<br /> <br /> == FAQ ==<br /> === How should I take the tablet? ===<br /> The lowest effective dose should be used to avoid excessive drowsiness during the day time or motor impairment. This medication is used for a short period of time or as an “as required” medication. Swallow the tablet whole with a glass of water at bedtime.<br /> === What should I avoid while taking? ===<br /> Do not eat grapefruit or drink grapefruit juice as it may increase blood levels of nitrazepam. <br /> <br /> Avoid drinking alcohol while taking nitrazepam because it may enhance the side effects of sedation and respiratory depression.<br /> <br /> Avoid driving or hazardous activity while you are taking nitrazepam. <br /> ==== What happen if I overdose? ====<br /> Contact your primary care doctor.<br /> If emergency situation, call 999.<br /> <br /> ==== What happen if I miss a dose? ====<br /> Take it as soon as you <br /> remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=Nitrazepam&diff=2718 2020-10-20T06:33:10Z

<p>Ctol2: /* Renal impairment */</p> <hr /> <div>[[Category: Drugs]][[Category: benzodiazepine]]<br /> '''Nitrazepam''' (中文:[[硝西泮]]) is a long-acting benzodiazepine. It is used as a hypnotic in the short-term management of insomnia. It is reported to act in 30 to 60 minutes to produce sleep lasting for 6 to 8 hours.<br /> <br /> ==Drug Names==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam Tablet 5 mg<br /> |NITR01<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |}<br /> <br /> ==Mechanism of Action==<br /> *Nitrazepam is a benzodiazepine. <br /> *Gama-Aminobutyric acid (GABA) is an inhibitory neurotransmitter, acting on the GABA receptors in the central nervous system (CNS), inducing sleepiness, muscular relaxation, and control of anxiety and seizures.<br /> *Nitrazepam acts on the benzodiazepine receptors in the brain and the spinal cord. Benzodiazepine receptors in the CNS are linked with GABA receptors as a complex. <br /> *Nitrazepam by binding to the benzodiazepine receptors results in activation of the GABA-benzodiazepine receptor complex.<br /> *Thus, Nitrazepam helps to promote muscle relaxation, reduce anxiety, control of convulsions and promote sleep.<br /> <br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Insomnia (short-term use)<br /> |''Oral''<br /> *ADULT: 5 – 10 mg daily, to be taken at bedtime.<br /> *ELDERLY: 2.5 – 5 mg daily, to be taken at bedtime.<br /> |}<br /> <br /> Benzodiazepines are sometimes used in the management of epilepsy, but their long-term use is limited by problems of sedation, dependence, and tolerance to the antiepileptic effects. <br /> <br /> Nitrazepam has been used in the treatment of infantile spasms (as for example in West’s syndrome) and the so-called infantile myoclonic seizures.<br /> <br /> Usual oral dose: 0.3 to 1 mg/kg daily in 3 divided doses.<br /> <br /> ==Side Effects==<br /> Nitrazepam is an unsuitable hypnotic for the elderly as it causes:<br /> <br /> *Impairments in body balance and standing steadiness in individuals who wake up at night; <br /> *As a result, leading to falls and hip fractures;<br /> *It induces general mental deterioration;<br /> *Inability to walk;<br /> *Incontinence;<br /> *Confusion and disorientation.<br /> <br /> The nitrazepam-induced symptoms can lead to a misdiagnosis of dementia. <br /> <br /> Elderly are more likely to experience sedation and decreased coordination. The lowest effective dose of nitrazepam should be used for the shortest possible length of time. <br /> <br /> Possible side effects include: <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Very common (&gt;10% of incidence) <br /> or '''Common'''(1-10% of incidence)<br /> |<br /> *Shakiness and unsteady walk (especially in the elderly)<br /> *Trembling, , impairment of muscle functions or coordination<br /> *Confusion (especially in the elderly)<br /> *Amnesia(impairment of memory)<br /> *Drowsiness the next day<br /> *Numbed emotions<br /> *Reduced alertness<br /> *Muscle weakness<br /> *Paradoxical increase in aggression<br /> |-<br /> !style=&quot;text-align: left&quot;| Infrequent (0.1 -1% of incidence)<br /> |<br /> *Dysarthria<br /> *Hypotension<br /> *hypothermia<br /> *Gastro-intestinal disturbances<br /> *Gynaecomastia<br /> *Low blood pressure<br /> *Incontinence<br /> *Drooling, impaired swallowing and aspiration pneumonia<br /> *Slurred speech<br /> *Tremor<br /> *Vertigo<br /> *Visual disturbances<br /> |-<br /> !style=&quot;text-align: left&quot;| Rare (&lt;0.1% of incidence)<br /> |<br /> *Apnoea<br /> *Blood disorders<br /> *Jaundice<br /> *Respiratory depression<br /> *hypersensitivity reactions<br /> |}<br /> <br /> '''Overdosage''' can produce CNS depression and coma.<br /> <br /> '''Paradoxical reactions (the opposite of what is to be expected) may occur'''. Symptoms include<br /> *Aggression, rage;<br /> *Mania, agitation, and restlessness;<br /> *Hallucinations, inappropriate behavior;<br /> *Twitches and tremor.<br /> <br /> ==Pharmacokinetics==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Oral bioavailability<br /> |Nitrazepam is well absorbed after oral doses.<br /> |-<br /> !style=&quot;text-align: left&quot;| Onset of action<br /> |Peak plasma concentrations occur about 2 to 3 hours after ingestion.<br /> |-<br /> !style=&quot;text-align: left&quot;| Metabolism<br /> |Nitrazepam is metabolized in the liver, mediated by the cytochrome P450 system. <br /> |-<br /> !style=&quot;text-align: left&quot;| Elimination half-life<br /> |<br /> Nitrazepam is excreted in the urine. Up to about 20% of an oral dose is found in the faeces.<br /> <br /> The half-life of nitrazepam is between 16.5 and 48.3 hours. In young people, nitrazepam has a half-life of about 29 hours, and a much longer half-life of 40 hours in the elderly.<br /> <br /> Nitrazepam’s half-life in the cerebrospinal fluid, 68 hours, indicates its extremely slow elimination from the cerebrospinal fluid.<br /> |}<br /> <br /> ==Drug Management==<br /> ====Monitoring====<br /> *Blood pressure, pulse and respiratory rate are recommended.<br /> *Elderly may be sensitivity to nitrazepam’s effects. Impairment of memory, cognitive function, and psychomotor performance and behavior disinhibition may be common. Long-term use commonly exacerbates underlying dementia in elderly patients.<br /> *Nitrazepam may make elderly patients feel dizzy, increasing risk of falls, so fall prevention is needed.<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended.<br /> *changes in mood, the development or worsening depression, and/or any thoughts or behaviour of suicide.<br /> <br /> ===Dependence and Withdrawal===<br /> *One-third of individuals treated with benzodiazepines for longer than 4 weeks develop a dependence on the drug and experience a withdrawal syndrome on cessation.<br /> *Withdrawal symptoms can range from insomnia and anxiety to more serious symptoms, including seizures and psychosis.<br /> *Nitrazepam should therefore be withdrawn by tapering the dose to minimize occurrence of withdrawal symptoms. <br /> *Tolerance to the sleep-inducing effects of nitrazepam occurs after 7 days. <br /> <br /> ===Drug interaction=== <br /> Medicines that interact with nitrazepam may either <br /> *Decrease its effect<br /> *Affect how long it works for<br /> *Increase side effects<br /> <br /> Common medications that may interact with nitrazepam include:<br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Drugs given with nitrazepam<br /> !style=&quot;text-align: left&quot;| Potential Effect<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *Alcohol, <br /> *Hypnotics / sedative (e.g. [[barbiturates]])<br /> *Antidepressants (e.g. [[fluoxetine]], [[citalopram]], [[paroxetine]], [[sertraline]], [[amitriptyline]])<br /> *Sedative histamines (e.g. [[chlorpheniramine]], [[dimenhydrinate]], [[diphenhydramine]])<br /> *Antipsychotic (e.g. [[chlorpromazine]], [[clozapine]], [[haloperidol]], [[clozapine]], [[quetiapine]], [[risperidone]])<br /> |May worsens the side effects such as drowsiness , dizziness and respiratory depression<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *[[Cimetidine]]<br /> *[[Omeprazole]]<br /> *[[Oxcarbazepine]], [[Topiramate]], [[Valproate]]<br /> *[[Ketoconazole]]<br /> *[[Itraconazole]]<br /> *[[Isoniazid]]<br /> *[[Erythromycin]], [[ciprofloxacin]]<br /> *[[Propranolol]]<br /> *[[Fluoxetine]]<br /> |Prolong the action of nitrazepam by inhibiting its elimination<br /> |-<br /> |style=&quot;text-align: left&quot;| Alcohol <br /> |May cause a synergistic enhancement of the hypotensive effect of nitrazepam and alcohol<br /> |-<br /> |style=&quot;text-align: left&quot;| Oral contraceptives<br /> |Oral contraceptives significant decrease the elimination of nitrazepam, so prolong the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *[[Rifampicin]]<br /> *[[Phenytoin]]<br /> *[[Carbamazepine]]<br /> *[[Phenobarbitone]]<br /> |All these drugs increase the metabolism of nitrazepam, thus decreasing drug levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *Steroid (e.g. [[Dexamethasone]])<br /> *St John’s wort<br /> |Increase the metabolism of nitrazepam, thus decreasing nitrazepam plasma levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| [[Theophylline]]<br /> |May inhibit the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| [[Levodopa]] (e.g. [[Sinemet]])<br /> |nitrazepam may block the action of levodopa used in the treatment of Parkinson’s disease.<br /> |}<br /> <br /> ===Caution=== <br /> *Particular care in pregnancy, <br /> *Elderly, due to increased susceptibility to side-effects, especially loss of coordination and drowsiness<br /> *In patients with hepatic or renal impairment, who may require reduced doses<br /> *People with history of alcohol dependence or abuse<br /> *People with history of drug dependence or abuse<br /> *People with psychiatric disorders<br /> *Avoid prolonged use and abrupt withdrawal thereafter<br /> <br /> ===Contra-indications===<br /> Use of nitrazepam should be avoided, when possible, in individuals with: <br /> *Severe hepatic impairment<br /> *Sleep apnoea <br /> *Chronic obstructive airways disease (COPD) <br /> *Myasthenia gravis<br /> *Acute narrow-angle glaucoma<br /> *Chronic schizophrenia<br /> Nitrazepam is recommended to be avoided in patients who drive or operate machinery, as it can impaired driving skills up to 17 hours after dosing.<br /> <br /> ===Hepatic impairment===<br /> *Start with smaller initial doses or reduce dose.<br /> *Can precipitate coma.<br /> *Avoid in severe impairment.<br /> <br /> ===Renal impairment===<br /> Start with small doses in severe impairment.<br /> <br /> ===Pregnancy===<br /> Possible adverse effects of use of benzodiazepines during pregnancy include: miscarriage, malformation, intrauterine growth retardation, and function deficits. <br /> <br /> ===Breast-feeding===<br /> Use during breast feeding is not recommended.<br /> <br /> ===Driving and skilled tasks===<br /> May impair judgment and increase reaction time, and so affect ability to drive or operate machinery. Moreover the hangover effects of a night dose may impair driving on the following day.<br /> <br /> == FAQ ==<br /> === How should I take the tablet? ===<br /> The lowest effective dose should be used to avoid excessive drowsiness during the day time or motor impairment. This medication is used for a short period of time or as an “as required” medication. Swallow the tablet whole with a glass of water at bedtime.<br /> === What should I avoid while taking? ===<br /> Do not eat grapefruit or drink grapefruit juice as it may increase blood levels of nitrazepam. <br /> <br /> Avoid drinking alcohol while taking nitrazepam because it may enhance the side effects of sedation and respiratory depression.<br /> <br /> Avoid driving or hazardous activity while you are taking nitrazepam. <br /> ==== What happen if I overdose? ====<br /> Contact your primary care doctor.<br /> If emergency situation, call 999<br /> ==== What happen if I miss a dose? ====<br /> Take it as soon as you <br /> remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=Nitrazepam&diff=2717 2020-10-20T06:33:01Z

<p>Ctol2: /* Contra-indications */</p> <hr /> <div>[[Category: Drugs]][[Category: benzodiazepine]]<br /> '''Nitrazepam''' (中文:[[硝西泮]]) is a long-acting benzodiazepine. It is used as a hypnotic in the short-term management of insomnia. It is reported to act in 30 to 60 minutes to produce sleep lasting for 6 to 8 hours.<br /> <br /> ==Drug Names==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam Tablet 5 mg<br /> |NITR01<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |}<br /> <br /> ==Mechanism of Action==<br /> *Nitrazepam is a benzodiazepine. <br /> *Gama-Aminobutyric acid (GABA) is an inhibitory neurotransmitter, acting on the GABA receptors in the central nervous system (CNS), inducing sleepiness, muscular relaxation, and control of anxiety and seizures.<br /> *Nitrazepam acts on the benzodiazepine receptors in the brain and the spinal cord. Benzodiazepine receptors in the CNS are linked with GABA receptors as a complex. <br /> *Nitrazepam by binding to the benzodiazepine receptors results in activation of the GABA-benzodiazepine receptor complex.<br /> *Thus, Nitrazepam helps to promote muscle relaxation, reduce anxiety, control of convulsions and promote sleep.<br /> <br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Insomnia (short-term use)<br /> |''Oral''<br /> *ADULT: 5 – 10 mg daily, to be taken at bedtime.<br /> *ELDERLY: 2.5 – 5 mg daily, to be taken at bedtime.<br /> |}<br /> <br /> Benzodiazepines are sometimes used in the management of epilepsy, but their long-term use is limited by problems of sedation, dependence, and tolerance to the antiepileptic effects. <br /> <br /> Nitrazepam has been used in the treatment of infantile spasms (as for example in West’s syndrome) and the so-called infantile myoclonic seizures.<br /> <br /> Usual oral dose: 0.3 to 1 mg/kg daily in 3 divided doses.<br /> <br /> ==Side Effects==<br /> Nitrazepam is an unsuitable hypnotic for the elderly as it causes:<br /> <br /> *Impairments in body balance and standing steadiness in individuals who wake up at night; <br /> *As a result, leading to falls and hip fractures;<br /> *It induces general mental deterioration;<br /> *Inability to walk;<br /> *Incontinence;<br /> *Confusion and disorientation.<br /> <br /> The nitrazepam-induced symptoms can lead to a misdiagnosis of dementia. <br /> <br /> Elderly are more likely to experience sedation and decreased coordination. The lowest effective dose of nitrazepam should be used for the shortest possible length of time. <br /> <br /> Possible side effects include: <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Very common (&gt;10% of incidence) <br /> or '''Common'''(1-10% of incidence)<br /> |<br /> *Shakiness and unsteady walk (especially in the elderly)<br /> *Trembling, , impairment of muscle functions or coordination<br /> *Confusion (especially in the elderly)<br /> *Amnesia(impairment of memory)<br /> *Drowsiness the next day<br /> *Numbed emotions<br /> *Reduced alertness<br /> *Muscle weakness<br /> *Paradoxical increase in aggression<br /> |-<br /> !style=&quot;text-align: left&quot;| Infrequent (0.1 -1% of incidence)<br /> |<br /> *Dysarthria<br /> *Hypotension<br /> *hypothermia<br /> *Gastro-intestinal disturbances<br /> *Gynaecomastia<br /> *Low blood pressure<br /> *Incontinence<br /> *Drooling, impaired swallowing and aspiration pneumonia<br /> *Slurred speech<br /> *Tremor<br /> *Vertigo<br /> *Visual disturbances<br /> |-<br /> !style=&quot;text-align: left&quot;| Rare (&lt;0.1% of incidence)<br /> |<br /> *Apnoea<br /> *Blood disorders<br /> *Jaundice<br /> *Respiratory depression<br /> *hypersensitivity reactions<br /> |}<br /> <br /> '''Overdosage''' can produce CNS depression and coma.<br /> <br /> '''Paradoxical reactions (the opposite of what is to be expected) may occur'''. Symptoms include<br /> *Aggression, rage;<br /> *Mania, agitation, and restlessness;<br /> *Hallucinations, inappropriate behavior;<br /> *Twitches and tremor.<br /> <br /> ==Pharmacokinetics==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Oral bioavailability<br /> |Nitrazepam is well absorbed after oral doses.<br /> |-<br /> !style=&quot;text-align: left&quot;| Onset of action<br /> |Peak plasma concentrations occur about 2 to 3 hours after ingestion.<br /> |-<br /> !style=&quot;text-align: left&quot;| Metabolism<br /> |Nitrazepam is metabolized in the liver, mediated by the cytochrome P450 system. <br /> |-<br /> !style=&quot;text-align: left&quot;| Elimination half-life<br /> |<br /> Nitrazepam is excreted in the urine. Up to about 20% of an oral dose is found in the faeces.<br /> <br /> The half-life of nitrazepam is between 16.5 and 48.3 hours. In young people, nitrazepam has a half-life of about 29 hours, and a much longer half-life of 40 hours in the elderly.<br /> <br /> Nitrazepam’s half-life in the cerebrospinal fluid, 68 hours, indicates its extremely slow elimination from the cerebrospinal fluid.<br /> |}<br /> <br /> ==Drug Management==<br /> ====Monitoring====<br /> *Blood pressure, pulse and respiratory rate are recommended.<br /> *Elderly may be sensitivity to nitrazepam’s effects. Impairment of memory, cognitive function, and psychomotor performance and behavior disinhibition may be common. Long-term use commonly exacerbates underlying dementia in elderly patients.<br /> *Nitrazepam may make elderly patients feel dizzy, increasing risk of falls, so fall prevention is needed.<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended.<br /> *changes in mood, the development or worsening depression, and/or any thoughts or behaviour of suicide.<br /> <br /> ===Dependence and Withdrawal===<br /> *One-third of individuals treated with benzodiazepines for longer than 4 weeks develop a dependence on the drug and experience a withdrawal syndrome on cessation.<br /> *Withdrawal symptoms can range from insomnia and anxiety to more serious symptoms, including seizures and psychosis.<br /> *Nitrazepam should therefore be withdrawn by tapering the dose to minimize occurrence of withdrawal symptoms. <br /> *Tolerance to the sleep-inducing effects of nitrazepam occurs after 7 days. <br /> <br /> ===Drug interaction=== <br /> Medicines that interact with nitrazepam may either <br /> *Decrease its effect<br /> *Affect how long it works for<br /> *Increase side effects<br /> <br /> Common medications that may interact with nitrazepam include:<br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Drugs given with nitrazepam<br /> !style=&quot;text-align: left&quot;| Potential Effect<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *Alcohol, <br /> *Hypnotics / sedative (e.g. [[barbiturates]])<br /> *Antidepressants (e.g. [[fluoxetine]], [[citalopram]], [[paroxetine]], [[sertraline]], [[amitriptyline]])<br /> *Sedative histamines (e.g. [[chlorpheniramine]], [[dimenhydrinate]], [[diphenhydramine]])<br /> *Antipsychotic (e.g. [[chlorpromazine]], [[clozapine]], [[haloperidol]], [[clozapine]], [[quetiapine]], [[risperidone]])<br /> |May worsens the side effects such as drowsiness , dizziness and respiratory depression<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *[[Cimetidine]]<br /> *[[Omeprazole]]<br /> *[[Oxcarbazepine]], [[Topiramate]], [[Valproate]]<br /> *[[Ketoconazole]]<br /> *[[Itraconazole]]<br /> *[[Isoniazid]]<br /> *[[Erythromycin]], [[ciprofloxacin]]<br /> *[[Propranolol]]<br /> *[[Fluoxetine]]<br /> |Prolong the action of nitrazepam by inhibiting its elimination<br /> |-<br /> |style=&quot;text-align: left&quot;| Alcohol <br /> |May cause a synergistic enhancement of the hypotensive effect of nitrazepam and alcohol<br /> |-<br /> |style=&quot;text-align: left&quot;| Oral contraceptives<br /> |Oral contraceptives significant decrease the elimination of nitrazepam, so prolong the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *[[Rifampicin]]<br /> *[[Phenytoin]]<br /> *[[Carbamazepine]]<br /> *[[Phenobarbitone]]<br /> |All these drugs increase the metabolism of nitrazepam, thus decreasing drug levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *Steroid (e.g. [[Dexamethasone]])<br /> *St John’s wort<br /> |Increase the metabolism of nitrazepam, thus decreasing nitrazepam plasma levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| [[Theophylline]]<br /> |May inhibit the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| [[Levodopa]] (e.g. [[Sinemet]])<br /> |nitrazepam may block the action of levodopa used in the treatment of Parkinson’s disease.<br /> |}<br /> <br /> ===Caution=== <br /> *Particular care in pregnancy, <br /> *Elderly, due to increased susceptibility to side-effects, especially loss of coordination and drowsiness<br /> *In patients with hepatic or renal impairment, who may require reduced doses<br /> *People with history of alcohol dependence or abuse<br /> *People with history of drug dependence or abuse<br /> *People with psychiatric disorders<br /> *Avoid prolonged use and abrupt withdrawal thereafter<br /> <br /> ===Contra-indications===<br /> Use of nitrazepam should be avoided, when possible, in individuals with: <br /> *Severe hepatic impairment<br /> *Sleep apnoea <br /> *Chronic obstructive airways disease (COPD) <br /> *Myasthenia gravis<br /> *Acute narrow-angle glaucoma<br /> *Chronic schizophrenia<br /> Nitrazepam is recommended to be avoided in patients who drive or operate machinery, as it can impaired driving skills up to 17 hours after dosing.<br /> <br /> ===Hepatic impairment===<br /> *Start with smaller initial doses or reduce dose.<br /> *Can precipitate coma.<br /> *Avoid in severe impairment.<br /> <br /> ===Renal impairment===<br /> *Start with small doses in severe impairment.<br /> <br /> ===Pregnancy===<br /> Possible adverse effects of use of benzodiazepines during pregnancy include: miscarriage, malformation, intrauterine growth retardation, and function deficits. <br /> <br /> ===Breast-feeding===<br /> Use during breast feeding is not recommended.<br /> <br /> ===Driving and skilled tasks===<br /> May impair judgment and increase reaction time, and so affect ability to drive or operate machinery. Moreover the hangover effects of a night dose may impair driving on the following day.<br /> <br /> == FAQ ==<br /> === How should I take the tablet? ===<br /> The lowest effective dose should be used to avoid excessive drowsiness during the day time or motor impairment. This medication is used for a short period of time or as an “as required” medication. Swallow the tablet whole with a glass of water at bedtime.<br /> === What should I avoid while taking? ===<br /> Do not eat grapefruit or drink grapefruit juice as it may increase blood levels of nitrazepam. <br /> <br /> Avoid drinking alcohol while taking nitrazepam because it may enhance the side effects of sedation and respiratory depression.<br /> <br /> Avoid driving or hazardous activity while you are taking nitrazepam. <br /> ==== What happen if I overdose? ====<br /> Contact your primary care doctor.<br /> If emergency situation, call 999<br /> ==== What happen if I miss a dose? ====<br /> Take it as soon as you <br /> remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=Nitrazepam&diff=2716 2020-10-20T06:32:33Z

<p>Ctol2: /* Caution */</p> <hr /> <div>[[Category: Drugs]][[Category: benzodiazepine]]<br /> '''Nitrazepam''' (中文:[[硝西泮]]) is a long-acting benzodiazepine. It is used as a hypnotic in the short-term management of insomnia. It is reported to act in 30 to 60 minutes to produce sleep lasting for 6 to 8 hours.<br /> <br /> ==Drug Names==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam Tablet 5 mg<br /> |NITR01<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |}<br /> <br /> ==Mechanism of Action==<br /> *Nitrazepam is a benzodiazepine. <br /> *Gama-Aminobutyric acid (GABA) is an inhibitory neurotransmitter, acting on the GABA receptors in the central nervous system (CNS), inducing sleepiness, muscular relaxation, and control of anxiety and seizures.<br /> *Nitrazepam acts on the benzodiazepine receptors in the brain and the spinal cord. Benzodiazepine receptors in the CNS are linked with GABA receptors as a complex. <br /> *Nitrazepam by binding to the benzodiazepine receptors results in activation of the GABA-benzodiazepine receptor complex.<br /> *Thus, Nitrazepam helps to promote muscle relaxation, reduce anxiety, control of convulsions and promote sleep.<br /> <br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Insomnia (short-term use)<br /> |''Oral''<br /> *ADULT: 5 – 10 mg daily, to be taken at bedtime.<br /> *ELDERLY: 2.5 – 5 mg daily, to be taken at bedtime.<br /> |}<br /> <br /> Benzodiazepines are sometimes used in the management of epilepsy, but their long-term use is limited by problems of sedation, dependence, and tolerance to the antiepileptic effects. <br /> <br /> Nitrazepam has been used in the treatment of infantile spasms (as for example in West’s syndrome) and the so-called infantile myoclonic seizures.<br /> <br /> Usual oral dose: 0.3 to 1 mg/kg daily in 3 divided doses.<br /> <br /> ==Side Effects==<br /> Nitrazepam is an unsuitable hypnotic for the elderly as it causes:<br /> <br /> *Impairments in body balance and standing steadiness in individuals who wake up at night; <br /> *As a result, leading to falls and hip fractures;<br /> *It induces general mental deterioration;<br /> *Inability to walk;<br /> *Incontinence;<br /> *Confusion and disorientation.<br /> <br /> The nitrazepam-induced symptoms can lead to a misdiagnosis of dementia. <br /> <br /> Elderly are more likely to experience sedation and decreased coordination. The lowest effective dose of nitrazepam should be used for the shortest possible length of time. <br /> <br /> Possible side effects include: <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Very common (&gt;10% of incidence) <br /> or '''Common'''(1-10% of incidence)<br /> |<br /> *Shakiness and unsteady walk (especially in the elderly)<br /> *Trembling, , impairment of muscle functions or coordination<br /> *Confusion (especially in the elderly)<br /> *Amnesia(impairment of memory)<br /> *Drowsiness the next day<br /> *Numbed emotions<br /> *Reduced alertness<br /> *Muscle weakness<br /> *Paradoxical increase in aggression<br /> |-<br /> !style=&quot;text-align: left&quot;| Infrequent (0.1 -1% of incidence)<br /> |<br /> *Dysarthria<br /> *Hypotension<br /> *hypothermia<br /> *Gastro-intestinal disturbances<br /> *Gynaecomastia<br /> *Low blood pressure<br /> *Incontinence<br /> *Drooling, impaired swallowing and aspiration pneumonia<br /> *Slurred speech<br /> *Tremor<br /> *Vertigo<br /> *Visual disturbances<br /> |-<br /> !style=&quot;text-align: left&quot;| Rare (&lt;0.1% of incidence)<br /> |<br /> *Apnoea<br /> *Blood disorders<br /> *Jaundice<br /> *Respiratory depression<br /> *hypersensitivity reactions<br /> |}<br /> <br /> '''Overdosage''' can produce CNS depression and coma.<br /> <br /> '''Paradoxical reactions (the opposite of what is to be expected) may occur'''. Symptoms include<br /> *Aggression, rage;<br /> *Mania, agitation, and restlessness;<br /> *Hallucinations, inappropriate behavior;<br /> *Twitches and tremor.<br /> <br /> ==Pharmacokinetics==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Oral bioavailability<br /> |Nitrazepam is well absorbed after oral doses.<br /> |-<br /> !style=&quot;text-align: left&quot;| Onset of action<br /> |Peak plasma concentrations occur about 2 to 3 hours after ingestion.<br /> |-<br /> !style=&quot;text-align: left&quot;| Metabolism<br /> |Nitrazepam is metabolized in the liver, mediated by the cytochrome P450 system. <br /> |-<br /> !style=&quot;text-align: left&quot;| Elimination half-life<br /> |<br /> Nitrazepam is excreted in the urine. Up to about 20% of an oral dose is found in the faeces.<br /> <br /> The half-life of nitrazepam is between 16.5 and 48.3 hours. In young people, nitrazepam has a half-life of about 29 hours, and a much longer half-life of 40 hours in the elderly.<br /> <br /> Nitrazepam’s half-life in the cerebrospinal fluid, 68 hours, indicates its extremely slow elimination from the cerebrospinal fluid.<br /> |}<br /> <br /> ==Drug Management==<br /> ====Monitoring====<br /> *Blood pressure, pulse and respiratory rate are recommended.<br /> *Elderly may be sensitivity to nitrazepam’s effects. Impairment of memory, cognitive function, and psychomotor performance and behavior disinhibition may be common. Long-term use commonly exacerbates underlying dementia in elderly patients.<br /> *Nitrazepam may make elderly patients feel dizzy, increasing risk of falls, so fall prevention is needed.<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended.<br /> *changes in mood, the development or worsening depression, and/or any thoughts or behaviour of suicide.<br /> <br /> ===Dependence and Withdrawal===<br /> *One-third of individuals treated with benzodiazepines for longer than 4 weeks develop a dependence on the drug and experience a withdrawal syndrome on cessation.<br /> *Withdrawal symptoms can range from insomnia and anxiety to more serious symptoms, including seizures and psychosis.<br /> *Nitrazepam should therefore be withdrawn by tapering the dose to minimize occurrence of withdrawal symptoms. <br /> *Tolerance to the sleep-inducing effects of nitrazepam occurs after 7 days. <br /> <br /> ===Drug interaction=== <br /> Medicines that interact with nitrazepam may either <br /> *Decrease its effect<br /> *Affect how long it works for<br /> *Increase side effects<br /> <br /> Common medications that may interact with nitrazepam include:<br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Drugs given with nitrazepam<br /> !style=&quot;text-align: left&quot;| Potential Effect<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *Alcohol, <br /> *Hypnotics / sedative (e.g. [[barbiturates]])<br /> *Antidepressants (e.g. [[fluoxetine]], [[citalopram]], [[paroxetine]], [[sertraline]], [[amitriptyline]])<br /> *Sedative histamines (e.g. [[chlorpheniramine]], [[dimenhydrinate]], [[diphenhydramine]])<br /> *Antipsychotic (e.g. [[chlorpromazine]], [[clozapine]], [[haloperidol]], [[clozapine]], [[quetiapine]], [[risperidone]])<br /> |May worsens the side effects such as drowsiness , dizziness and respiratory depression<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *[[Cimetidine]]<br /> *[[Omeprazole]]<br /> *[[Oxcarbazepine]], [[Topiramate]], [[Valproate]]<br /> *[[Ketoconazole]]<br /> *[[Itraconazole]]<br /> *[[Isoniazid]]<br /> *[[Erythromycin]], [[ciprofloxacin]]<br /> *[[Propranolol]]<br /> *[[Fluoxetine]]<br /> |Prolong the action of nitrazepam by inhibiting its elimination<br /> |-<br /> |style=&quot;text-align: left&quot;| Alcohol <br /> |May cause a synergistic enhancement of the hypotensive effect of nitrazepam and alcohol<br /> |-<br /> |style=&quot;text-align: left&quot;| Oral contraceptives<br /> |Oral contraceptives significant decrease the elimination of nitrazepam, so prolong the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *[[Rifampicin]]<br /> *[[Phenytoin]]<br /> *[[Carbamazepine]]<br /> *[[Phenobarbitone]]<br /> |All these drugs increase the metabolism of nitrazepam, thus decreasing drug levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *Steroid (e.g. [[Dexamethasone]])<br /> *St John’s wort<br /> |Increase the metabolism of nitrazepam, thus decreasing nitrazepam plasma levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| [[Theophylline]]<br /> |May inhibit the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| [[Levodopa]] (e.g. [[Sinemet]])<br /> |nitrazepam may block the action of levodopa used in the treatment of Parkinson’s disease.<br /> |}<br /> <br /> ===Caution=== <br /> *Particular care in pregnancy, <br /> *Elderly, due to increased susceptibility to side-effects, especially loss of coordination and drowsiness<br /> *In patients with hepatic or renal impairment, who may require reduced doses<br /> *People with history of alcohol dependence or abuse<br /> *People with history of drug dependence or abuse<br /> *People with psychiatric disorders<br /> *Avoid prolonged use and abrupt withdrawal thereafter<br /> <br /> ===Contra-indications===<br /> Use of nitrazepam should be avoided, when possible, in individuals with: <br /> *severe hepatic impairment<br /> *sleep apnoea <br /> *chronic obstructive airways disease (COPD) <br /> *Myasthenia gravis<br /> *Acute narrow-angle glaucoma<br /> *Chronic schizophrenia<br /> Nitrazepam is recommended to be avoided in patients who drive or operate machinery, as it can impaired driving skills up to 17 hours after dosing. <br /> <br /> ===Hepatic impairment===<br /> *Start with smaller initial doses or reduce dose.<br /> *Can precipitate coma.<br /> *Avoid in severe impairment.<br /> <br /> ===Renal impairment===<br /> *Start with small doses in severe impairment.<br /> <br /> ===Pregnancy===<br /> Possible adverse effects of use of benzodiazepines during pregnancy include: miscarriage, malformation, intrauterine growth retardation, and function deficits. <br /> <br /> ===Breast-feeding===<br /> Use during breast feeding is not recommended.<br /> <br /> ===Driving and skilled tasks===<br /> May impair judgment and increase reaction time, and so affect ability to drive or operate machinery. Moreover the hangover effects of a night dose may impair driving on the following day.<br /> <br /> == FAQ ==<br /> === How should I take the tablet? ===<br /> The lowest effective dose should be used to avoid excessive drowsiness during the day time or motor impairment. This medication is used for a short period of time or as an “as required” medication. Swallow the tablet whole with a glass of water at bedtime.<br /> === What should I avoid while taking? ===<br /> Do not eat grapefruit or drink grapefruit juice as it may increase blood levels of nitrazepam. <br /> <br /> Avoid drinking alcohol while taking nitrazepam because it may enhance the side effects of sedation and respiratory depression.<br /> <br /> Avoid driving or hazardous activity while you are taking nitrazepam. <br /> ==== What happen if I overdose? ====<br /> Contact your primary care doctor.<br /> If emergency situation, call 999<br /> ==== What happen if I miss a dose? ====<br /> Take it as soon as you <br /> remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=Nitrazepam&diff=2715 2020-10-20T06:31:04Z

<p>Ctol2: /* Drug interaction */</p> <hr /> <div>[[Category: Drugs]][[Category: benzodiazepine]]<br /> '''Nitrazepam''' (中文:[[硝西泮]]) is a long-acting benzodiazepine. It is used as a hypnotic in the short-term management of insomnia. It is reported to act in 30 to 60 minutes to produce sleep lasting for 6 to 8 hours.<br /> <br /> ==Drug Names==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam Tablet 5 mg<br /> |NITR01<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |}<br /> <br /> ==Mechanism of Action==<br /> *Nitrazepam is a benzodiazepine. <br /> *Gama-Aminobutyric acid (GABA) is an inhibitory neurotransmitter, acting on the GABA receptors in the central nervous system (CNS), inducing sleepiness, muscular relaxation, and control of anxiety and seizures.<br /> *Nitrazepam acts on the benzodiazepine receptors in the brain and the spinal cord. Benzodiazepine receptors in the CNS are linked with GABA receptors as a complex. <br /> *Nitrazepam by binding to the benzodiazepine receptors results in activation of the GABA-benzodiazepine receptor complex.<br /> *Thus, Nitrazepam helps to promote muscle relaxation, reduce anxiety, control of convulsions and promote sleep.<br /> <br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Insomnia (short-term use)<br /> |''Oral''<br /> *ADULT: 5 – 10 mg daily, to be taken at bedtime.<br /> *ELDERLY: 2.5 – 5 mg daily, to be taken at bedtime.<br /> |}<br /> <br /> Benzodiazepines are sometimes used in the management of epilepsy, but their long-term use is limited by problems of sedation, dependence, and tolerance to the antiepileptic effects. <br /> <br /> Nitrazepam has been used in the treatment of infantile spasms (as for example in West’s syndrome) and the so-called infantile myoclonic seizures.<br /> <br /> Usual oral dose: 0.3 to 1 mg/kg daily in 3 divided doses.<br /> <br /> ==Side Effects==<br /> Nitrazepam is an unsuitable hypnotic for the elderly as it causes:<br /> <br /> *Impairments in body balance and standing steadiness in individuals who wake up at night; <br /> *As a result, leading to falls and hip fractures;<br /> *It induces general mental deterioration;<br /> *Inability to walk;<br /> *Incontinence;<br /> *Confusion and disorientation.<br /> <br /> The nitrazepam-induced symptoms can lead to a misdiagnosis of dementia. <br /> <br /> Elderly are more likely to experience sedation and decreased coordination. The lowest effective dose of nitrazepam should be used for the shortest possible length of time. <br /> <br /> Possible side effects include: <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Very common (&gt;10% of incidence) <br /> or '''Common'''(1-10% of incidence)<br /> |<br /> *Shakiness and unsteady walk (especially in the elderly)<br /> *Trembling, , impairment of muscle functions or coordination<br /> *Confusion (especially in the elderly)<br /> *Amnesia(impairment of memory)<br /> *Drowsiness the next day<br /> *Numbed emotions<br /> *Reduced alertness<br /> *Muscle weakness<br /> *Paradoxical increase in aggression<br /> |-<br /> !style=&quot;text-align: left&quot;| Infrequent (0.1 -1% of incidence)<br /> |<br /> *Dysarthria<br /> *Hypotension<br /> *hypothermia<br /> *Gastro-intestinal disturbances<br /> *Gynaecomastia<br /> *Low blood pressure<br /> *Incontinence<br /> *Drooling, impaired swallowing and aspiration pneumonia<br /> *Slurred speech<br /> *Tremor<br /> *Vertigo<br /> *Visual disturbances<br /> |-<br /> !style=&quot;text-align: left&quot;| Rare (&lt;0.1% of incidence)<br /> |<br /> *Apnoea<br /> *Blood disorders<br /> *Jaundice<br /> *Respiratory depression<br /> *hypersensitivity reactions<br /> |}<br /> <br /> '''Overdosage''' can produce CNS depression and coma.<br /> <br /> '''Paradoxical reactions (the opposite of what is to be expected) may occur'''. Symptoms include<br /> *Aggression, rage;<br /> *Mania, agitation, and restlessness;<br /> *Hallucinations, inappropriate behavior;<br /> *Twitches and tremor.<br /> <br /> ==Pharmacokinetics==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Oral bioavailability<br /> |Nitrazepam is well absorbed after oral doses.<br /> |-<br /> !style=&quot;text-align: left&quot;| Onset of action<br /> |Peak plasma concentrations occur about 2 to 3 hours after ingestion.<br /> |-<br /> !style=&quot;text-align: left&quot;| Metabolism<br /> |Nitrazepam is metabolized in the liver, mediated by the cytochrome P450 system. <br /> |-<br /> !style=&quot;text-align: left&quot;| Elimination half-life<br /> |<br /> Nitrazepam is excreted in the urine. Up to about 20% of an oral dose is found in the faeces.<br /> <br /> The half-life of nitrazepam is between 16.5 and 48.3 hours. In young people, nitrazepam has a half-life of about 29 hours, and a much longer half-life of 40 hours in the elderly.<br /> <br /> Nitrazepam’s half-life in the cerebrospinal fluid, 68 hours, indicates its extremely slow elimination from the cerebrospinal fluid.<br /> |}<br /> <br /> ==Drug Management==<br /> ====Monitoring====<br /> *Blood pressure, pulse and respiratory rate are recommended.<br /> *Elderly may be sensitivity to nitrazepam’s effects. Impairment of memory, cognitive function, and psychomotor performance and behavior disinhibition may be common. Long-term use commonly exacerbates underlying dementia in elderly patients.<br /> *Nitrazepam may make elderly patients feel dizzy, increasing risk of falls, so fall prevention is needed.<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended.<br /> *changes in mood, the development or worsening depression, and/or any thoughts or behaviour of suicide.<br /> <br /> ===Dependence and Withdrawal===<br /> *One-third of individuals treated with benzodiazepines for longer than 4 weeks develop a dependence on the drug and experience a withdrawal syndrome on cessation.<br /> *Withdrawal symptoms can range from insomnia and anxiety to more serious symptoms, including seizures and psychosis.<br /> *Nitrazepam should therefore be withdrawn by tapering the dose to minimize occurrence of withdrawal symptoms. <br /> *Tolerance to the sleep-inducing effects of nitrazepam occurs after 7 days. <br /> <br /> ===Drug interaction=== <br /> Medicines that interact with nitrazepam may either <br /> *Decrease its effect<br /> *Affect how long it works for<br /> *Increase side effects<br /> <br /> Common medications that may interact with nitrazepam include:<br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Drugs given with nitrazepam<br /> !style=&quot;text-align: left&quot;| Potential Effect<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *Alcohol, <br /> *Hypnotics / sedative (e.g. [[barbiturates]])<br /> *Antidepressants (e.g. [[fluoxetine]], [[citalopram]], [[paroxetine]], [[sertraline]], [[amitriptyline]])<br /> *Sedative histamines (e.g. [[chlorpheniramine]], [[dimenhydrinate]], [[diphenhydramine]])<br /> *Antipsychotic (e.g. [[chlorpromazine]], [[clozapine]], [[haloperidol]], [[clozapine]], [[quetiapine]], [[risperidone]])<br /> |May worsens the side effects such as drowsiness , dizziness and respiratory depression<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *[[Cimetidine]]<br /> *[[Omeprazole]]<br /> *[[Oxcarbazepine]], [[Topiramate]], [[Valproate]]<br /> *[[Ketoconazole]]<br /> *[[Itraconazole]]<br /> *[[Isoniazid]]<br /> *[[Erythromycin]], [[ciprofloxacin]]<br /> *[[Propranolol]]<br /> *[[Fluoxetine]]<br /> |Prolong the action of nitrazepam by inhibiting its elimination<br /> |-<br /> |style=&quot;text-align: left&quot;| Alcohol <br /> |May cause a synergistic enhancement of the hypotensive effect of nitrazepam and alcohol<br /> |-<br /> |style=&quot;text-align: left&quot;| Oral contraceptives<br /> |Oral contraceptives significant decrease the elimination of nitrazepam, so prolong the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *[[Rifampicin]]<br /> *[[Phenytoin]]<br /> *[[Carbamazepine]]<br /> *[[Phenobarbitone]]<br /> |All these drugs increase the metabolism of nitrazepam, thus decreasing drug levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> *Steroid (e.g. [[Dexamethasone]])<br /> *St John’s wort<br /> |Increase the metabolism of nitrazepam, thus decreasing nitrazepam plasma levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| [[Theophylline]]<br /> |May inhibit the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| [[Levodopa]] (e.g. [[Sinemet]])<br /> |nitrazepam may block the action of levodopa used in the treatment of Parkinson’s disease.<br /> |}<br /> <br /> ===Caution=== <br /> *particular care in pregnancy, <br /> *elderly, due to increased susceptibility to side-effects, especially loss of coordination and drowsiness<br /> *in patients with hepatic or renal impairment, who may require reduced doses<br /> *people with history of alcohol dependence or abuse<br /> *people with history of drug dependence or abuse<br /> *people with psychiatric disorders<br /> *avoid prolonged use and abrupt withdrawal thereafter<br /> <br /> ===Contra-indications===<br /> Use of nitrazepam should be avoided, when possible, in individuals with: <br /> *severe hepatic impairment<br /> *sleep apnoea <br /> *chronic obstructive airways disease (COPD) <br /> *Myasthenia gravis<br /> *Acute narrow-angle glaucoma<br /> *Chronic schizophrenia<br /> Nitrazepam is recommended to be avoided in patients who drive or operate machinery, as it can impaired driving skills up to 17 hours after dosing. <br /> <br /> ===Hepatic impairment===<br /> *Start with smaller initial doses or reduce dose.<br /> *Can precipitate coma.<br /> *Avoid in severe impairment.<br /> <br /> ===Renal impairment===<br /> *Start with small doses in severe impairment.<br /> <br /> ===Pregnancy===<br /> Possible adverse effects of use of benzodiazepines during pregnancy include: miscarriage, malformation, intrauterine growth retardation, and function deficits. <br /> <br /> ===Breast-feeding===<br /> Use during breast feeding is not recommended.<br /> <br /> ===Driving and skilled tasks===<br /> May impair judgment and increase reaction time, and so affect ability to drive or operate machinery. Moreover the hangover effects of a night dose may impair driving on the following day.<br /> <br /> == FAQ ==<br /> === How should I take the tablet? ===<br /> The lowest effective dose should be used to avoid excessive drowsiness during the day time or motor impairment. This medication is used for a short period of time or as an “as required” medication. Swallow the tablet whole with a glass of water at bedtime.<br /> === What should I avoid while taking? ===<br /> Do not eat grapefruit or drink grapefruit juice as it may increase blood levels of nitrazepam. <br /> <br /> Avoid drinking alcohol while taking nitrazepam because it may enhance the side effects of sedation and respiratory depression.<br /> <br /> Avoid driving or hazardous activity while you are taking nitrazepam. <br /> ==== What happen if I overdose? ====<br /> Contact your primary care doctor.<br /> If emergency situation, call 999<br /> ==== What happen if I miss a dose? ====<br /> Take it as soon as you <br /> remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=Nitrazepam&diff=2712 2020-10-20T06:24:13Z

<p>Ctol2: /* Drug Management */</p> <hr /> <div>[[Category: Drugs]][[Category: benzodiazepine]]<br /> '''Nitrazepam''' (中文:[[硝西泮]]) is a long-acting benzodiazepine. It is used as a hypnotic in the short-term management of insomnia. It is reported to act in 30 to 60 minutes to produce sleep lasting for 6 to 8 hours.<br /> <br /> ==Drug Names==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam Tablet 5 mg<br /> |NITR01<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |}<br /> <br /> ==Mechanism of Action==<br /> *Nitrazepam is a benzodiazepine. <br /> *Gama-Aminobutyric acid (GABA) is an inhibitory neurotransmitter, acting on the GABA receptors in the central nervous system (CNS), inducing sleepiness, muscular relaxation, and control of anxiety and seizures.<br /> *Nitrazepam acts on the benzodiazepine receptors in the brain and the spinal cord. Benzodiazepine receptors in the CNS are linked with GABA receptors as a complex. <br /> *Nitrazepam by binding to the benzodiazepine receptors results in activation of the GABA-benzodiazepine receptor complex.<br /> *Thus, Nitrazepam helps to promote muscle relaxation, reduce anxiety, control of convulsions and promote sleep.<br /> <br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Insomnia (short-term use)<br /> |''Oral''<br /> *ADULT: 5 – 10 mg daily, to be taken at bedtime.<br /> *ELDERLY: 2.5 – 5 mg daily, to be taken at bedtime.<br /> |}<br /> <br /> Benzodiazepines are sometimes used in the management of epilepsy, but their long-term use is limited by problems of sedation, dependence, and tolerance to the antiepileptic effects. <br /> <br /> Nitrazepam has been used in the treatment of infantile spasms (as for example in West’s syndrome) and the so-called infantile myoclonic seizures.<br /> <br /> Usual oral dose: 0.3 to 1 mg/kg daily in 3 divided doses.<br /> <br /> ==Side Effects==<br /> Nitrazepam is an unsuitable hypnotic for the elderly as it causes:<br /> <br /> *Impairments in body balance and standing steadiness in individuals who wake up at night; <br /> *As a result, leading to falls and hip fractures;<br /> *It induces general mental deterioration;<br /> *Inability to walk;<br /> *Incontinence;<br /> *Confusion and disorientation.<br /> <br /> The nitrazepam-induced symptoms can lead to a misdiagnosis of dementia. <br /> <br /> Elderly are more likely to experience sedation and decreased coordination. The lowest effective dose of nitrazepam should be used for the shortest possible length of time. <br /> <br /> Possible side effects include: <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Very common (&gt;10% of incidence) <br /> or '''Common'''(1-10% of incidence)<br /> |<br /> *Shakiness and unsteady walk (especially in the elderly)<br /> *Trembling, , impairment of muscle functions or coordination<br /> *Confusion (especially in the elderly)<br /> *Amnesia(impairment of memory)<br /> *Drowsiness the next day<br /> *Numbed emotions<br /> *Reduced alertness<br /> *Muscle weakness<br /> *Paradoxical increase in aggression<br /> |-<br /> !style=&quot;text-align: left&quot;| Infrequent (0.1 -1% of incidence)<br /> |<br /> *Dysarthria<br /> *Hypotension<br /> *hypothermia<br /> *Gastro-intestinal disturbances<br /> *Gynaecomastia<br /> *Low blood pressure<br /> *Incontinence<br /> *Drooling, impaired swallowing and aspiration pneumonia<br /> *Slurred speech<br /> *Tremor<br /> *Vertigo<br /> *Visual disturbances<br /> |-<br /> !style=&quot;text-align: left&quot;| Rare (&lt;0.1% of incidence)<br /> |<br /> *Apnoea<br /> *Blood disorders<br /> *Jaundice<br /> *Respiratory depression<br /> *hypersensitivity reactions<br /> |}<br /> <br /> '''Overdosage''' can produce CNS depression and coma.<br /> <br /> '''Paradoxical reactions (the opposite of what is to be expected) may occur'''. Symptoms include<br /> *Aggression, rage;<br /> *Mania, agitation, and restlessness;<br /> *Hallucinations, inappropriate behavior;<br /> *Twitches and tremor.<br /> <br /> ==Pharmacokinetics==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Oral bioavailability<br /> |Nitrazepam is well absorbed after oral doses.<br /> |-<br /> !style=&quot;text-align: left&quot;| Onset of action<br /> |Peak plasma concentrations occur about 2 to 3 hours after ingestion.<br /> |-<br /> !style=&quot;text-align: left&quot;| Metabolism<br /> |Nitrazepam is metabolized in the liver, mediated by the cytochrome P450 system. <br /> |-<br /> !style=&quot;text-align: left&quot;| Elimination half-life<br /> |<br /> Nitrazepam is excreted in the urine. Up to about 20% of an oral dose is found in the faeces.<br /> <br /> The half-life of nitrazepam is between 16.5 and 48.3 hours. In young people, nitrazepam has a half-life of about 29 hours, and a much longer half-life of 40 hours in the elderly.<br /> <br /> Nitrazepam’s half-life in the cerebrospinal fluid, 68 hours, indicates its extremely slow elimination from the cerebrospinal fluid.<br /> |}<br /> <br /> ==Drug Management==<br /> ====Monitoring====<br /> *Blood pressure, pulse and respiratory rate are recommended.<br /> *Elderly may be sensitivity to nitrazepam’s effects. Impairment of memory, cognitive function, and psychomotor performance and behavior disinhibition may be common. Long-term use commonly exacerbates underlying dementia in elderly patients.<br /> *Nitrazepam may make elderly patients feel dizzy, increasing risk of falls, so fall prevention is needed.<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended.<br /> *changes in mood, the development or worsening depression, and/or any thoughts or behaviour of suicide.<br /> <br /> ===Dependence and Withdrawal===<br /> *One-third of individuals treated with benzodiazepines for longer than 4 weeks develop a dependence on the drug and experience a withdrawal syndrome on cessation.<br /> *Withdrawal symptoms can range from insomnia and anxiety to more serious symptoms, including seizures and psychosis.<br /> *Nitrazepam should therefore be withdrawn by tapering the dose to minimize occurrence of withdrawal symptoms. <br /> *Tolerance to the sleep-inducing effects of nitrazepam occurs after 7 days. <br /> <br /> ===Drug interaction=== <br /> Medicines that interact with nitrazepam may either <br /> *Decrease its effect<br /> *Affect how long it works for<br /> *Increase side effects<br /> <br /> Common medications that may interact with nitrazepam include:<br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Drugs given with nitrazepam<br /> !style=&quot;text-align: left&quot;| Potential Effect<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Alcohol, <br /> Hypnotics/sedative (e.g. barbiturates)<br /> Antidepressants (e.g. fluoxetine, citalopram, paroxetine, sertraline, amitriptyline)<br /> Sedative histamines (e.g. chlorpheniramine, dimenhydrinate, diphenhydramine)<br /> Antipsychotic (e.g. chlorpromazine, clozapine, haloperidol, clozapine, quetiapine, risperidone)<br /> |May worsens the side effects such as drowsiness , dizziness and respiratory depression<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Cimetidine <br /> Omeprazole<br /> Oxcarbazepine, topiramate, valproate<br /> Ketoconazole<br /> Itraconazole<br /> Isoniazid<br /> Erythromycin, ciprofloxacin<br /> Propranolol<br /> fluoxetine<br /> |Prolong the action of nitrazepam by inhibiting its elimination<br /> |-<br /> |style=&quot;text-align: left&quot;| Alcohol <br /> |May cause a synergistic enhancement of the hypotensive effect of nitrazepam and alcohol<br /> |-<br /> |style=&quot;text-align: left&quot;| Oral contraceptives<br /> |Oral contraceptives significant decrease the elimination of nitrazepam, so prolong the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Rifampicin<br /> Phenytoin<br /> Carbamazepine<br /> phenobarbitone<br /> |All these drugs increase the metabolism of nitrazepam, thus decreasing drug levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Steroid (e.g. Dexamethasone)<br /> St John’s wort<br /> |Increase the metabolism of nitrazepam, thus decreasing nitrazepam plasma levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| Theophylline<br /> |May inhibit the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| Levodopa (e.g. Sinemet)<br /> |nitrazepam may block the action of levodopa used in the treatment of Parkinson’s disease.<br /> |}<br /> <br /> ===Caution=== <br /> *particular care in pregnancy, <br /> *elderly, due to increased susceptibility to side-effects, especially loss of coordination and drowsiness<br /> *in patients with hepatic or renal impairment, who may require reduced doses<br /> *people with history of alcohol dependence or abuse<br /> *people with history of drug dependence or abuse<br /> *people with psychiatric disorders<br /> *avoid prolonged use and abrupt withdrawal thereafter<br /> <br /> ===Contra-indications===<br /> Use of nitrazepam should be avoided, when possible, in individuals with: <br /> *severe hepatic impairment<br /> *sleep apnoea <br /> *chronic obstructive airways disease (COPD) <br /> *Myasthenia gravis<br /> *Acute narrow-angle glaucoma<br /> *Chronic schizophrenia<br /> Nitrazepam is recommended to be avoided in patients who drive or operate machinery, as it can impaired driving skills up to 17 hours after dosing. <br /> <br /> ===Hepatic impairment===<br /> *Start with smaller initial doses or reduce dose.<br /> *Can precipitate coma.<br /> *Avoid in severe impairment.<br /> <br /> ===Renal impairment===<br /> *Start with small doses in severe impairment.<br /> <br /> ===Pregnancy===<br /> Possible adverse effects of use of benzodiazepines during pregnancy include: miscarriage, malformation, intrauterine growth retardation, and function deficits. <br /> <br /> ===Breast-feeding===<br /> Use during breast feeding is not recommended.<br /> <br /> ===Driving and skilled tasks===<br /> May impair judgment and increase reaction time, and so affect ability to drive or operate machinery. Moreover the hangover effects of a night dose may impair driving on the following day.<br /> <br /> == FAQ ==<br /> === How should I take the tablet? ===<br /> The lowest effective dose should be used to avoid excessive drowsiness during the day time or motor impairment. This medication is used for a short period of time or as an “as required” medication. Swallow the tablet whole with a glass of water at bedtime.<br /> === What should I avoid while taking? ===<br /> Do not eat grapefruit or drink grapefruit juice as it may increase blood levels of nitrazepam. <br /> <br /> Avoid drinking alcohol while taking nitrazepam because it may enhance the side effects of sedation and respiratory depression.<br /> <br /> Avoid driving or hazardous activity while you are taking nitrazepam. <br /> ==== What happen if I overdose? ====<br /> Contact your primary care doctor.<br /> If emergency situation, call 999<br /> ==== What happen if I miss a dose? ====<br /> Take it as soon as you <br /> remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=Nitrazepam&diff=2711 2020-10-20T06:23:52Z

<p>Ctol2: /* Pharmacokinetics */</p> <hr /> <div>[[Category: Drugs]][[Category: benzodiazepine]]<br /> '''Nitrazepam''' (中文:[[硝西泮]]) is a long-acting benzodiazepine. It is used as a hypnotic in the short-term management of insomnia. It is reported to act in 30 to 60 minutes to produce sleep lasting for 6 to 8 hours.<br /> <br /> ==Drug Names==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam Tablet 5 mg<br /> |NITR01<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |}<br /> <br /> ==Mechanism of Action==<br /> *Nitrazepam is a benzodiazepine. <br /> *Gama-Aminobutyric acid (GABA) is an inhibitory neurotransmitter, acting on the GABA receptors in the central nervous system (CNS), inducing sleepiness, muscular relaxation, and control of anxiety and seizures.<br /> *Nitrazepam acts on the benzodiazepine receptors in the brain and the spinal cord. Benzodiazepine receptors in the CNS are linked with GABA receptors as a complex. <br /> *Nitrazepam by binding to the benzodiazepine receptors results in activation of the GABA-benzodiazepine receptor complex.<br /> *Thus, Nitrazepam helps to promote muscle relaxation, reduce anxiety, control of convulsions and promote sleep.<br /> <br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Insomnia (short-term use)<br /> |''Oral''<br /> *ADULT: 5 – 10 mg daily, to be taken at bedtime.<br /> *ELDERLY: 2.5 – 5 mg daily, to be taken at bedtime.<br /> |}<br /> <br /> Benzodiazepines are sometimes used in the management of epilepsy, but their long-term use is limited by problems of sedation, dependence, and tolerance to the antiepileptic effects. <br /> <br /> Nitrazepam has been used in the treatment of infantile spasms (as for example in West’s syndrome) and the so-called infantile myoclonic seizures.<br /> <br /> Usual oral dose: 0.3 to 1 mg/kg daily in 3 divided doses.<br /> <br /> ==Side Effects==<br /> Nitrazepam is an unsuitable hypnotic for the elderly as it causes:<br /> <br /> *Impairments in body balance and standing steadiness in individuals who wake up at night; <br /> *As a result, leading to falls and hip fractures;<br /> *It induces general mental deterioration;<br /> *Inability to walk;<br /> *Incontinence;<br /> *Confusion and disorientation.<br /> <br /> The nitrazepam-induced symptoms can lead to a misdiagnosis of dementia. <br /> <br /> Elderly are more likely to experience sedation and decreased coordination. The lowest effective dose of nitrazepam should be used for the shortest possible length of time. <br /> <br /> Possible side effects include: <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Very common (&gt;10% of incidence) <br /> or '''Common'''(1-10% of incidence)<br /> |<br /> *Shakiness and unsteady walk (especially in the elderly)<br /> *Trembling, , impairment of muscle functions or coordination<br /> *Confusion (especially in the elderly)<br /> *Amnesia(impairment of memory)<br /> *Drowsiness the next day<br /> *Numbed emotions<br /> *Reduced alertness<br /> *Muscle weakness<br /> *Paradoxical increase in aggression<br /> |-<br /> !style=&quot;text-align: left&quot;| Infrequent (0.1 -1% of incidence)<br /> |<br /> *Dysarthria<br /> *Hypotension<br /> *hypothermia<br /> *Gastro-intestinal disturbances<br /> *Gynaecomastia<br /> *Low blood pressure<br /> *Incontinence<br /> *Drooling, impaired swallowing and aspiration pneumonia<br /> *Slurred speech<br /> *Tremor<br /> *Vertigo<br /> *Visual disturbances<br /> |-<br /> !style=&quot;text-align: left&quot;| Rare (&lt;0.1% of incidence)<br /> |<br /> *Apnoea<br /> *Blood disorders<br /> *Jaundice<br /> *Respiratory depression<br /> *hypersensitivity reactions<br /> |}<br /> <br /> '''Overdosage''' can produce CNS depression and coma.<br /> <br /> '''Paradoxical reactions (the opposite of what is to be expected) may occur'''. Symptoms include<br /> *Aggression, rage;<br /> *Mania, agitation, and restlessness;<br /> *Hallucinations, inappropriate behavior;<br /> *Twitches and tremor.<br /> <br /> ==Pharmacokinetics==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Oral bioavailability<br /> |Nitrazepam is well absorbed after oral doses.<br /> |-<br /> !style=&quot;text-align: left&quot;| Onset of action<br /> |Peak plasma concentrations occur about 2 to 3 hours after ingestion.<br /> |-<br /> !style=&quot;text-align: left&quot;| Metabolism<br /> |Nitrazepam is metabolized in the liver, mediated by the cytochrome P450 system. <br /> |-<br /> !style=&quot;text-align: left&quot;| Elimination half-life<br /> |<br /> Nitrazepam is excreted in the urine. Up to about 20% of an oral dose is found in the faeces.<br /> <br /> The half-life of nitrazepam is between 16.5 and 48.3 hours. In young people, nitrazepam has a half-life of about 29 hours, and a much longer half-life of 40 hours in the elderly.<br /> <br /> Nitrazepam’s half-life in the cerebrospinal fluid, 68 hours, indicates its extremely slow elimination from the cerebrospinal fluid.<br /> |}<br /> <br /> ==Drug Management==<br /> ====Monitoring====<br /> *Blood pressure, pulse and respiratory rate are recommended<br /> *Elderly may be sensitivity to nitrazepam’s effects. Impairment of memory, cognitive function, and psychomotor performance and behavior disinhibition may be common. Long-term use commonly exacerbates underlying dementia in elderly patients.<br /> *Nitrazepam may make elderly patients feel dizzy, increasing risk of falls, so fall prevention is needed<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended<br /> *changes in mood, the development or worsening depression, and/or any thoughts or behaviour of suicide.<br /> <br /> ===Dependence and Withdrawal===<br /> *One-third of individuals treated with benzodiazepines for longer than 4 weeks develop a dependence on the drug and experience a withdrawal syndrome on cessation.<br /> *Withdrawal symptoms can range from insomnia and anxiety to more serious symptoms, including seizures and psychosis.<br /> *Nitrazepam should therefore be withdrawn by tapering the dose to minimize occurrence of withdrawal symptoms. <br /> *Tolerance to the sleep-inducing effects of nitrazepam occurs after 7 days. <br /> <br /> ===Drug interaction=== <br /> Medicines that interact with nitrazepam may either <br /> *Decrease its effect<br /> *Affect how long it works for<br /> *Increase side effects<br /> <br /> Common medications that may interact with nitrazepam include:<br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Drugs given with nitrazepam<br /> !style=&quot;text-align: left&quot;| Potential Effect<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Alcohol, <br /> Hypnotics/sedative (e.g. barbiturates)<br /> Antidepressants (e.g. fluoxetine, citalopram, paroxetine, sertraline, amitriptyline)<br /> Sedative histamines (e.g. chlorpheniramine, dimenhydrinate, diphenhydramine)<br /> Antipsychotic (e.g. chlorpromazine, clozapine, haloperidol, clozapine, quetiapine, risperidone)<br /> |May worsens the side effects such as drowsiness , dizziness and respiratory depression<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Cimetidine <br /> Omeprazole<br /> Oxcarbazepine, topiramate, valproate<br /> Ketoconazole<br /> Itraconazole<br /> Isoniazid<br /> Erythromycin, ciprofloxacin<br /> Propranolol<br /> fluoxetine<br /> |Prolong the action of nitrazepam by inhibiting its elimination<br /> |-<br /> |style=&quot;text-align: left&quot;| Alcohol <br /> |May cause a synergistic enhancement of the hypotensive effect of nitrazepam and alcohol<br /> |-<br /> |style=&quot;text-align: left&quot;| Oral contraceptives<br /> |Oral contraceptives significant decrease the elimination of nitrazepam, so prolong the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Rifampicin<br /> Phenytoin<br /> Carbamazepine<br /> phenobarbitone<br /> |All these drugs increase the metabolism of nitrazepam, thus decreasing drug levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Steroid (e.g. Dexamethasone)<br /> St John’s wort<br /> |Increase the metabolism of nitrazepam, thus decreasing nitrazepam plasma levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| Theophylline<br /> |May inhibit the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| Levodopa (e.g. Sinemet)<br /> |nitrazepam may block the action of levodopa used in the treatment of Parkinson’s disease.<br /> |}<br /> <br /> ===Caution=== <br /> *particular care in pregnancy, <br /> *elderly, due to increased susceptibility to side-effects, especially loss of coordination and drowsiness<br /> *in patients with hepatic or renal impairment, who may require reduced doses<br /> *people with history of alcohol dependence or abuse<br /> *people with history of drug dependence or abuse<br /> *people with psychiatric disorders<br /> *avoid prolonged use and abrupt withdrawal thereafter<br /> <br /> ===Contra-indications===<br /> Use of nitrazepam should be avoided, when possible, in individuals with: <br /> *severe hepatic impairment<br /> *sleep apnoea <br /> *chronic obstructive airways disease (COPD) <br /> *Myasthenia gravis<br /> *Acute narrow-angle glaucoma<br /> *Chronic schizophrenia<br /> Nitrazepam is recommended to be avoided in patients who drive or operate machinery, as it can impaired driving skills up to 17 hours after dosing. <br /> <br /> ===Hepatic impairment===<br /> *Start with smaller initial doses or reduce dose.<br /> *Can precipitate coma.<br /> *Avoid in severe impairment.<br /> <br /> ===Renal impairment===<br /> *Start with small doses in severe impairment.<br /> <br /> ===Pregnancy===<br /> Possible adverse effects of use of benzodiazepines during pregnancy include: miscarriage, malformation, intrauterine growth retardation, and function deficits. <br /> <br /> ===Breast-feeding===<br /> Use during breast feeding is not recommended.<br /> <br /> ===Driving and skilled tasks===<br /> May impair judgment and increase reaction time, and so affect ability to drive or operate machinery. Moreover the hangover effects of a night dose may impair driving on the following day.<br /> <br /> == FAQ ==<br /> === How should I take the tablet? ===<br /> The lowest effective dose should be used to avoid excessive drowsiness during the day time or motor impairment. This medication is used for a short period of time or as an “as required” medication. Swallow the tablet whole with a glass of water at bedtime.<br /> === What should I avoid while taking? ===<br /> Do not eat grapefruit or drink grapefruit juice as it may increase blood levels of nitrazepam. <br /> <br /> Avoid drinking alcohol while taking nitrazepam because it may enhance the side effects of sedation and respiratory depression.<br /> <br /> Avoid driving or hazardous activity while you are taking nitrazepam. <br /> ==== What happen if I overdose? ====<br /> Contact your primary care doctor.<br /> If emergency situation, call 999<br /> ==== What happen if I miss a dose? ====<br /> Take it as soon as you <br /> remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=Nitrazepam&diff=2710 2020-10-20T06:22:58Z

<p>Ctol2: /* Side Effects */</p> <hr /> <div>[[Category: Drugs]][[Category: benzodiazepine]]<br /> '''Nitrazepam''' (中文:[[硝西泮]]) is a long-acting benzodiazepine. It is used as a hypnotic in the short-term management of insomnia. It is reported to act in 30 to 60 minutes to produce sleep lasting for 6 to 8 hours.<br /> <br /> ==Drug Names==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam Tablet 5 mg<br /> |NITR01<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |}<br /> <br /> ==Mechanism of Action==<br /> *Nitrazepam is a benzodiazepine. <br /> *Gama-Aminobutyric acid (GABA) is an inhibitory neurotransmitter, acting on the GABA receptors in the central nervous system (CNS), inducing sleepiness, muscular relaxation, and control of anxiety and seizures.<br /> *Nitrazepam acts on the benzodiazepine receptors in the brain and the spinal cord. Benzodiazepine receptors in the CNS are linked with GABA receptors as a complex. <br /> *Nitrazepam by binding to the benzodiazepine receptors results in activation of the GABA-benzodiazepine receptor complex.<br /> *Thus, Nitrazepam helps to promote muscle relaxation, reduce anxiety, control of convulsions and promote sleep.<br /> <br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Insomnia (short-term use)<br /> |''Oral''<br /> *ADULT: 5 – 10 mg daily, to be taken at bedtime.<br /> *ELDERLY: 2.5 – 5 mg daily, to be taken at bedtime.<br /> |}<br /> <br /> Benzodiazepines are sometimes used in the management of epilepsy, but their long-term use is limited by problems of sedation, dependence, and tolerance to the antiepileptic effects. <br /> <br /> Nitrazepam has been used in the treatment of infantile spasms (as for example in West’s syndrome) and the so-called infantile myoclonic seizures.<br /> <br /> Usual oral dose: 0.3 to 1 mg/kg daily in 3 divided doses.<br /> <br /> ==Side Effects==<br /> Nitrazepam is an unsuitable hypnotic for the elderly as it causes:<br /> <br /> *Impairments in body balance and standing steadiness in individuals who wake up at night; <br /> *As a result, leading to falls and hip fractures;<br /> *It induces general mental deterioration;<br /> *Inability to walk;<br /> *Incontinence;<br /> *Confusion and disorientation.<br /> <br /> The nitrazepam-induced symptoms can lead to a misdiagnosis of dementia. <br /> <br /> Elderly are more likely to experience sedation and decreased coordination. The lowest effective dose of nitrazepam should be used for the shortest possible length of time. <br /> <br /> Possible side effects include: <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Very common (&gt;10% of incidence) <br /> or '''Common'''(1-10% of incidence)<br /> |<br /> *Shakiness and unsteady walk (especially in the elderly)<br /> *Trembling, , impairment of muscle functions or coordination<br /> *Confusion (especially in the elderly)<br /> *Amnesia(impairment of memory)<br /> *Drowsiness the next day<br /> *Numbed emotions<br /> *Reduced alertness<br /> *Muscle weakness<br /> *Paradoxical increase in aggression<br /> |-<br /> !style=&quot;text-align: left&quot;| Infrequent (0.1 -1% of incidence)<br /> |<br /> *Dysarthria<br /> *Hypotension<br /> *hypothermia<br /> *Gastro-intestinal disturbances<br /> *Gynaecomastia<br /> *Low blood pressure<br /> *Incontinence<br /> *Drooling, impaired swallowing and aspiration pneumonia<br /> *Slurred speech<br /> *Tremor<br /> *Vertigo<br /> *Visual disturbances<br /> |-<br /> !style=&quot;text-align: left&quot;| Rare (&lt;0.1% of incidence)<br /> |<br /> *Apnoea<br /> *Blood disorders<br /> *Jaundice<br /> *Respiratory depression<br /> *hypersensitivity reactions<br /> |}<br /> <br /> '''Overdosage''' can produce CNS depression and coma.<br /> <br /> '''Paradoxical reactions (the opposite of what is to be expected) may occur'''. Symptoms include<br /> *Aggression, rage;<br /> *Mania, agitation, and restlessness;<br /> *Hallucinations, inappropriate behavior;<br /> *Twitches and tremor.<br /> <br /> ==Pharmacokinetics==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Oral bioavailability<br /> |Nitrazepam is well absorbed after oral doses.<br /> |-<br /> !style=&quot;text-align: left&quot;| Onset of action<br /> |Peak plasma concentrations occur about 2 to 3 hours after ingestion<br /> |-<br /> !style=&quot;text-align: left&quot;| Metabolism<br /> |Nitrazepam is metabolized in the liver, mediated by the cytochrome P450 system. <br /> |-<br /> !style=&quot;text-align: left&quot;| Elimination half-life<br /> |<br /> Nitrazepam is excreted in the urine. Up to about 20% of an oral dose is found in the faeces.<br /> The half-life of nitrazepam is between 16.5 and 48.3 hours. In young people, nitrazepam has a half-life of about 29 hours, and a much longer half-life of 40 hours in the elderly.<br /> Nitrazepam’s half-life in the cerebrospinal fluid, 68 hours, indicates its extremely slow elimination from the cerebrospinal fluid.<br /> |}<br /> <br /> ==Drug Management==<br /> ====Monitoring====<br /> *Blood pressure, pulse and respiratory rate are recommended<br /> *Elderly may be sensitivity to nitrazepam’s effects. Impairment of memory, cognitive function, and psychomotor performance and behavior disinhibition may be common. Long-term use commonly exacerbates underlying dementia in elderly patients.<br /> *Nitrazepam may make elderly patients feel dizzy, increasing risk of falls, so fall prevention is needed<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended<br /> *changes in mood, the development or worsening depression, and/or any thoughts or behaviour of suicide.<br /> <br /> ===Dependence and Withdrawal===<br /> *One-third of individuals treated with benzodiazepines for longer than 4 weeks develop a dependence on the drug and experience a withdrawal syndrome on cessation.<br /> *Withdrawal symptoms can range from insomnia and anxiety to more serious symptoms, including seizures and psychosis.<br /> *Nitrazepam should therefore be withdrawn by tapering the dose to minimize occurrence of withdrawal symptoms. <br /> *Tolerance to the sleep-inducing effects of nitrazepam occurs after 7 days. <br /> <br /> ===Drug interaction=== <br /> Medicines that interact with nitrazepam may either <br /> *Decrease its effect<br /> *Affect how long it works for<br /> *Increase side effects<br /> <br /> Common medications that may interact with nitrazepam include:<br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Drugs given with nitrazepam<br /> !style=&quot;text-align: left&quot;| Potential Effect<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Alcohol, <br /> Hypnotics/sedative (e.g. barbiturates)<br /> Antidepressants (e.g. fluoxetine, citalopram, paroxetine, sertraline, amitriptyline)<br /> Sedative histamines (e.g. chlorpheniramine, dimenhydrinate, diphenhydramine)<br /> Antipsychotic (e.g. chlorpromazine, clozapine, haloperidol, clozapine, quetiapine, risperidone)<br /> |May worsens the side effects such as drowsiness , dizziness and respiratory depression<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Cimetidine <br /> Omeprazole<br /> Oxcarbazepine, topiramate, valproate<br /> Ketoconazole<br /> Itraconazole<br /> Isoniazid<br /> Erythromycin, ciprofloxacin<br /> Propranolol<br /> fluoxetine<br /> |Prolong the action of nitrazepam by inhibiting its elimination<br /> |-<br /> |style=&quot;text-align: left&quot;| Alcohol <br /> |May cause a synergistic enhancement of the hypotensive effect of nitrazepam and alcohol<br /> |-<br /> |style=&quot;text-align: left&quot;| Oral contraceptives<br /> |Oral contraceptives significant decrease the elimination of nitrazepam, so prolong the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Rifampicin<br /> Phenytoin<br /> Carbamazepine<br /> phenobarbitone<br /> |All these drugs increase the metabolism of nitrazepam, thus decreasing drug levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Steroid (e.g. Dexamethasone)<br /> St John’s wort<br /> |Increase the metabolism of nitrazepam, thus decreasing nitrazepam plasma levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| Theophylline<br /> |May inhibit the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| Levodopa (e.g. Sinemet)<br /> |nitrazepam may block the action of levodopa used in the treatment of Parkinson’s disease.<br /> |}<br /> <br /> ===Caution=== <br /> *particular care in pregnancy, <br /> *elderly, due to increased susceptibility to side-effects, especially loss of coordination and drowsiness<br /> *in patients with hepatic or renal impairment, who may require reduced doses<br /> *people with history of alcohol dependence or abuse<br /> *people with history of drug dependence or abuse<br /> *people with psychiatric disorders<br /> *avoid prolonged use and abrupt withdrawal thereafter<br /> <br /> ===Contra-indications===<br /> Use of nitrazepam should be avoided, when possible, in individuals with: <br /> *severe hepatic impairment<br /> *sleep apnoea <br /> *chronic obstructive airways disease (COPD) <br /> *Myasthenia gravis<br /> *Acute narrow-angle glaucoma<br /> *Chronic schizophrenia<br /> Nitrazepam is recommended to be avoided in patients who drive or operate machinery, as it can impaired driving skills up to 17 hours after dosing. <br /> <br /> ===Hepatic impairment===<br /> *Start with smaller initial doses or reduce dose.<br /> *Can precipitate coma.<br /> *Avoid in severe impairment.<br /> <br /> ===Renal impairment===<br /> *Start with small doses in severe impairment.<br /> <br /> ===Pregnancy===<br /> Possible adverse effects of use of benzodiazepines during pregnancy include: miscarriage, malformation, intrauterine growth retardation, and function deficits. <br /> <br /> ===Breast-feeding===<br /> Use during breast feeding is not recommended.<br /> <br /> ===Driving and skilled tasks===<br /> May impair judgment and increase reaction time, and so affect ability to drive or operate machinery. Moreover the hangover effects of a night dose may impair driving on the following day.<br /> <br /> == FAQ ==<br /> === How should I take the tablet? ===<br /> The lowest effective dose should be used to avoid excessive drowsiness during the day time or motor impairment. This medication is used for a short period of time or as an “as required” medication. Swallow the tablet whole with a glass of water at bedtime.<br /> === What should I avoid while taking? ===<br /> Do not eat grapefruit or drink grapefruit juice as it may increase blood levels of nitrazepam. <br /> <br /> Avoid drinking alcohol while taking nitrazepam because it may enhance the side effects of sedation and respiratory depression.<br /> <br /> Avoid driving or hazardous activity while you are taking nitrazepam. <br /> ==== What happen if I overdose? ====<br /> Contact your primary care doctor.<br /> If emergency situation, call 999<br /> ==== What happen if I miss a dose? ====<br /> Take it as soon as you <br /> remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=Nitrazepam&diff=2709 2020-10-20T06:22:32Z

<p>Ctol2: /* Side Effects */</p> <hr /> <div>[[Category: Drugs]][[Category: benzodiazepine]]<br /> '''Nitrazepam''' (中文:[[硝西泮]]) is a long-acting benzodiazepine. It is used as a hypnotic in the short-term management of insomnia. It is reported to act in 30 to 60 minutes to produce sleep lasting for 6 to 8 hours.<br /> <br /> ==Drug Names==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam Tablet 5 mg<br /> |NITR01<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |}<br /> <br /> ==Mechanism of Action==<br /> *Nitrazepam is a benzodiazepine. <br /> *Gama-Aminobutyric acid (GABA) is an inhibitory neurotransmitter, acting on the GABA receptors in the central nervous system (CNS), inducing sleepiness, muscular relaxation, and control of anxiety and seizures.<br /> *Nitrazepam acts on the benzodiazepine receptors in the brain and the spinal cord. Benzodiazepine receptors in the CNS are linked with GABA receptors as a complex. <br /> *Nitrazepam by binding to the benzodiazepine receptors results in activation of the GABA-benzodiazepine receptor complex.<br /> *Thus, Nitrazepam helps to promote muscle relaxation, reduce anxiety, control of convulsions and promote sleep.<br /> <br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Insomnia (short-term use)<br /> |''Oral''<br /> *ADULT: 5 – 10 mg daily, to be taken at bedtime.<br /> *ELDERLY: 2.5 – 5 mg daily, to be taken at bedtime.<br /> |}<br /> <br /> Benzodiazepines are sometimes used in the management of epilepsy, but their long-term use is limited by problems of sedation, dependence, and tolerance to the antiepileptic effects. <br /> <br /> Nitrazepam has been used in the treatment of infantile spasms (as for example in West’s syndrome) and the so-called infantile myoclonic seizures.<br /> <br /> Usual oral dose: 0.3 to 1 mg/kg daily in 3 divided doses.<br /> <br /> ==Side Effects==<br /> Nitrazepam is an unsuitable hypnotic for the elderly as it causes:<br /> <br /> *Impairments in body balance and standing steadiness in individuals who wake up at night; <br /> *As a result, leading to falls and hip fractures;<br /> *It induces general mental deterioration;<br /> *Inability to walk;<br /> *Incontinence;<br /> *Confusion and disorientation.<br /> <br /> The nitrazepam-induced symptoms can lead to a misdiagnosis of dementia. <br /> <br /> Elderly are more likely to experience sedation and decreased coordination. The lowest effective dose of nitrazepam should be used for the shortest possible length of time. <br /> <br /> Possible side effects include: <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Very common (&gt;10% of incidence) <br /> or '''Common'''(1-10% of incidence)<br /> |<br /> *Shakiness and unsteady walk (especially in the elderly)<br /> *Trembling, , impairment of muscle functions or coordination<br /> *Confusion (especially in the elderly)<br /> *Amnesia(impairment of memory)<br /> *Drowsiness the next day<br /> *Numbed emotions<br /> *Reduced alertness<br /> *Muscle weakness<br /> *Paradoxical increase in aggression<br /> |-<br /> !style=&quot;text-align: left&quot;| Infrequent (0.1 -1% of incidence)<br /> |<br /> *Dysarthria<br /> *Hypotension<br /> *hypothermia<br /> *Gastro-intestinal disturbances<br /> *Gynaecomastia<br /> *Low blood pressure<br /> *Incontinence<br /> *Drooling, impaired swallowing and aspiration pneumonia<br /> *Slurred speech<br /> *Tremor<br /> *Vertigo<br /> *Visual disturbances<br /> |-<br /> !style=&quot;text-align: left&quot;| Rare (&lt;0.1% of incidence)<br /> |<br /> *Apnoea<br /> *Blood disorders<br /> *Jaundice<br /> *Respiratory depression<br /> *hypersensitivity reactions<br /> |}<br /> <br /> '''Overdosage''' can produce CNS depression and coma.<br /> <br /> '''Paradoxical reactions (the opposite of what is to be expected) may occur'''. Symptoms include<br /> *Aggression, rage;<br /> *Mania, agitation, and restlessness;<br /> *Hallucinations, inappropriate behavior;<br /> *Twitches and tremor.<br /> <br /> ==Pharmacokinetics==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Oral bioavailability<br /> |Nitrazepam is well absorbed after oral doses.<br /> |-<br /> !style=&quot;text-align: left&quot;| Onset of action<br /> |Peak plasma concentrations occur about 2 to 3 hours after ingestion<br /> |-<br /> !style=&quot;text-align: left&quot;| Metabolism<br /> |Nitrazepam is metabolized in the liver, mediated by the cytochrome P450 system. <br /> |-<br /> !style=&quot;text-align: left&quot;| Elimination half-life<br /> |<br /> Nitrazepam is excreted in the urine. Up to about 20% of an oral dose is found in the faeces.<br /> The half-life of nitrazepam is between 16.5 and 48.3 hours. In young people, nitrazepam has a half-life of about 29 hours, and a much longer half-life of 40 hours in the elderly.<br /> Nitrazepam’s half-life in the cerebrospinal fluid, 68 hours, indicates its extremely slow elimination from the cerebrospinal fluid.<br /> |}<br /> <br /> ==Drug Management==<br /> ====Monitoring====<br /> *Blood pressure, pulse and respiratory rate are recommended<br /> *Elderly may be sensitivity to nitrazepam’s effects. Impairment of memory, cognitive function, and psychomotor performance and behavior disinhibition may be common. Long-term use commonly exacerbates underlying dementia in elderly patients.<br /> *Nitrazepam may make elderly patients feel dizzy, increasing risk of falls, so fall prevention is needed<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended<br /> *changes in mood, the development or worsening depression, and/or any thoughts or behaviour of suicide.<br /> <br /> ===Dependence and Withdrawal===<br /> *One-third of individuals treated with benzodiazepines for longer than 4 weeks develop a dependence on the drug and experience a withdrawal syndrome on cessation.<br /> *Withdrawal symptoms can range from insomnia and anxiety to more serious symptoms, including seizures and psychosis.<br /> *Nitrazepam should therefore be withdrawn by tapering the dose to minimize occurrence of withdrawal symptoms. <br /> *Tolerance to the sleep-inducing effects of nitrazepam occurs after 7 days. <br /> <br /> ===Drug interaction=== <br /> Medicines that interact with nitrazepam may either <br /> *Decrease its effect<br /> *Affect how long it works for<br /> *Increase side effects<br /> <br /> Common medications that may interact with nitrazepam include:<br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Drugs given with nitrazepam<br /> !style=&quot;text-align: left&quot;| Potential Effect<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Alcohol, <br /> Hypnotics/sedative (e.g. barbiturates)<br /> Antidepressants (e.g. fluoxetine, citalopram, paroxetine, sertraline, amitriptyline)<br /> Sedative histamines (e.g. chlorpheniramine, dimenhydrinate, diphenhydramine)<br /> Antipsychotic (e.g. chlorpromazine, clozapine, haloperidol, clozapine, quetiapine, risperidone)<br /> |May worsens the side effects such as drowsiness , dizziness and respiratory depression<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Cimetidine <br /> Omeprazole<br /> Oxcarbazepine, topiramate, valproate<br /> Ketoconazole<br /> Itraconazole<br /> Isoniazid<br /> Erythromycin, ciprofloxacin<br /> Propranolol<br /> fluoxetine<br /> |Prolong the action of nitrazepam by inhibiting its elimination<br /> |-<br /> |style=&quot;text-align: left&quot;| Alcohol <br /> |May cause a synergistic enhancement of the hypotensive effect of nitrazepam and alcohol<br /> |-<br /> |style=&quot;text-align: left&quot;| Oral contraceptives<br /> |Oral contraceptives significant decrease the elimination of nitrazepam, so prolong the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Rifampicin<br /> Phenytoin<br /> Carbamazepine<br /> phenobarbitone<br /> |All these drugs increase the metabolism of nitrazepam, thus decreasing drug levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Steroid (e.g. Dexamethasone)<br /> St John’s wort<br /> |Increase the metabolism of nitrazepam, thus decreasing nitrazepam plasma levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| Theophylline<br /> |May inhibit the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| Levodopa (e.g. Sinemet)<br /> |nitrazepam may block the action of levodopa used in the treatment of Parkinson’s disease.<br /> |}<br /> <br /> ===Caution=== <br /> *particular care in pregnancy, <br /> *elderly, due to increased susceptibility to side-effects, especially loss of coordination and drowsiness<br /> *in patients with hepatic or renal impairment, who may require reduced doses<br /> *people with history of alcohol dependence or abuse<br /> *people with history of drug dependence or abuse<br /> *people with psychiatric disorders<br /> *avoid prolonged use and abrupt withdrawal thereafter<br /> <br /> ===Contra-indications===<br /> Use of nitrazepam should be avoided, when possible, in individuals with: <br /> *severe hepatic impairment<br /> *sleep apnoea <br /> *chronic obstructive airways disease (COPD) <br /> *Myasthenia gravis<br /> *Acute narrow-angle glaucoma<br /> *Chronic schizophrenia<br /> Nitrazepam is recommended to be avoided in patients who drive or operate machinery, as it can impaired driving skills up to 17 hours after dosing. <br /> <br /> ===Hepatic impairment===<br /> *Start with smaller initial doses or reduce dose.<br /> *Can precipitate coma.<br /> *Avoid in severe impairment.<br /> <br /> ===Renal impairment===<br /> *Start with small doses in severe impairment.<br /> <br /> ===Pregnancy===<br /> Possible adverse effects of use of benzodiazepines during pregnancy include: miscarriage, malformation, intrauterine growth retardation, and function deficits. <br /> <br /> ===Breast-feeding===<br /> Use during breast feeding is not recommended.<br /> <br /> ===Driving and skilled tasks===<br /> May impair judgment and increase reaction time, and so affect ability to drive or operate machinery. Moreover the hangover effects of a night dose may impair driving on the following day.<br /> <br /> == FAQ ==<br /> === How should I take the tablet? ===<br /> The lowest effective dose should be used to avoid excessive drowsiness during the day time or motor impairment. This medication is used for a short period of time or as an “as required” medication. Swallow the tablet whole with a glass of water at bedtime.<br /> === What should I avoid while taking? ===<br /> Do not eat grapefruit or drink grapefruit juice as it may increase blood levels of nitrazepam. <br /> <br /> Avoid drinking alcohol while taking nitrazepam because it may enhance the side effects of sedation and respiratory depression.<br /> <br /> Avoid driving or hazardous activity while you are taking nitrazepam. <br /> ==== What happen if I overdose? ====<br /> Contact your primary care doctor.<br /> If emergency situation, call 999<br /> ==== What happen if I miss a dose? ====<br /> Take it as soon as you <br /> remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=Nitrazepam&diff=2708 2020-10-20T06:22:14Z

<p>Ctol2: /* Side Effects */</p> <hr /> <div>[[Category: Drugs]][[Category: benzodiazepine]]<br /> '''Nitrazepam''' (中文:[[硝西泮]]) is a long-acting benzodiazepine. It is used as a hypnotic in the short-term management of insomnia. It is reported to act in 30 to 60 minutes to produce sleep lasting for 6 to 8 hours.<br /> <br /> ==Drug Names==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam Tablet 5 mg<br /> |NITR01<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |}<br /> <br /> ==Mechanism of Action==<br /> *Nitrazepam is a benzodiazepine. <br /> *Gama-Aminobutyric acid (GABA) is an inhibitory neurotransmitter, acting on the GABA receptors in the central nervous system (CNS), inducing sleepiness, muscular relaxation, and control of anxiety and seizures.<br /> *Nitrazepam acts on the benzodiazepine receptors in the brain and the spinal cord. Benzodiazepine receptors in the CNS are linked with GABA receptors as a complex. <br /> *Nitrazepam by binding to the benzodiazepine receptors results in activation of the GABA-benzodiazepine receptor complex.<br /> *Thus, Nitrazepam helps to promote muscle relaxation, reduce anxiety, control of convulsions and promote sleep.<br /> <br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Insomnia (short-term use)<br /> |''Oral''<br /> *ADULT: 5 – 10 mg daily, to be taken at bedtime.<br /> *ELDERLY: 2.5 – 5 mg daily, to be taken at bedtime.<br /> |}<br /> <br /> Benzodiazepines are sometimes used in the management of epilepsy, but their long-term use is limited by problems of sedation, dependence, and tolerance to the antiepileptic effects. <br /> <br /> Nitrazepam has been used in the treatment of infantile spasms (as for example in West’s syndrome) and the so-called infantile myoclonic seizures.<br /> <br /> Usual oral dose: 0.3 to 1 mg/kg daily in 3 divided doses.<br /> <br /> ==Side Effects==<br /> Nitrazepam is an unsuitable hypnotic for the elderly as it causes:<br /> <br /> *Impairments in body balance and standing steadiness in individuals who wake up at night <br /> *As a result, leading to falls and hip fractures<br /> *It induces general mental deterioration<br /> *Inability to walk<br /> *Incontinence<br /> *Confusion and disorientation<br /> <br /> The nitrazepam-induced symptoms can lead to a misdiagnosis of dementia. <br /> <br /> Elderly are more likely to experience sedation and decreased coordination. The lowest effective dose of nitrazepam should be used for the shortest possible length of time. <br /> <br /> Possible side effects include: <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Very common (&gt;10% of incidence) <br /> or '''Common'''(1-10% of incidence)<br /> |<br /> *Shakiness and unsteady walk (especially in the elderly)<br /> *Trembling, , impairment of muscle functions or coordination<br /> *Confusion (especially in the elderly)<br /> *Amnesia(impairment of memory)<br /> *Drowsiness the next day<br /> *Numbed emotions<br /> *Reduced alertness<br /> *Muscle weakness<br /> *Paradoxical increase in aggression<br /> |-<br /> !style=&quot;text-align: left&quot;| Infrequent (0.1 -1% of incidence)<br /> |<br /> *Dysarthria<br /> *Hypotension<br /> *hypothermia<br /> *Gastro-intestinal disturbances<br /> *Gynaecomastia<br /> *Low blood pressure<br /> *Incontinence<br /> *Drooling, impaired swallowing and aspiration pneumonia<br /> *Slurred speech<br /> *Tremor<br /> *Vertigo<br /> *Visual disturbances<br /> |-<br /> !style=&quot;text-align: left&quot;| Rare (&lt;0.1% of incidence)<br /> |<br /> *Apnoea<br /> *Blood disorders<br /> *Jaundice<br /> *Respiratory depression<br /> *hypersensitivity reactions<br /> |}<br /> <br /> '''Overdosage''' can produce CNS depression and coma.<br /> <br /> '''Paradoxical reactions (the opposite of what is to be expected) may occur'''. Symptoms include<br /> *Aggression, rage;<br /> *Mania, agitation, and restlessness;<br /> *Hallucinations, inappropriate behavior;<br /> *Twitches and tremor.<br /> <br /> ==Pharmacokinetics==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Oral bioavailability<br /> |Nitrazepam is well absorbed after oral doses.<br /> |-<br /> !style=&quot;text-align: left&quot;| Onset of action<br /> |Peak plasma concentrations occur about 2 to 3 hours after ingestion<br /> |-<br /> !style=&quot;text-align: left&quot;| Metabolism<br /> |Nitrazepam is metabolized in the liver, mediated by the cytochrome P450 system. <br /> |-<br /> !style=&quot;text-align: left&quot;| Elimination half-life<br /> |<br /> Nitrazepam is excreted in the urine. Up to about 20% of an oral dose is found in the faeces.<br /> The half-life of nitrazepam is between 16.5 and 48.3 hours. In young people, nitrazepam has a half-life of about 29 hours, and a much longer half-life of 40 hours in the elderly.<br /> Nitrazepam’s half-life in the cerebrospinal fluid, 68 hours, indicates its extremely slow elimination from the cerebrospinal fluid.<br /> |}<br /> <br /> ==Drug Management==<br /> ====Monitoring====<br /> *Blood pressure, pulse and respiratory rate are recommended<br /> *Elderly may be sensitivity to nitrazepam’s effects. Impairment of memory, cognitive function, and psychomotor performance and behavior disinhibition may be common. Long-term use commonly exacerbates underlying dementia in elderly patients.<br /> *Nitrazepam may make elderly patients feel dizzy, increasing risk of falls, so fall prevention is needed<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended<br /> *changes in mood, the development or worsening depression, and/or any thoughts or behaviour of suicide.<br /> <br /> ===Dependence and Withdrawal===<br /> *One-third of individuals treated with benzodiazepines for longer than 4 weeks develop a dependence on the drug and experience a withdrawal syndrome on cessation.<br /> *Withdrawal symptoms can range from insomnia and anxiety to more serious symptoms, including seizures and psychosis.<br /> *Nitrazepam should therefore be withdrawn by tapering the dose to minimize occurrence of withdrawal symptoms. <br /> *Tolerance to the sleep-inducing effects of nitrazepam occurs after 7 days. <br /> <br /> ===Drug interaction=== <br /> Medicines that interact with nitrazepam may either <br /> *Decrease its effect<br /> *Affect how long it works for<br /> *Increase side effects<br /> <br /> Common medications that may interact with nitrazepam include:<br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Drugs given with nitrazepam<br /> !style=&quot;text-align: left&quot;| Potential Effect<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Alcohol, <br /> Hypnotics/sedative (e.g. barbiturates)<br /> Antidepressants (e.g. fluoxetine, citalopram, paroxetine, sertraline, amitriptyline)<br /> Sedative histamines (e.g. chlorpheniramine, dimenhydrinate, diphenhydramine)<br /> Antipsychotic (e.g. chlorpromazine, clozapine, haloperidol, clozapine, quetiapine, risperidone)<br /> |May worsens the side effects such as drowsiness , dizziness and respiratory depression<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Cimetidine <br /> Omeprazole<br /> Oxcarbazepine, topiramate, valproate<br /> Ketoconazole<br /> Itraconazole<br /> Isoniazid<br /> Erythromycin, ciprofloxacin<br /> Propranolol<br /> fluoxetine<br /> |Prolong the action of nitrazepam by inhibiting its elimination<br /> |-<br /> |style=&quot;text-align: left&quot;| Alcohol <br /> |May cause a synergistic enhancement of the hypotensive effect of nitrazepam and alcohol<br /> |-<br /> |style=&quot;text-align: left&quot;| Oral contraceptives<br /> |Oral contraceptives significant decrease the elimination of nitrazepam, so prolong the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Rifampicin<br /> Phenytoin<br /> Carbamazepine<br /> phenobarbitone<br /> |All these drugs increase the metabolism of nitrazepam, thus decreasing drug levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Steroid (e.g. Dexamethasone)<br /> St John’s wort<br /> |Increase the metabolism of nitrazepam, thus decreasing nitrazepam plasma levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| Theophylline<br /> |May inhibit the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| Levodopa (e.g. Sinemet)<br /> |nitrazepam may block the action of levodopa used in the treatment of Parkinson’s disease.<br /> |}<br /> <br /> ===Caution=== <br /> *particular care in pregnancy, <br /> *elderly, due to increased susceptibility to side-effects, especially loss of coordination and drowsiness<br /> *in patients with hepatic or renal impairment, who may require reduced doses<br /> *people with history of alcohol dependence or abuse<br /> *people with history of drug dependence or abuse<br /> *people with psychiatric disorders<br /> *avoid prolonged use and abrupt withdrawal thereafter<br /> <br /> ===Contra-indications===<br /> Use of nitrazepam should be avoided, when possible, in individuals with: <br /> *severe hepatic impairment<br /> *sleep apnoea <br /> *chronic obstructive airways disease (COPD) <br /> *Myasthenia gravis<br /> *Acute narrow-angle glaucoma<br /> *Chronic schizophrenia<br /> Nitrazepam is recommended to be avoided in patients who drive or operate machinery, as it can impaired driving skills up to 17 hours after dosing. <br /> <br /> ===Hepatic impairment===<br /> *Start with smaller initial doses or reduce dose.<br /> *Can precipitate coma.<br /> *Avoid in severe impairment.<br /> <br /> ===Renal impairment===<br /> *Start with small doses in severe impairment.<br /> <br /> ===Pregnancy===<br /> Possible adverse effects of use of benzodiazepines during pregnancy include: miscarriage, malformation, intrauterine growth retardation, and function deficits. <br /> <br /> ===Breast-feeding===<br /> Use during breast feeding is not recommended.<br /> <br /> ===Driving and skilled tasks===<br /> May impair judgment and increase reaction time, and so affect ability to drive or operate machinery. Moreover the hangover effects of a night dose may impair driving on the following day.<br /> <br /> == FAQ ==<br /> === How should I take the tablet? ===<br /> The lowest effective dose should be used to avoid excessive drowsiness during the day time or motor impairment. This medication is used for a short period of time or as an “as required” medication. Swallow the tablet whole with a glass of water at bedtime.<br /> === What should I avoid while taking? ===<br /> Do not eat grapefruit or drink grapefruit juice as it may increase blood levels of nitrazepam. <br /> <br /> Avoid drinking alcohol while taking nitrazepam because it may enhance the side effects of sedation and respiratory depression.<br /> <br /> Avoid driving or hazardous activity while you are taking nitrazepam. <br /> ==== What happen if I overdose? ====<br /> Contact your primary care doctor.<br /> If emergency situation, call 999<br /> ==== What happen if I miss a dose? ====<br /> Take it as soon as you <br /> remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=Nitrazepam&diff=2705 2020-10-20T06:16:35Z

<p>Ctol2: /* Mechanism of Action */</p> <hr /> <div>[[Category: Drugs]][[Category: benzodiazepine]]<br /> '''Nitrazepam''' (中文:[[硝西泮]]) is a long-acting benzodiazepine. It is used as a hypnotic in the short-term management of insomnia. It is reported to act in 30 to 60 minutes to produce sleep lasting for 6 to 8 hours.<br /> <br /> ==Drug Names==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam Tablet 5 mg<br /> |NITR01<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |}<br /> <br /> ==Mechanism of Action==<br /> *Nitrazepam is a benzodiazepine. <br /> *Gama-Aminobutyric acid (GABA) is an inhibitory neurotransmitter, acting on the GABA receptors in the central nervous system (CNS), inducing sleepiness, muscular relaxation, and control of anxiety and seizures.<br /> *Nitrazepam acts on the benzodiazepine receptors in the brain and the spinal cord. Benzodiazepine receptors in the CNS are linked with GABA receptors as a complex. <br /> *Nitrazepam by binding to the benzodiazepine receptors results in activation of the GABA-benzodiazepine receptor complex.<br /> *Thus, Nitrazepam helps to promote muscle relaxation, reduce anxiety, control of convulsions and promote sleep.<br /> <br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Insomnia (short-term use)<br /> |''Oral''<br /> *ADULT: 5 – 10 mg daily, to be taken at bedtime.<br /> *ELDERLY: 2.5 – 5 mg daily, to be taken at bedtime.<br /> |}<br /> <br /> Benzodiazepines are sometimes used in the management of epilepsy, but their long-term use is limited by problems of sedation, dependence, and tolerance to the antiepileptic effects. <br /> <br /> Nitrazepam has been used in the treatment of infantile spasms (as for example in West’s syndrome) and the so-called infantile myoclonic seizures.<br /> <br /> Usual oral dose: 0.3 to 1 mg/kg daily in 3 divided doses.<br /> <br /> ==Side Effects==<br /> Nitrazepam is an unsuitable hypnotic for the elderly as it causes:<br /> <br /> *Impairments in body balance and standing steadiness in individuals who wake up at night <br /> *As a result, leading to falls and hip fractures<br /> *It induces general mental deterioration<br /> *Inability to walk<br /> *Incontinence<br /> *Confusion and disorientation<br /> <br /> The nitrazepam-induced symptoms can lead to a misdiagnosis of dementia. <br /> <br /> Elderly are more likely to experience sedation and decreased coordination. The lowest effective dose of nitrazepam should be used for the shortest possible length of time. <br /> <br /> Possible side effects include: <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Very common (&gt;10% of incidence) <br /> or''' Common '''(1-10% of incidence)<br /> |<br /> *Shakiness and unsteady walk (especially in the elderly)<br /> *Trembling, , impairment of muscle functions or coordination<br /> *Confusion (especially in the elderly)<br /> *Amnesia(impairment of memory)<br /> *Drowsiness the next day<br /> *Numbed emotions<br /> *Reduced alertness<br /> *Muscle weakness<br /> *Paradoxical increase in aggression<br /> |-<br /> !style=&quot;text-align: left&quot;| Infrequent (0.1 -1% of incidence)<br /> |<br /> *Dysarthria<br /> *Hypotension<br /> *hypothermia<br /> *Gastro-intestinal disturbances<br /> *Gynaecomastia<br /> *Low blood pressure<br /> *Incontinence<br /> *Drooling, impaired swallowing and aspiration pneumonia<br /> *Slurred speech<br /> *Tremor<br /> *Vertigo<br /> *Visual disturbances<br /> |-<br /> !style=&quot;text-align: left&quot;| Rare (&lt;0.1% of incidence)<br /> |<br /> *Apnoea<br /> *Blood disorders<br /> *Jaundice<br /> *Respiratory depression<br /> *hypersensitivity reactions<br /> |}<br /> <br /> '''Overdosage''' can produce CNS depression and coma.<br /> <br /> '''Paradoxical reactions (the opposite of what is to be expected) may occur'''. Symptoms include<br /> *aggression, rage<br /> *mania, agitation, and restlessness<br /> *hallucinations, inappropriate behavior<br /> *twitches and tremor<br /> <br /> ==Pharmacokinetics==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Oral bioavailability<br /> |Nitrazepam is well absorbed after oral doses.<br /> |-<br /> !style=&quot;text-align: left&quot;| Onset of action<br /> |Peak plasma concentrations occur about 2 to 3 hours after ingestion<br /> |-<br /> !style=&quot;text-align: left&quot;| Metabolism<br /> |Nitrazepam is metabolized in the liver, mediated by the cytochrome P450 system. <br /> |-<br /> !style=&quot;text-align: left&quot;| Elimination half-life<br /> |<br /> Nitrazepam is excreted in the urine. Up to about 20% of an oral dose is found in the faeces.<br /> The half-life of nitrazepam is between 16.5 and 48.3 hours. In young people, nitrazepam has a half-life of about 29 hours, and a much longer half-life of 40 hours in the elderly.<br /> Nitrazepam’s half-life in the cerebrospinal fluid, 68 hours, indicates its extremely slow elimination from the cerebrospinal fluid.<br /> |}<br /> <br /> ==Drug Management==<br /> ====Monitoring====<br /> *Blood pressure, pulse and respiratory rate are recommended<br /> *Elderly may be sensitivity to nitrazepam’s effects. Impairment of memory, cognitive function, and psychomotor performance and behavior disinhibition may be common. Long-term use commonly exacerbates underlying dementia in elderly patients.<br /> *Nitrazepam may make elderly patients feel dizzy, increasing risk of falls, so fall prevention is needed<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended<br /> *changes in mood, the development or worsening depression, and/or any thoughts or behaviour of suicide.<br /> <br /> ===Dependence and Withdrawal===<br /> *One-third of individuals treated with benzodiazepines for longer than 4 weeks develop a dependence on the drug and experience a withdrawal syndrome on cessation.<br /> *Withdrawal symptoms can range from insomnia and anxiety to more serious symptoms, including seizures and psychosis.<br /> *Nitrazepam should therefore be withdrawn by tapering the dose to minimize occurrence of withdrawal symptoms. <br /> *Tolerance to the sleep-inducing effects of nitrazepam occurs after 7 days. <br /> <br /> ===Drug interaction=== <br /> Medicines that interact with nitrazepam may either <br /> *Decrease its effect<br /> *Affect how long it works for<br /> *Increase side effects<br /> <br /> Common medications that may interact with nitrazepam include:<br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Drugs given with nitrazepam<br /> !style=&quot;text-align: left&quot;| Potential Effect<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Alcohol, <br /> Hypnotics/sedative (e.g. barbiturates)<br /> Antidepressants (e.g. fluoxetine, citalopram, paroxetine, sertraline, amitriptyline)<br /> Sedative histamines (e.g. chlorpheniramine, dimenhydrinate, diphenhydramine)<br /> Antipsychotic (e.g. chlorpromazine, clozapine, haloperidol, clozapine, quetiapine, risperidone)<br /> |May worsens the side effects such as drowsiness , dizziness and respiratory depression<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Cimetidine <br /> Omeprazole<br /> Oxcarbazepine, topiramate, valproate<br /> Ketoconazole<br /> Itraconazole<br /> Isoniazid<br /> Erythromycin, ciprofloxacin<br /> Propranolol<br /> fluoxetine<br /> |Prolong the action of nitrazepam by inhibiting its elimination<br /> |-<br /> |style=&quot;text-align: left&quot;| Alcohol <br /> |May cause a synergistic enhancement of the hypotensive effect of nitrazepam and alcohol<br /> |-<br /> |style=&quot;text-align: left&quot;| Oral contraceptives<br /> |Oral contraceptives significant decrease the elimination of nitrazepam, so prolong the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Rifampicin<br /> Phenytoin<br /> Carbamazepine<br /> phenobarbitone<br /> |All these drugs increase the metabolism of nitrazepam, thus decreasing drug levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Steroid (e.g. Dexamethasone)<br /> St John’s wort<br /> |Increase the metabolism of nitrazepam, thus decreasing nitrazepam plasma levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| Theophylline<br /> |May inhibit the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| Levodopa (e.g. Sinemet)<br /> |nitrazepam may block the action of levodopa used in the treatment of Parkinson’s disease.<br /> |}<br /> <br /> ===Caution=== <br /> *particular care in pregnancy, <br /> *elderly, due to increased susceptibility to side-effects, especially loss of coordination and drowsiness<br /> *in patients with hepatic or renal impairment, who may require reduced doses<br /> *people with history of alcohol dependence or abuse<br /> *people with history of drug dependence or abuse<br /> *people with psychiatric disorders<br /> *avoid prolonged use and abrupt withdrawal thereafter<br /> <br /> ===Contra-indications===<br /> Use of nitrazepam should be avoided, when possible, in individuals with: <br /> *severe hepatic impairment<br /> *sleep apnoea <br /> *chronic obstructive airways disease (COPD) <br /> *Myasthenia gravis<br /> *Acute narrow-angle glaucoma<br /> *Chronic schizophrenia<br /> Nitrazepam is recommended to be avoided in patients who drive or operate machinery, as it can impaired driving skills up to 17 hours after dosing. <br /> <br /> ===Hepatic impairment===<br /> *Start with smaller initial doses or reduce dose.<br /> *Can precipitate coma.<br /> *Avoid in severe impairment.<br /> <br /> ===Renal impairment===<br /> *Start with small doses in severe impairment.<br /> <br /> ===Pregnancy===<br /> Possible adverse effects of use of benzodiazepines during pregnancy include: miscarriage, malformation, intrauterine growth retardation, and function deficits. <br /> <br /> ===Breast-feeding===<br /> Use during breast feeding is not recommended.<br /> <br /> ===Driving and skilled tasks===<br /> May impair judgment and increase reaction time, and so affect ability to drive or operate machinery. Moreover the hangover effects of a night dose may impair driving on the following day.<br /> <br /> == FAQ ==<br /> === How should I take the tablet? ===<br /> The lowest effective dose should be used to avoid excessive drowsiness during the day time or motor impairment. This medication is used for a short period of time or as an “as required” medication. Swallow the tablet whole with a glass of water at bedtime.<br /> === What should I avoid while taking? ===<br /> Do not eat grapefruit or drink grapefruit juice as it may increase blood levels of nitrazepam. <br /> <br /> Avoid drinking alcohol while taking nitrazepam because it may enhance the side effects of sedation and respiratory depression.<br /> <br /> Avoid driving or hazardous activity while you are taking nitrazepam. <br /> ==== What happen if I overdose? ====<br /> Contact your primary care doctor.<br /> If emergency situation, call 999<br /> ==== What happen if I miss a dose? ====<br /> Take it as soon as you <br /> remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=Nitrazepam&diff=2704 2020-10-20T06:16:11Z

<p>Ctol2: /* Mechanism of Action */</p> <hr /> <div>[[Category: Drugs]][[Category: benzodiazepine]]<br /> '''Nitrazepam''' (中文:[[硝西泮]]) is a long-acting benzodiazepine. It is used as a hypnotic in the short-term management of insomnia. It is reported to act in 30 to 60 minutes to produce sleep lasting for 6 to 8 hours.<br /> <br /> ==Drug Names==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam Tablet 5 mg<br /> |NITR01<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |}<br /> <br /> ==Mechanism of Action==<br /> *Nitrazepam is a benzodiazepine. <br /> *Gama-Aminobutyric acid (GABA) is an inhibitory neurotransmitter, acting on the GABA receptors in the central nervous system (CNS), inducing sleepiness, muscular relaxation, and control of anxiety and seizures.<br /> *Nitrazepam acts on the benzodiazepine receptors in the brain and the spinal cord. Benzodiazepine receptors in the CNS are linked with GABA receptors as a complex. <br /> *Nitrazepam by binding to the benzodiazepine receptors results in activation of the GABA-benzodiazepine receptor complex.<br /> *Thus, Nitrazepam helps to promote muscle relaxation, reduce anxiety, control of convulsions and promote sleep.<br /> <br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Insomnia (short-term use)<br /> |''Oral''<br /> ADULT: 5 – 10 mg daily, to be taken at bedtime.<br /> <br /> ELDERLY: 2.5 – 5 mg daily, to be taken at bedtime<br /> |}<br /> <br /> Benzodiazepines are sometimes used in the management of epilepsy, but their long-term use is limited by problems of sedation, dependence, and tolerance to the antiepileptic effects. <br /> <br /> Nitrazepam has been used in the treatment of infantile spasms (as for example in West’s syndrome) and the so-called infantile myoclonic seizures.<br /> <br /> Usual oral dose: 0.3 to 1 mg/kg daily in 3 divided doses.<br /> <br /> ==Side Effects==<br /> Nitrazepam is an unsuitable hypnotic for the elderly as it causes:<br /> <br /> *Impairments in body balance and standing steadiness in individuals who wake up at night <br /> *As a result, leading to falls and hip fractures<br /> *It induces general mental deterioration<br /> *Inability to walk<br /> *Incontinence<br /> *Confusion and disorientation<br /> <br /> The nitrazepam-induced symptoms can lead to a misdiagnosis of dementia. <br /> <br /> Elderly are more likely to experience sedation and decreased coordination. The lowest effective dose of nitrazepam should be used for the shortest possible length of time. <br /> <br /> Possible side effects include: <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Very common (&gt;10% of incidence) <br /> or''' Common '''(1-10% of incidence)<br /> |<br /> *Shakiness and unsteady walk (especially in the elderly)<br /> *Trembling, , impairment of muscle functions or coordination<br /> *Confusion (especially in the elderly)<br /> *Amnesia(impairment of memory)<br /> *Drowsiness the next day<br /> *Numbed emotions<br /> *Reduced alertness<br /> *Muscle weakness<br /> *Paradoxical increase in aggression<br /> |-<br /> !style=&quot;text-align: left&quot;| Infrequent (0.1 -1% of incidence)<br /> |<br /> *Dysarthria<br /> *Hypotension<br /> *hypothermia<br /> *Gastro-intestinal disturbances<br /> *Gynaecomastia<br /> *Low blood pressure<br /> *Incontinence<br /> *Drooling, impaired swallowing and aspiration pneumonia<br /> *Slurred speech<br /> *Tremor<br /> *Vertigo<br /> *Visual disturbances<br /> |-<br /> !style=&quot;text-align: left&quot;| Rare (&lt;0.1% of incidence)<br /> |<br /> *Apnoea<br /> *Blood disorders<br /> *Jaundice<br /> *Respiratory depression<br /> *hypersensitivity reactions<br /> |}<br /> <br /> '''Overdosage''' can produce CNS depression and coma.<br /> <br /> '''Paradoxical reactions (the opposite of what is to be expected) may occur'''. Symptoms include<br /> *aggression, rage<br /> *mania, agitation, and restlessness<br /> *hallucinations, inappropriate behavior<br /> *twitches and tremor<br /> <br /> ==Pharmacokinetics==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Oral bioavailability<br /> |Nitrazepam is well absorbed after oral doses.<br /> |-<br /> !style=&quot;text-align: left&quot;| Onset of action<br /> |Peak plasma concentrations occur about 2 to 3 hours after ingestion<br /> |-<br /> !style=&quot;text-align: left&quot;| Metabolism<br /> |Nitrazepam is metabolized in the liver, mediated by the cytochrome P450 system. <br /> |-<br /> !style=&quot;text-align: left&quot;| Elimination half-life<br /> |<br /> Nitrazepam is excreted in the urine. Up to about 20% of an oral dose is found in the faeces.<br /> The half-life of nitrazepam is between 16.5 and 48.3 hours. In young people, nitrazepam has a half-life of about 29 hours, and a much longer half-life of 40 hours in the elderly.<br /> Nitrazepam’s half-life in the cerebrospinal fluid, 68 hours, indicates its extremely slow elimination from the cerebrospinal fluid.<br /> |}<br /> <br /> ==Drug Management==<br /> ====Monitoring====<br /> *Blood pressure, pulse and respiratory rate are recommended<br /> *Elderly may be sensitivity to nitrazepam’s effects. Impairment of memory, cognitive function, and psychomotor performance and behavior disinhibition may be common. Long-term use commonly exacerbates underlying dementia in elderly patients.<br /> *Nitrazepam may make elderly patients feel dizzy, increasing risk of falls, so fall prevention is needed<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended<br /> *changes in mood, the development or worsening depression, and/or any thoughts or behaviour of suicide.<br /> <br /> ===Dependence and Withdrawal===<br /> *One-third of individuals treated with benzodiazepines for longer than 4 weeks develop a dependence on the drug and experience a withdrawal syndrome on cessation.<br /> *Withdrawal symptoms can range from insomnia and anxiety to more serious symptoms, including seizures and psychosis.<br /> *Nitrazepam should therefore be withdrawn by tapering the dose to minimize occurrence of withdrawal symptoms. <br /> *Tolerance to the sleep-inducing effects of nitrazepam occurs after 7 days. <br /> <br /> ===Drug interaction=== <br /> Medicines that interact with nitrazepam may either <br /> *Decrease its effect<br /> *Affect how long it works for<br /> *Increase side effects<br /> <br /> Common medications that may interact with nitrazepam include:<br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Drugs given with nitrazepam<br /> !style=&quot;text-align: left&quot;| Potential Effect<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Alcohol, <br /> Hypnotics/sedative (e.g. barbiturates)<br /> Antidepressants (e.g. fluoxetine, citalopram, paroxetine, sertraline, amitriptyline)<br /> Sedative histamines (e.g. chlorpheniramine, dimenhydrinate, diphenhydramine)<br /> Antipsychotic (e.g. chlorpromazine, clozapine, haloperidol, clozapine, quetiapine, risperidone)<br /> |May worsens the side effects such as drowsiness , dizziness and respiratory depression<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Cimetidine <br /> Omeprazole<br /> Oxcarbazepine, topiramate, valproate<br /> Ketoconazole<br /> Itraconazole<br /> Isoniazid<br /> Erythromycin, ciprofloxacin<br /> Propranolol<br /> fluoxetine<br /> |Prolong the action of nitrazepam by inhibiting its elimination<br /> |-<br /> |style=&quot;text-align: left&quot;| Alcohol <br /> |May cause a synergistic enhancement of the hypotensive effect of nitrazepam and alcohol<br /> |-<br /> |style=&quot;text-align: left&quot;| Oral contraceptives<br /> |Oral contraceptives significant decrease the elimination of nitrazepam, so prolong the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Rifampicin<br /> Phenytoin<br /> Carbamazepine<br /> phenobarbitone<br /> |All these drugs increase the metabolism of nitrazepam, thus decreasing drug levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Steroid (e.g. Dexamethasone)<br /> St John’s wort<br /> |Increase the metabolism of nitrazepam, thus decreasing nitrazepam plasma levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| Theophylline<br /> |May inhibit the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| Levodopa (e.g. Sinemet)<br /> |nitrazepam may block the action of levodopa used in the treatment of Parkinson’s disease.<br /> |}<br /> <br /> ===Caution=== <br /> *particular care in pregnancy, <br /> *elderly, due to increased susceptibility to side-effects, especially loss of coordination and drowsiness<br /> *in patients with hepatic or renal impairment, who may require reduced doses<br /> *people with history of alcohol dependence or abuse<br /> *people with history of drug dependence or abuse<br /> *people with psychiatric disorders<br /> *avoid prolonged use and abrupt withdrawal thereafter<br /> <br /> ===Contra-indications===<br /> Use of nitrazepam should be avoided, when possible, in individuals with: <br /> *severe hepatic impairment<br /> *sleep apnoea <br /> *chronic obstructive airways disease (COPD) <br /> *Myasthenia gravis<br /> *Acute narrow-angle glaucoma<br /> *Chronic schizophrenia<br /> Nitrazepam is recommended to be avoided in patients who drive or operate machinery, as it can impaired driving skills up to 17 hours after dosing. <br /> <br /> ===Hepatic impairment===<br /> *Start with smaller initial doses or reduce dose.<br /> *Can precipitate coma.<br /> *Avoid in severe impairment.<br /> <br /> ===Renal impairment===<br /> *Start with small doses in severe impairment.<br /> <br /> ===Pregnancy===<br /> Possible adverse effects of use of benzodiazepines during pregnancy include: miscarriage, malformation, intrauterine growth retardation, and function deficits. <br /> <br /> ===Breast-feeding===<br /> Use during breast feeding is not recommended.<br /> <br /> ===Driving and skilled tasks===<br /> May impair judgment and increase reaction time, and so affect ability to drive or operate machinery. Moreover the hangover effects of a night dose may impair driving on the following day.<br /> <br /> == FAQ ==<br /> === How should I take the tablet? ===<br /> The lowest effective dose should be used to avoid excessive drowsiness during the day time or motor impairment. This medication is used for a short period of time or as an “as required” medication. Swallow the tablet whole with a glass of water at bedtime.<br /> === What should I avoid while taking? ===<br /> Do not eat grapefruit or drink grapefruit juice as it may increase blood levels of nitrazepam. <br /> <br /> Avoid drinking alcohol while taking nitrazepam because it may enhance the side effects of sedation and respiratory depression.<br /> <br /> Avoid driving or hazardous activity while you are taking nitrazepam. <br /> ==== What happen if I overdose? ====<br /> Contact your primary care doctor.<br /> If emergency situation, call 999<br /> ==== What happen if I miss a dose? ====<br /> Take it as soon as you <br /> remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=Nitrazepam&diff=2703 2020-10-20T06:15:49Z

<p>Ctol2: /* Mechanism of Action */</p> <hr /> <div>[[Category: Drugs]][[Category: benzodiazepine]]<br /> '''Nitrazepam''' (中文:[[硝西泮]]) is a long-acting benzodiazepine. It is used as a hypnotic in the short-term management of insomnia. It is reported to act in 30 to 60 minutes to produce sleep lasting for 6 to 8 hours.<br /> <br /> ==Drug Names==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam Tablet 5 mg<br /> |NITR01<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |}<br /> <br /> ==Mechanism of Action==<br /> *Nitrazepam is a benzodiazepine. <br /> *Gama-Aminobutyric acid (GABA) is an inhibitory neurotransmitter, acting on the GABA receptors in the central nervous system (CNS), inducing sleepiness, muscular relaxation, and control of anxiety and seizures.<br /> *Nitrazepam acts on the benzodiazepine receptors in the brain and the spinal cord. Benzodiazepine receptors in the CNS are linked with GABA receptors as a complex. <br /> *Nitrazepam by binding to the benzodiazepine receptors results in activation of the GABA-benzodiazepine receptor complex.<br /> *Thus, Nitrazepam helps to promote muscle relaxation, reduce anxiety, control of convulsions and promote sleep.<br /> <br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Insomnia (short-term use)<br /> |''Oral''<br /> ADULT: <br /> *5 – 10 mg daily, to be taken at bedtime.<br /> ELDERLY: <br /> *2.5 – 5 mg daily, to be taken at bedtime<br /> |}<br /> <br /> Benzodiazepines are sometimes used in the management of epilepsy, but their long-term use is limited by problems of sedation, dependence, and tolerance to the antiepileptic effects. <br /> <br /> Nitrazepam has been used in the treatment of infantile spasms (as for example in West’s syndrome) and the so-called infantile myoclonic seizures.<br /> <br /> Usual oral dose: 0.3 to 1 mg/kg daily in 3 divided doses.<br /> <br /> ==Side Effects==<br /> Nitrazepam is an unsuitable hypnotic for the elderly as it causes:<br /> <br /> *Impairments in body balance and standing steadiness in individuals who wake up at night <br /> *As a result, leading to falls and hip fractures<br /> *It induces general mental deterioration<br /> *Inability to walk<br /> *Incontinence<br /> *Confusion and disorientation<br /> <br /> The nitrazepam-induced symptoms can lead to a misdiagnosis of dementia. <br /> <br /> Elderly are more likely to experience sedation and decreased coordination. The lowest effective dose of nitrazepam should be used for the shortest possible length of time. <br /> <br /> Possible side effects include: <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Very common (&gt;10% of incidence) <br /> or''' Common '''(1-10% of incidence)<br /> |<br /> *Shakiness and unsteady walk (especially in the elderly)<br /> *Trembling, , impairment of muscle functions or coordination<br /> *Confusion (especially in the elderly)<br /> *Amnesia(impairment of memory)<br /> *Drowsiness the next day<br /> *Numbed emotions<br /> *Reduced alertness<br /> *Muscle weakness<br /> *Paradoxical increase in aggression<br /> |-<br /> !style=&quot;text-align: left&quot;| Infrequent (0.1 -1% of incidence)<br /> |<br /> *Dysarthria<br /> *Hypotension<br /> *hypothermia<br /> *Gastro-intestinal disturbances<br /> *Gynaecomastia<br /> *Low blood pressure<br /> *Incontinence<br /> *Drooling, impaired swallowing and aspiration pneumonia<br /> *Slurred speech<br /> *Tremor<br /> *Vertigo<br /> *Visual disturbances<br /> |-<br /> !style=&quot;text-align: left&quot;| Rare (&lt;0.1% of incidence)<br /> |<br /> *Apnoea<br /> *Blood disorders<br /> *Jaundice<br /> *Respiratory depression<br /> *hypersensitivity reactions<br /> |}<br /> <br /> '''Overdosage''' can produce CNS depression and coma.<br /> <br /> '''Paradoxical reactions (the opposite of what is to be expected) may occur'''. Symptoms include<br /> *aggression, rage<br /> *mania, agitation, and restlessness<br /> *hallucinations, inappropriate behavior<br /> *twitches and tremor<br /> <br /> ==Pharmacokinetics==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Oral bioavailability<br /> |Nitrazepam is well absorbed after oral doses.<br /> |-<br /> !style=&quot;text-align: left&quot;| Onset of action<br /> |Peak plasma concentrations occur about 2 to 3 hours after ingestion<br /> |-<br /> !style=&quot;text-align: left&quot;| Metabolism<br /> |Nitrazepam is metabolized in the liver, mediated by the cytochrome P450 system. <br /> |-<br /> !style=&quot;text-align: left&quot;| Elimination half-life<br /> |<br /> Nitrazepam is excreted in the urine. Up to about 20% of an oral dose is found in the faeces.<br /> The half-life of nitrazepam is between 16.5 and 48.3 hours. In young people, nitrazepam has a half-life of about 29 hours, and a much longer half-life of 40 hours in the elderly.<br /> Nitrazepam’s half-life in the cerebrospinal fluid, 68 hours, indicates its extremely slow elimination from the cerebrospinal fluid.<br /> |}<br /> <br /> ==Drug Management==<br /> ====Monitoring====<br /> *Blood pressure, pulse and respiratory rate are recommended<br /> *Elderly may be sensitivity to nitrazepam’s effects. Impairment of memory, cognitive function, and psychomotor performance and behavior disinhibition may be common. Long-term use commonly exacerbates underlying dementia in elderly patients.<br /> *Nitrazepam may make elderly patients feel dizzy, increasing risk of falls, so fall prevention is needed<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended<br /> *changes in mood, the development or worsening depression, and/or any thoughts or behaviour of suicide.<br /> <br /> ===Dependence and Withdrawal===<br /> *One-third of individuals treated with benzodiazepines for longer than 4 weeks develop a dependence on the drug and experience a withdrawal syndrome on cessation.<br /> *Withdrawal symptoms can range from insomnia and anxiety to more serious symptoms, including seizures and psychosis.<br /> *Nitrazepam should therefore be withdrawn by tapering the dose to minimize occurrence of withdrawal symptoms. <br /> *Tolerance to the sleep-inducing effects of nitrazepam occurs after 7 days. <br /> <br /> ===Drug interaction=== <br /> Medicines that interact with nitrazepam may either <br /> *Decrease its effect<br /> *Affect how long it works for<br /> *Increase side effects<br /> <br /> Common medications that may interact with nitrazepam include:<br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Drugs given with nitrazepam<br /> !style=&quot;text-align: left&quot;| Potential Effect<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Alcohol, <br /> Hypnotics/sedative (e.g. barbiturates)<br /> Antidepressants (e.g. fluoxetine, citalopram, paroxetine, sertraline, amitriptyline)<br /> Sedative histamines (e.g. chlorpheniramine, dimenhydrinate, diphenhydramine)<br /> Antipsychotic (e.g. chlorpromazine, clozapine, haloperidol, clozapine, quetiapine, risperidone)<br /> |May worsens the side effects such as drowsiness , dizziness and respiratory depression<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Cimetidine <br /> Omeprazole<br /> Oxcarbazepine, topiramate, valproate<br /> Ketoconazole<br /> Itraconazole<br /> Isoniazid<br /> Erythromycin, ciprofloxacin<br /> Propranolol<br /> fluoxetine<br /> |Prolong the action of nitrazepam by inhibiting its elimination<br /> |-<br /> |style=&quot;text-align: left&quot;| Alcohol <br /> |May cause a synergistic enhancement of the hypotensive effect of nitrazepam and alcohol<br /> |-<br /> |style=&quot;text-align: left&quot;| Oral contraceptives<br /> |Oral contraceptives significant decrease the elimination of nitrazepam, so prolong the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Rifampicin<br /> Phenytoin<br /> Carbamazepine<br /> phenobarbitone<br /> |All these drugs increase the metabolism of nitrazepam, thus decreasing drug levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Steroid (e.g. Dexamethasone)<br /> St John’s wort<br /> |Increase the metabolism of nitrazepam, thus decreasing nitrazepam plasma levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| Theophylline<br /> |May inhibit the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| Levodopa (e.g. Sinemet)<br /> |nitrazepam may block the action of levodopa used in the treatment of Parkinson’s disease.<br /> |}<br /> <br /> ===Caution=== <br /> *particular care in pregnancy, <br /> *elderly, due to increased susceptibility to side-effects, especially loss of coordination and drowsiness<br /> *in patients with hepatic or renal impairment, who may require reduced doses<br /> *people with history of alcohol dependence or abuse<br /> *people with history of drug dependence or abuse<br /> *people with psychiatric disorders<br /> *avoid prolonged use and abrupt withdrawal thereafter<br /> <br /> ===Contra-indications===<br /> Use of nitrazepam should be avoided, when possible, in individuals with: <br /> *severe hepatic impairment<br /> *sleep apnoea <br /> *chronic obstructive airways disease (COPD) <br /> *Myasthenia gravis<br /> *Acute narrow-angle glaucoma<br /> *Chronic schizophrenia<br /> Nitrazepam is recommended to be avoided in patients who drive or operate machinery, as it can impaired driving skills up to 17 hours after dosing. <br /> <br /> ===Hepatic impairment===<br /> *Start with smaller initial doses or reduce dose.<br /> *Can precipitate coma.<br /> *Avoid in severe impairment.<br /> <br /> ===Renal impairment===<br /> *Start with small doses in severe impairment.<br /> <br /> ===Pregnancy===<br /> Possible adverse effects of use of benzodiazepines during pregnancy include: miscarriage, malformation, intrauterine growth retardation, and function deficits. <br /> <br /> ===Breast-feeding===<br /> Use during breast feeding is not recommended.<br /> <br /> ===Driving and skilled tasks===<br /> May impair judgment and increase reaction time, and so affect ability to drive or operate machinery. Moreover the hangover effects of a night dose may impair driving on the following day.<br /> <br /> == FAQ ==<br /> === How should I take the tablet? ===<br /> The lowest effective dose should be used to avoid excessive drowsiness during the day time or motor impairment. This medication is used for a short period of time or as an “as required” medication. Swallow the tablet whole with a glass of water at bedtime.<br /> === What should I avoid while taking? ===<br /> Do not eat grapefruit or drink grapefruit juice as it may increase blood levels of nitrazepam. <br /> <br /> Avoid drinking alcohol while taking nitrazepam because it may enhance the side effects of sedation and respiratory depression.<br /> <br /> Avoid driving or hazardous activity while you are taking nitrazepam. <br /> ==== What happen if I overdose? ====<br /> Contact your primary care doctor.<br /> If emergency situation, call 999<br /> ==== What happen if I miss a dose? ====<br /> Take it as soon as you <br /> remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=Nitrazepam&diff=2702 2020-10-20T06:15:14Z

<p>Ctol2: /* Mechanism of Action */</p> <hr /> <div>[[Category: Drugs]][[Category: benzodiazepine]]<br /> '''Nitrazepam''' (中文:[[硝西泮]]) is a long-acting benzodiazepine. It is used as a hypnotic in the short-term management of insomnia. It is reported to act in 30 to 60 minutes to produce sleep lasting for 6 to 8 hours.<br /> <br /> ==Drug Names==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam Tablet 5 mg<br /> |NITR01<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |}<br /> <br /> ==Mechanism of Action==<br /> *Nitrazepam is a benzodiazepine. <br /> *Gama-Aminobutyric acid (GABA) is an inhibitory neurotransmitter, acting on the GABA receptors in the central nervous system (CNS), inducing sleepiness, muscular relaxation, and control of anxiety and seizures.<br /> *Nitrazepam acts on the benzodiazepine receptors in the brain and the spinal cord. Benzodiazepine receptors in the CNS are linked with GABA receptors as a complex. <br /> *Nitrazepam by binding to the benzodiazepine receptors results in activation of the GABA-benzodiazepine receptor complex.<br /> *Thus, Nitrazepam helps to promote muscle relaxation, reduce anxiety, control of convulsions and promote sleep.<br /> <br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Insomnia (short-term use)<br /> |By ''mouth''<br /> ADULT: <br /> *5 – 10 mg daily, to be taken at bedtime.<br /> ELDERLY: <br /> *2.5 – 5 mg daily, to be taken at bedtime<br /> |}<br /> <br /> Benzodiazepines are sometimes used in the management of epilepsy, but their long-term use is limited by problems of sedation, dependence, and tolerance to the antiepileptic effects. <br /> <br /> Nitrazepam has been used in the treatment of infantile spasms (as for example in West’s syndrome) and the so-called infantile myoclonic seizures.<br /> <br /> Usual oral dose: 0.3 to 1 mg/kg daily in 3 divided doses.<br /> <br /> ==Side Effects==<br /> Nitrazepam is an unsuitable hypnotic for the elderly as it causes:<br /> <br /> *Impairments in body balance and standing steadiness in individuals who wake up at night <br /> *As a result, leading to falls and hip fractures<br /> *It induces general mental deterioration<br /> *Inability to walk<br /> *Incontinence<br /> *Confusion and disorientation<br /> <br /> The nitrazepam-induced symptoms can lead to a misdiagnosis of dementia. <br /> <br /> Elderly are more likely to experience sedation and decreased coordination. The lowest effective dose of nitrazepam should be used for the shortest possible length of time. <br /> <br /> Possible side effects include: <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Very common (&gt;10% of incidence) <br /> or''' Common '''(1-10% of incidence)<br /> |<br /> *Shakiness and unsteady walk (especially in the elderly)<br /> *Trembling, , impairment of muscle functions or coordination<br /> *Confusion (especially in the elderly)<br /> *Amnesia(impairment of memory)<br /> *Drowsiness the next day<br /> *Numbed emotions<br /> *Reduced alertness<br /> *Muscle weakness<br /> *Paradoxical increase in aggression<br /> |-<br /> !style=&quot;text-align: left&quot;| Infrequent (0.1 -1% of incidence)<br /> |<br /> *Dysarthria<br /> *Hypotension<br /> *hypothermia<br /> *Gastro-intestinal disturbances<br /> *Gynaecomastia<br /> *Low blood pressure<br /> *Incontinence<br /> *Drooling, impaired swallowing and aspiration pneumonia<br /> *Slurred speech<br /> *Tremor<br /> *Vertigo<br /> *Visual disturbances<br /> |-<br /> !style=&quot;text-align: left&quot;| Rare (&lt;0.1% of incidence)<br /> |<br /> *Apnoea<br /> *Blood disorders<br /> *Jaundice<br /> *Respiratory depression<br /> *hypersensitivity reactions<br /> |}<br /> <br /> '''Overdosage''' can produce CNS depression and coma.<br /> <br /> '''Paradoxical reactions (the opposite of what is to be expected) may occur'''. Symptoms include<br /> *aggression, rage<br /> *mania, agitation, and restlessness<br /> *hallucinations, inappropriate behavior<br /> *twitches and tremor<br /> <br /> ==Pharmacokinetics==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Oral bioavailability<br /> |Nitrazepam is well absorbed after oral doses.<br /> |-<br /> !style=&quot;text-align: left&quot;| Onset of action<br /> |Peak plasma concentrations occur about 2 to 3 hours after ingestion<br /> |-<br /> !style=&quot;text-align: left&quot;| Metabolism<br /> |Nitrazepam is metabolized in the liver, mediated by the cytochrome P450 system. <br /> |-<br /> !style=&quot;text-align: left&quot;| Elimination half-life<br /> |<br /> Nitrazepam is excreted in the urine. Up to about 20% of an oral dose is found in the faeces.<br /> The half-life of nitrazepam is between 16.5 and 48.3 hours. In young people, nitrazepam has a half-life of about 29 hours, and a much longer half-life of 40 hours in the elderly.<br /> Nitrazepam’s half-life in the cerebrospinal fluid, 68 hours, indicates its extremely slow elimination from the cerebrospinal fluid.<br /> |}<br /> <br /> ==Drug Management==<br /> ====Monitoring====<br /> *Blood pressure, pulse and respiratory rate are recommended<br /> *Elderly may be sensitivity to nitrazepam’s effects. Impairment of memory, cognitive function, and psychomotor performance and behavior disinhibition may be common. Long-term use commonly exacerbates underlying dementia in elderly patients.<br /> *Nitrazepam may make elderly patients feel dizzy, increasing risk of falls, so fall prevention is needed<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended<br /> *changes in mood, the development or worsening depression, and/or any thoughts or behaviour of suicide.<br /> <br /> ===Dependence and Withdrawal===<br /> *One-third of individuals treated with benzodiazepines for longer than 4 weeks develop a dependence on the drug and experience a withdrawal syndrome on cessation.<br /> *Withdrawal symptoms can range from insomnia and anxiety to more serious symptoms, including seizures and psychosis.<br /> *Nitrazepam should therefore be withdrawn by tapering the dose to minimize occurrence of withdrawal symptoms. <br /> *Tolerance to the sleep-inducing effects of nitrazepam occurs after 7 days. <br /> <br /> ===Drug interaction=== <br /> Medicines that interact with nitrazepam may either <br /> *Decrease its effect<br /> *Affect how long it works for<br /> *Increase side effects<br /> <br /> Common medications that may interact with nitrazepam include:<br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Drugs given with nitrazepam<br /> !style=&quot;text-align: left&quot;| Potential Effect<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Alcohol, <br /> Hypnotics/sedative (e.g. barbiturates)<br /> Antidepressants (e.g. fluoxetine, citalopram, paroxetine, sertraline, amitriptyline)<br /> Sedative histamines (e.g. chlorpheniramine, dimenhydrinate, diphenhydramine)<br /> Antipsychotic (e.g. chlorpromazine, clozapine, haloperidol, clozapine, quetiapine, risperidone)<br /> |May worsens the side effects such as drowsiness , dizziness and respiratory depression<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Cimetidine <br /> Omeprazole<br /> Oxcarbazepine, topiramate, valproate<br /> Ketoconazole<br /> Itraconazole<br /> Isoniazid<br /> Erythromycin, ciprofloxacin<br /> Propranolol<br /> fluoxetine<br /> |Prolong the action of nitrazepam by inhibiting its elimination<br /> |-<br /> |style=&quot;text-align: left&quot;| Alcohol <br /> |May cause a synergistic enhancement of the hypotensive effect of nitrazepam and alcohol<br /> |-<br /> |style=&quot;text-align: left&quot;| Oral contraceptives<br /> |Oral contraceptives significant decrease the elimination of nitrazepam, so prolong the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Rifampicin<br /> Phenytoin<br /> Carbamazepine<br /> phenobarbitone<br /> |All these drugs increase the metabolism of nitrazepam, thus decreasing drug levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Steroid (e.g. Dexamethasone)<br /> St John’s wort<br /> |Increase the metabolism of nitrazepam, thus decreasing nitrazepam plasma levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| Theophylline<br /> |May inhibit the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| Levodopa (e.g. Sinemet)<br /> |nitrazepam may block the action of levodopa used in the treatment of Parkinson’s disease.<br /> |}<br /> <br /> ===Caution=== <br /> *particular care in pregnancy, <br /> *elderly, due to increased susceptibility to side-effects, especially loss of coordination and drowsiness<br /> *in patients with hepatic or renal impairment, who may require reduced doses<br /> *people with history of alcohol dependence or abuse<br /> *people with history of drug dependence or abuse<br /> *people with psychiatric disorders<br /> *avoid prolonged use and abrupt withdrawal thereafter<br /> <br /> ===Contra-indications===<br /> Use of nitrazepam should be avoided, when possible, in individuals with: <br /> *severe hepatic impairment<br /> *sleep apnoea <br /> *chronic obstructive airways disease (COPD) <br /> *Myasthenia gravis<br /> *Acute narrow-angle glaucoma<br /> *Chronic schizophrenia<br /> Nitrazepam is recommended to be avoided in patients who drive or operate machinery, as it can impaired driving skills up to 17 hours after dosing. <br /> <br /> ===Hepatic impairment===<br /> *Start with smaller initial doses or reduce dose.<br /> *Can precipitate coma.<br /> *Avoid in severe impairment.<br /> <br /> ===Renal impairment===<br /> *Start with small doses in severe impairment.<br /> <br /> ===Pregnancy===<br /> Possible adverse effects of use of benzodiazepines during pregnancy include: miscarriage, malformation, intrauterine growth retardation, and function deficits. <br /> <br /> ===Breast-feeding===<br /> Use during breast feeding is not recommended.<br /> <br /> ===Driving and skilled tasks===<br /> May impair judgment and increase reaction time, and so affect ability to drive or operate machinery. Moreover the hangover effects of a night dose may impair driving on the following day.<br /> <br /> == FAQ ==<br /> === How should I take the tablet? ===<br /> The lowest effective dose should be used to avoid excessive drowsiness during the day time or motor impairment. This medication is used for a short period of time or as an “as required” medication. Swallow the tablet whole with a glass of water at bedtime.<br /> === What should I avoid while taking? ===<br /> Do not eat grapefruit or drink grapefruit juice as it may increase blood levels of nitrazepam. <br /> <br /> Avoid drinking alcohol while taking nitrazepam because it may enhance the side effects of sedation and respiratory depression.<br /> <br /> Avoid driving or hazardous activity while you are taking nitrazepam. <br /> ==== What happen if I overdose? ====<br /> Contact your primary care doctor.<br /> If emergency situation, call 999<br /> ==== What happen if I miss a dose? ====<br /> Take it as soon as you <br /> remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=Nitrazepam&diff=2701 2020-10-20T06:14:42Z

<p>Ctol2: /* Mechanism of Action */</p> <hr /> <div>[[Category: Drugs]][[Category: benzodiazepine]]<br /> '''Nitrazepam''' (中文:[[硝西泮]]) is a long-acting benzodiazepine. It is used as a hypnotic in the short-term management of insomnia. It is reported to act in 30 to 60 minutes to produce sleep lasting for 6 to 8 hours.<br /> <br /> ==Drug Names==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam Tablet 5 mg<br /> |NITR01<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |}<br /> <br /> ==Mechanism of Action==<br /> *Nitrazepam is a benzodiazepine. <br /> *Gama-Aminobutyric acid (GABA) is an inhibitory neurotransmitter, acting on the GABA receptors in the central nervous system (CNS), inducing sleepiness, muscular relaxation, and control of anxiety and seizures.<br /> *Nitrazepam acts on the benzodiazepine receptors in the brain and the spinal cord. Benzodiazepine receptors in the CNS are linked with GABA receptors as a complex. <br /> *Nitrazepam by binding to the benzodiazepine receptors results in activation of the GABA-benzodiazepine receptor complex.<br /> *Thus, Nitrazepam helps to promote muscle relaxation, reduce anxiety, control of convulsions and promote sleep.<br /> <br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Insomnia (short-term use)<br /> |By ''mouth<br /> ADULT: <br /> *5 – 10 mg daily, to be taken at bedtime.<br /> ELDERLY: <br /> *2.5 – 5 mg daily, to be taken at bedtime<br /> |}<br /> <br /> Benzodiazepines are sometimes used in the management of epilepsy, but their long-term use is limited by problems of sedation, dependence, and tolerance to the antiepileptic effects. <br /> <br /> Nitrazepam has been used in the treatment of infantile spasms (as for example in West’s syndrome) and the so-called infantile myoclonic seizures.<br /> <br /> Usual oral dose: 0.3 to 1 mg/kg daily in 3 divided doses.<br /> <br /> ==Side Effects==<br /> Nitrazepam is an unsuitable hypnotic for the elderly as it causes:<br /> <br /> *Impairments in body balance and standing steadiness in individuals who wake up at night <br /> *As a result, leading to falls and hip fractures<br /> *It induces general mental deterioration<br /> *Inability to walk<br /> *Incontinence<br /> *Confusion and disorientation<br /> <br /> The nitrazepam-induced symptoms can lead to a misdiagnosis of dementia. <br /> <br /> Elderly are more likely to experience sedation and decreased coordination. The lowest effective dose of nitrazepam should be used for the shortest possible length of time. <br /> <br /> Possible side effects include: <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Very common (&gt;10% of incidence) <br /> or''' Common '''(1-10% of incidence)<br /> |<br /> *Shakiness and unsteady walk (especially in the elderly)<br /> *Trembling, , impairment of muscle functions or coordination<br /> *Confusion (especially in the elderly)<br /> *Amnesia(impairment of memory)<br /> *Drowsiness the next day<br /> *Numbed emotions<br /> *Reduced alertness<br /> *Muscle weakness<br /> *Paradoxical increase in aggression<br /> |-<br /> !style=&quot;text-align: left&quot;| Infrequent (0.1 -1% of incidence)<br /> |<br /> *Dysarthria<br /> *Hypotension<br /> *hypothermia<br /> *Gastro-intestinal disturbances<br /> *Gynaecomastia<br /> *Low blood pressure<br /> *Incontinence<br /> *Drooling, impaired swallowing and aspiration pneumonia<br /> *Slurred speech<br /> *Tremor<br /> *Vertigo<br /> *Visual disturbances<br /> |-<br /> !style=&quot;text-align: left&quot;| Rare (&lt;0.1% of incidence)<br /> |<br /> *Apnoea<br /> *Blood disorders<br /> *Jaundice<br /> *Respiratory depression<br /> *hypersensitivity reactions<br /> |}<br /> <br /> '''Overdosage''' can produce CNS depression and coma.<br /> <br /> '''Paradoxical reactions (the opposite of what is to be expected) may occur'''. Symptoms include<br /> *aggression, rage<br /> *mania, agitation, and restlessness<br /> *hallucinations, inappropriate behavior<br /> *twitches and tremor<br /> <br /> ==Pharmacokinetics==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Oral bioavailability<br /> |Nitrazepam is well absorbed after oral doses.<br /> |-<br /> !style=&quot;text-align: left&quot;| Onset of action<br /> |Peak plasma concentrations occur about 2 to 3 hours after ingestion<br /> |-<br /> !style=&quot;text-align: left&quot;| Metabolism<br /> |Nitrazepam is metabolized in the liver, mediated by the cytochrome P450 system. <br /> |-<br /> !style=&quot;text-align: left&quot;| Elimination half-life<br /> |<br /> Nitrazepam is excreted in the urine. Up to about 20% of an oral dose is found in the faeces.<br /> The half-life of nitrazepam is between 16.5 and 48.3 hours. In young people, nitrazepam has a half-life of about 29 hours, and a much longer half-life of 40 hours in the elderly.<br /> Nitrazepam’s half-life in the cerebrospinal fluid, 68 hours, indicates its extremely slow elimination from the cerebrospinal fluid.<br /> |}<br /> <br /> ==Drug Management==<br /> ====Monitoring====<br /> *Blood pressure, pulse and respiratory rate are recommended<br /> *Elderly may be sensitivity to nitrazepam’s effects. Impairment of memory, cognitive function, and psychomotor performance and behavior disinhibition may be common. Long-term use commonly exacerbates underlying dementia in elderly patients.<br /> *Nitrazepam may make elderly patients feel dizzy, increasing risk of falls, so fall prevention is needed<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended<br /> *changes in mood, the development or worsening depression, and/or any thoughts or behaviour of suicide.<br /> <br /> ===Dependence and Withdrawal===<br /> *One-third of individuals treated with benzodiazepines for longer than 4 weeks develop a dependence on the drug and experience a withdrawal syndrome on cessation.<br /> *Withdrawal symptoms can range from insomnia and anxiety to more serious symptoms, including seizures and psychosis.<br /> *Nitrazepam should therefore be withdrawn by tapering the dose to minimize occurrence of withdrawal symptoms. <br /> *Tolerance to the sleep-inducing effects of nitrazepam occurs after 7 days. <br /> <br /> ===Drug interaction=== <br /> Medicines that interact with nitrazepam may either <br /> *Decrease its effect<br /> *Affect how long it works for<br /> *Increase side effects<br /> <br /> Common medications that may interact with nitrazepam include:<br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Drugs given with nitrazepam<br /> !style=&quot;text-align: left&quot;| Potential Effect<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Alcohol, <br /> Hypnotics/sedative (e.g. barbiturates)<br /> Antidepressants (e.g. fluoxetine, citalopram, paroxetine, sertraline, amitriptyline)<br /> Sedative histamines (e.g. chlorpheniramine, dimenhydrinate, diphenhydramine)<br /> Antipsychotic (e.g. chlorpromazine, clozapine, haloperidol, clozapine, quetiapine, risperidone)<br /> |May worsens the side effects such as drowsiness , dizziness and respiratory depression<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Cimetidine <br /> Omeprazole<br /> Oxcarbazepine, topiramate, valproate<br /> Ketoconazole<br /> Itraconazole<br /> Isoniazid<br /> Erythromycin, ciprofloxacin<br /> Propranolol<br /> fluoxetine<br /> |Prolong the action of nitrazepam by inhibiting its elimination<br /> |-<br /> |style=&quot;text-align: left&quot;| Alcohol <br /> |May cause a synergistic enhancement of the hypotensive effect of nitrazepam and alcohol<br /> |-<br /> |style=&quot;text-align: left&quot;| Oral contraceptives<br /> |Oral contraceptives significant decrease the elimination of nitrazepam, so prolong the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Rifampicin<br /> Phenytoin<br /> Carbamazepine<br /> phenobarbitone<br /> |All these drugs increase the metabolism of nitrazepam, thus decreasing drug levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Steroid (e.g. Dexamethasone)<br /> St John’s wort<br /> |Increase the metabolism of nitrazepam, thus decreasing nitrazepam plasma levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| Theophylline<br /> |May inhibit the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| Levodopa (e.g. Sinemet)<br /> |nitrazepam may block the action of levodopa used in the treatment of Parkinson’s disease.<br /> |}<br /> <br /> ===Caution=== <br /> *particular care in pregnancy, <br /> *elderly, due to increased susceptibility to side-effects, especially loss of coordination and drowsiness<br /> *in patients with hepatic or renal impairment, who may require reduced doses<br /> *people with history of alcohol dependence or abuse<br /> *people with history of drug dependence or abuse<br /> *people with psychiatric disorders<br /> *avoid prolonged use and abrupt withdrawal thereafter<br /> <br /> ===Contra-indications===<br /> Use of nitrazepam should be avoided, when possible, in individuals with: <br /> *severe hepatic impairment<br /> *sleep apnoea <br /> *chronic obstructive airways disease (COPD) <br /> *Myasthenia gravis<br /> *Acute narrow-angle glaucoma<br /> *Chronic schizophrenia<br /> Nitrazepam is recommended to be avoided in patients who drive or operate machinery, as it can impaired driving skills up to 17 hours after dosing. <br /> <br /> ===Hepatic impairment===<br /> *Start with smaller initial doses or reduce dose.<br /> *Can precipitate coma.<br /> *Avoid in severe impairment.<br /> <br /> ===Renal impairment===<br /> *Start with small doses in severe impairment.<br /> <br /> ===Pregnancy===<br /> Possible adverse effects of use of benzodiazepines during pregnancy include: miscarriage, malformation, intrauterine growth retardation, and function deficits. <br /> <br /> ===Breast-feeding===<br /> Use during breast feeding is not recommended.<br /> <br /> ===Driving and skilled tasks===<br /> May impair judgment and increase reaction time, and so affect ability to drive or operate machinery. Moreover the hangover effects of a night dose may impair driving on the following day.<br /> <br /> == FAQ ==<br /> === How should I take the tablet? ===<br /> The lowest effective dose should be used to avoid excessive drowsiness during the day time or motor impairment. This medication is used for a short period of time or as an “as required” medication. Swallow the tablet whole with a glass of water at bedtime.<br /> === What should I avoid while taking? ===<br /> Do not eat grapefruit or drink grapefruit juice as it may increase blood levels of nitrazepam. <br /> <br /> Avoid drinking alcohol while taking nitrazepam because it may enhance the side effects of sedation and respiratory depression.<br /> <br /> Avoid driving or hazardous activity while you are taking nitrazepam. <br /> ==== What happen if I overdose? ====<br /> Contact your primary care doctor.<br /> If emergency situation, call 999<br /> ==== What happen if I miss a dose? ====<br /> Take it as soon as you <br /> remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=Nitrazepam&diff=2699 2020-10-20T06:14:06Z

<p>Ctol2: </p> <hr /> <div>[[Category: Drugs]][[Category: benzodiazepine]]<br /> '''Nitrazepam''' (中文:[[硝西泮]]) is a long-acting benzodiazepine. It is used as a hypnotic in the short-term management of insomnia. It is reported to act in 30 to 60 minutes to produce sleep lasting for 6 to 8 hours.<br /> <br /> ==Drug Names==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam Tablet 5 mg<br /> |NITR01<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |}<br /> <br /> ==Mechanism of Action==<br /> *Nitrazepam is a benzodiazepine. <br /> *Gama-Aminobutyric acid (GABA) is an inhibitory neurotransmitter, acting on the GABA receptors in the central nervous system (CNS), inducing sleepiness, muscular relaxation, and control of anxiety and seizures.<br /> *Nitrazepam acts on the benzodiazepine receptors in the brain and the spinal cord. Benzodiazepine receptors in the CNS are linked with GABA receptors as a complex. <br /> *Nitrazepam by binding to the benzodiazepine receptors results in activation of the GABA-benzodiazepine receptor complex.<br /> *Thus, Nitrazepam helps to promote muscle relaxation, reduce anxiety, control of convulsions and promote sleep.<br /> <br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Insomnia (short-term use<br /> |By ''mouth<br /> ADULT: <br /> *5 – 10 mg daily, to be taken at bedtime.<br /> ELDERLY: <br /> *2.5 – 5 mg daily, to be taken at bedtime<br /> |}<br /> <br /> Benzodiazepines are sometimes used in the management of epilepsy, but their long-term use is limited by problems of sedation, dependence, and tolerance to the antiepileptic effects. <br /> <br /> Nitrazepam has been used in the treatment of infantile spasms (as for example in West’s syndrome) and the so-called infantile myoclonic seizures.<br /> <br /> Usual oral dose: 0.3 to 1 mg/kg daily in 3 divided doses. <br /> <br /> ==Side Effects==<br /> Nitrazepam is an unsuitable hypnotic for the elderly as it causes:<br /> <br /> *Impairments in body balance and standing steadiness in individuals who wake up at night <br /> *As a result, leading to falls and hip fractures<br /> *It induces general mental deterioration<br /> *Inability to walk<br /> *Incontinence<br /> *Confusion and disorientation<br /> <br /> The nitrazepam-induced symptoms can lead to a misdiagnosis of dementia. <br /> <br /> Elderly are more likely to experience sedation and decreased coordination. The lowest effective dose of nitrazepam should be used for the shortest possible length of time. <br /> <br /> Possible side effects include: <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Very common (&gt;10% of incidence) <br /> or''' Common '''(1-10% of incidence)<br /> |<br /> *Shakiness and unsteady walk (especially in the elderly)<br /> *Trembling, , impairment of muscle functions or coordination<br /> *Confusion (especially in the elderly)<br /> *Amnesia(impairment of memory)<br /> *Drowsiness the next day<br /> *Numbed emotions<br /> *Reduced alertness<br /> *Muscle weakness<br /> *Paradoxical increase in aggression<br /> |-<br /> !style=&quot;text-align: left&quot;| Infrequent (0.1 -1% of incidence)<br /> |<br /> *Dysarthria<br /> *Hypotension<br /> *hypothermia<br /> *Gastro-intestinal disturbances<br /> *Gynaecomastia<br /> *Low blood pressure<br /> *Incontinence<br /> *Drooling, impaired swallowing and aspiration pneumonia<br /> *Slurred speech<br /> *Tremor<br /> *Vertigo<br /> *Visual disturbances<br /> |-<br /> !style=&quot;text-align: left&quot;| Rare (&lt;0.1% of incidence)<br /> |<br /> *Apnoea<br /> *Blood disorders<br /> *Jaundice<br /> *Respiratory depression<br /> *hypersensitivity reactions<br /> |}<br /> <br /> '''Overdosage''' can produce CNS depression and coma.<br /> <br /> '''Paradoxical reactions (the opposite of what is to be expected) may occur'''. Symptoms include<br /> *aggression, rage<br /> *mania, agitation, and restlessness<br /> *hallucinations, inappropriate behavior<br /> *twitches and tremor<br /> <br /> ==Pharmacokinetics==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Oral bioavailability<br /> |Nitrazepam is well absorbed after oral doses.<br /> |-<br /> !style=&quot;text-align: left&quot;| Onset of action<br /> |Peak plasma concentrations occur about 2 to 3 hours after ingestion<br /> |-<br /> !style=&quot;text-align: left&quot;| Metabolism<br /> |Nitrazepam is metabolized in the liver, mediated by the cytochrome P450 system. <br /> |-<br /> !style=&quot;text-align: left&quot;| Elimination half-life<br /> |<br /> Nitrazepam is excreted in the urine. Up to about 20% of an oral dose is found in the faeces.<br /> The half-life of nitrazepam is between 16.5 and 48.3 hours. In young people, nitrazepam has a half-life of about 29 hours, and a much longer half-life of 40 hours in the elderly.<br /> Nitrazepam’s half-life in the cerebrospinal fluid, 68 hours, indicates its extremely slow elimination from the cerebrospinal fluid.<br /> |}<br /> <br /> ==Drug Management==<br /> ====Monitoring====<br /> *Blood pressure, pulse and respiratory rate are recommended<br /> *Elderly may be sensitivity to nitrazepam’s effects. Impairment of memory, cognitive function, and psychomotor performance and behavior disinhibition may be common. Long-term use commonly exacerbates underlying dementia in elderly patients.<br /> *Nitrazepam may make elderly patients feel dizzy, increasing risk of falls, so fall prevention is needed<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended<br /> *changes in mood, the development or worsening depression, and/or any thoughts or behaviour of suicide.<br /> <br /> ===Dependence and Withdrawal===<br /> *One-third of individuals treated with benzodiazepines for longer than 4 weeks develop a dependence on the drug and experience a withdrawal syndrome on cessation.<br /> *Withdrawal symptoms can range from insomnia and anxiety to more serious symptoms, including seizures and psychosis.<br /> *Nitrazepam should therefore be withdrawn by tapering the dose to minimize occurrence of withdrawal symptoms. <br /> *Tolerance to the sleep-inducing effects of nitrazepam occurs after 7 days. <br /> <br /> ===Drug interaction=== <br /> Medicines that interact with nitrazepam may either <br /> *Decrease its effect<br /> *Affect how long it works for<br /> *Increase side effects<br /> <br /> Common medications that may interact with nitrazepam include:<br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Drugs given with nitrazepam<br /> !style=&quot;text-align: left&quot;| Potential Effect<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Alcohol, <br /> Hypnotics/sedative (e.g. barbiturates)<br /> Antidepressants (e.g. fluoxetine, citalopram, paroxetine, sertraline, amitriptyline)<br /> Sedative histamines (e.g. chlorpheniramine, dimenhydrinate, diphenhydramine)<br /> Antipsychotic (e.g. chlorpromazine, clozapine, haloperidol, clozapine, quetiapine, risperidone)<br /> |May worsens the side effects such as drowsiness , dizziness and respiratory depression<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Cimetidine <br /> Omeprazole<br /> Oxcarbazepine, topiramate, valproate<br /> Ketoconazole<br /> Itraconazole<br /> Isoniazid<br /> Erythromycin, ciprofloxacin<br /> Propranolol<br /> fluoxetine<br /> |Prolong the action of nitrazepam by inhibiting its elimination<br /> |-<br /> |style=&quot;text-align: left&quot;| Alcohol <br /> |May cause a synergistic enhancement of the hypotensive effect of nitrazepam and alcohol<br /> |-<br /> |style=&quot;text-align: left&quot;| Oral contraceptives<br /> |Oral contraceptives significant decrease the elimination of nitrazepam, so prolong the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Rifampicin<br /> Phenytoin<br /> Carbamazepine<br /> phenobarbitone<br /> |All these drugs increase the metabolism of nitrazepam, thus decreasing drug levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Steroid (e.g. Dexamethasone)<br /> St John’s wort<br /> |Increase the metabolism of nitrazepam, thus decreasing nitrazepam plasma levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| Theophylline<br /> |May inhibit the action of nitrazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| Levodopa (e.g. Sinemet)<br /> |nitrazepam may block the action of levodopa used in the treatment of Parkinson’s disease.<br /> |}<br /> <br /> ===Caution=== <br /> *particular care in pregnancy, <br /> *elderly, due to increased susceptibility to side-effects, especially loss of coordination and drowsiness<br /> *in patients with hepatic or renal impairment, who may require reduced doses<br /> *people with history of alcohol dependence or abuse<br /> *people with history of drug dependence or abuse<br /> *people with psychiatric disorders<br /> *avoid prolonged use and abrupt withdrawal thereafter<br /> <br /> ===Contra-indications===<br /> Use of nitrazepam should be avoided, when possible, in individuals with: <br /> *severe hepatic impairment<br /> *sleep apnoea <br /> *chronic obstructive airways disease (COPD) <br /> *Myasthenia gravis<br /> *Acute narrow-angle glaucoma<br /> *Chronic schizophrenia<br /> Nitrazepam is recommended to be avoided in patients who drive or operate machinery, as it can impaired driving skills up to 17 hours after dosing. <br /> <br /> ===Hepatic impairment===<br /> *Start with smaller initial doses or reduce dose.<br /> *Can precipitate coma.<br /> *Avoid in severe impairment.<br /> <br /> ===Renal impairment===<br /> *Start with small doses in severe impairment.<br /> <br /> ===Pregnancy===<br /> Possible adverse effects of use of benzodiazepines during pregnancy include: miscarriage, malformation, intrauterine growth retardation, and function deficits. <br /> <br /> ===Breast-feeding===<br /> Use during breast feeding is not recommended.<br /> <br /> ===Driving and skilled tasks===<br /> May impair judgment and increase reaction time, and so affect ability to drive or operate machinery. Moreover the hangover effects of a night dose may impair driving on the following day.<br /> <br /> == FAQ ==<br /> === How should I take the tablet? ===<br /> The lowest effective dose should be used to avoid excessive drowsiness during the day time or motor impairment. This medication is used for a short period of time or as an “as required” medication. Swallow the tablet whole with a glass of water at bedtime.<br /> === What should I avoid while taking? ===<br /> Do not eat grapefruit or drink grapefruit juice as it may increase blood levels of nitrazepam. <br /> <br /> Avoid drinking alcohol while taking nitrazepam because it may enhance the side effects of sedation and respiratory depression.<br /> <br /> Avoid driving or hazardous activity while you are taking nitrazepam. <br /> ==== What happen if I overdose? ====<br /> Contact your primary care doctor.<br /> If emergency situation, call 999<br /> ==== What happen if I miss a dose? ====<br /> Take it as soon as you <br /> remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E7%A1%9D%E8%A5%BF%E6%B3%AE&diff=2697 2020-10-20T06:02:57Z

<p>Ctol2: /* 腎功能不全 */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''硝西泮''' (English: [[Nitrazepam]]) 是長效苯二氮䓬類藥物。它用作安眠藥短期治療失眠。據報導，它可以在 30 到 60 分鐘內起作用，使睡眠持續 6 到 8 個小時。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam tablet 5 mg<br /> |NITR01<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物。<br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> {| class = &quot;wikitable&quot;<br /> !失眠（短期使用）<br /> |口服<br /> 成人：臨睡前一次，每次 5-10mg<br /> <br /> 老年人和虛弱的患者：臨睡前一次，每次 2.5-5mg<br /> |}<br /> <br /> 苯二氮䓬類藥物有時用於癲癇的治療中，但是長期使用這類藥物的可引起鎮靜，依賴性和抗癲癇作用耐受性, 所以使用受到限制。<br /> <br /> 硝西泮已用於治療嬰兒痙攣症（例如在韋氏綜合症中）和所謂的嬰兒性肌陣攣性癲癇發作。<br /> <br /> 通常的口服劑量：每日 3 次, 每次 0.3 - 1 mg / kg。<br /> <br /> ==副作用==<br /> 硝西泮不合適年長患者使用，原因是：<br /> *夜間醒來的人的身體平衡和站立穩定性受損 <br /> *結果導致跌倒和髖部骨折<br /> *它引起一般的精神惡化<br /> *不能走路<br /> *失禁<br /> *混亂和迷失方向<br /> <br /> 硝西泮誘發的症狀可能導致癡呆症的誤診。 <br /> <br /> 老年人更容易出現鎮靜和協調能力下降。應在盡可能短的時間內使用最低有效劑量。<br /> <br /> 可能的副作用包括：<br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率&gt; 10％）或常見（發生率 1-10％）<br /> |行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *麻木的情緒<br /> *警覺性降低<br /> *肌肉無力<br /> *攻擊性反常增加<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 -1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *低溫<br /> *失禁<br /> *流口水，吞嚥障礙和吸入性肺炎<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt;0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> <br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> ===逆向反應===<br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |口服給藥後硝西泮吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |攝入後約2至3小時出現血漿峰值濃度。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |硝西泮從尿中排出。口服劑量的約20％ 中從糞便中排出<br /> <br /> 硝西泮的半衰期在16.5至48.3小時之間。在年輕人中，<br /> <br /> 硝西泮的半衰期約為29小時，而老年人的半衰期則更長，為40小時。<br /> <br /> 硝西泮在腦脊液中的半衰期為68小時，這表明其從腦脊液中的清除非常緩慢。<br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議血壓，脈搏和呼吸頻率<br /> *老年人可能對硝西泮的作用敏感。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的潛在癡呆。<br /> *硝西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *一些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過 4 星期以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對硝西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> <br /> ===藥物相互影響=== <br /> 與硝西泮相互作用的藥物可能 <br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與硝西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，西酞普蘭，帕羅西汀，舍曲林，阿米替林））<br /> <br /> 鎮靜劑組胺（例如扑爾敏，苯海拉明，苯海拉明）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平，氟哌啶醇，氯氮平，喹硫平，利培酮）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> |抑制硝西泮的代謝，從而延長其作用。<br /> |-<br /> |酒精<br /> |可能導致硝西泮和酒精的降壓作用協同增強<br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥會明顯減少硝西泮的清除，從而延長硝西泮的作用<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> |所有這些藥物都會增加硝西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加硝西泮的代謝，從而降低硝西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制硝西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |硝西泮可能會阻斷左旋多巴治療帕金森氏病的作用。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> 應減少劑量或從較小的初始劑量開始。<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛。<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電 999。<br /> <br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E7%A1%9D%E8%A5%BF%E6%B3%AE&diff=2696 2020-10-20T06:02:48Z

<p>Ctol2: /* 駕駛和技術性工作 */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''硝西泮''' (English: [[Nitrazepam]]) 是長效苯二氮䓬類藥物。它用作安眠藥短期治療失眠。據報導，它可以在 30 到 60 分鐘內起作用，使睡眠持續 6 到 8 個小時。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam tablet 5 mg<br /> |NITR01<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物。<br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> {| class = &quot;wikitable&quot;<br /> !失眠（短期使用）<br /> |口服<br /> 成人：臨睡前一次，每次 5-10mg<br /> <br /> 老年人和虛弱的患者：臨睡前一次，每次 2.5-5mg<br /> |}<br /> <br /> 苯二氮䓬類藥物有時用於癲癇的治療中，但是長期使用這類藥物的可引起鎮靜，依賴性和抗癲癇作用耐受性, 所以使用受到限制。<br /> <br /> 硝西泮已用於治療嬰兒痙攣症（例如在韋氏綜合症中）和所謂的嬰兒性肌陣攣性癲癇發作。<br /> <br /> 通常的口服劑量：每日 3 次, 每次 0.3 - 1 mg / kg。<br /> <br /> ==副作用==<br /> 硝西泮不合適年長患者使用，原因是：<br /> *夜間醒來的人的身體平衡和站立穩定性受損 <br /> *結果導致跌倒和髖部骨折<br /> *它引起一般的精神惡化<br /> *不能走路<br /> *失禁<br /> *混亂和迷失方向<br /> <br /> 硝西泮誘發的症狀可能導致癡呆症的誤診。 <br /> <br /> 老年人更容易出現鎮靜和協調能力下降。應在盡可能短的時間內使用最低有效劑量。<br /> <br /> 可能的副作用包括：<br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率&gt; 10％）或常見（發生率 1-10％）<br /> |行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *麻木的情緒<br /> *警覺性降低<br /> *肌肉無力<br /> *攻擊性反常增加<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 -1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *低溫<br /> *失禁<br /> *流口水，吞嚥障礙和吸入性肺炎<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt;0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> <br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> ===逆向反應===<br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |口服給藥後硝西泮吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |攝入後約2至3小時出現血漿峰值濃度。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |硝西泮從尿中排出。口服劑量的約20％ 中從糞便中排出<br /> <br /> 硝西泮的半衰期在16.5至48.3小時之間。在年輕人中，<br /> <br /> 硝西泮的半衰期約為29小時，而老年人的半衰期則更長，為40小時。<br /> <br /> 硝西泮在腦脊液中的半衰期為68小時，這表明其從腦脊液中的清除非常緩慢。<br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議血壓，脈搏和呼吸頻率<br /> *老年人可能對硝西泮的作用敏感。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的潛在癡呆。<br /> *硝西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *一些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過 4 星期以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對硝西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> <br /> ===藥物相互影響=== <br /> 與硝西泮相互作用的藥物可能 <br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與硝西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，西酞普蘭，帕羅西汀，舍曲林，阿米替林））<br /> <br /> 鎮靜劑組胺（例如扑爾敏，苯海拉明，苯海拉明）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平，氟哌啶醇，氯氮平，喹硫平，利培酮）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> |抑制硝西泮的代謝，從而延長其作用。<br /> |-<br /> |酒精<br /> |可能導致硝西泮和酒精的降壓作用協同增強<br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥會明顯減少硝西泮的清除，從而延長硝西泮的作用<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> |所有這些藥物都會增加硝西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加硝西泮的代謝，從而降低硝西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制硝西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |硝西泮可能會阻斷左旋多巴治療帕金森氏病的作用。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> 應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛。<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電 999。<br /> <br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E7%A1%9D%E8%A5%BF%E6%B3%AE&diff=2695 2020-10-20T06:02:39Z

<p>Ctol2: /* 如果服藥過量怎麼辦？ */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''硝西泮''' (English: [[Nitrazepam]]) 是長效苯二氮䓬類藥物。它用作安眠藥短期治療失眠。據報導，它可以在 30 到 60 分鐘內起作用，使睡眠持續 6 到 8 個小時。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam tablet 5 mg<br /> |NITR01<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物。<br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> {| class = &quot;wikitable&quot;<br /> !失眠（短期使用）<br /> |口服<br /> 成人：臨睡前一次，每次 5-10mg<br /> <br /> 老年人和虛弱的患者：臨睡前一次，每次 2.5-5mg<br /> |}<br /> <br /> 苯二氮䓬類藥物有時用於癲癇的治療中，但是長期使用這類藥物的可引起鎮靜，依賴性和抗癲癇作用耐受性, 所以使用受到限制。<br /> <br /> 硝西泮已用於治療嬰兒痙攣症（例如在韋氏綜合症中）和所謂的嬰兒性肌陣攣性癲癇發作。<br /> <br /> 通常的口服劑量：每日 3 次, 每次 0.3 - 1 mg / kg。<br /> <br /> ==副作用==<br /> 硝西泮不合適年長患者使用，原因是：<br /> *夜間醒來的人的身體平衡和站立穩定性受損 <br /> *結果導致跌倒和髖部骨折<br /> *它引起一般的精神惡化<br /> *不能走路<br /> *失禁<br /> *混亂和迷失方向<br /> <br /> 硝西泮誘發的症狀可能導致癡呆症的誤診。 <br /> <br /> 老年人更容易出現鎮靜和協調能力下降。應在盡可能短的時間內使用最低有效劑量。<br /> <br /> 可能的副作用包括：<br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率&gt; 10％）或常見（發生率 1-10％）<br /> |行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *麻木的情緒<br /> *警覺性降低<br /> *肌肉無力<br /> *攻擊性反常增加<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 -1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *低溫<br /> *失禁<br /> *流口水，吞嚥障礙和吸入性肺炎<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt;0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> <br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> ===逆向反應===<br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |口服給藥後硝西泮吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |攝入後約2至3小時出現血漿峰值濃度。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |硝西泮從尿中排出。口服劑量的約20％ 中從糞便中排出<br /> <br /> 硝西泮的半衰期在16.5至48.3小時之間。在年輕人中，<br /> <br /> 硝西泮的半衰期約為29小時，而老年人的半衰期則更長，為40小時。<br /> <br /> 硝西泮在腦脊液中的半衰期為68小時，這表明其從腦脊液中的清除非常緩慢。<br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議血壓，脈搏和呼吸頻率<br /> *老年人可能對硝西泮的作用敏感。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的潛在癡呆。<br /> *硝西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *一些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過 4 星期以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對硝西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> <br /> ===藥物相互影響=== <br /> 與硝西泮相互作用的藥物可能 <br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與硝西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，西酞普蘭，帕羅西汀，舍曲林，阿米替林））<br /> <br /> 鎮靜劑組胺（例如扑爾敏，苯海拉明，苯海拉明）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平，氟哌啶醇，氯氮平，喹硫平，利培酮）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> |抑制硝西泮的代謝，從而延長其作用。<br /> |-<br /> |酒精<br /> |可能導致硝西泮和酒精的降壓作用協同增強<br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥會明顯減少硝西泮的清除，從而延長硝西泮的作用<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> |所有這些藥物都會增加硝西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加硝西泮的代謝，從而降低硝西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制硝西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |硝西泮可能會阻斷左旋多巴治療帕金森氏病的作用。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> 應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電 999。<br /> <br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E7%A1%9D%E8%A5%BF%E6%B3%AE&diff=2694 2020-10-20T06:02:27Z

<p>Ctol2: /* 腎功能不全 */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''硝西泮''' (English: [[Nitrazepam]]) 是長效苯二氮䓬類藥物。它用作安眠藥短期治療失眠。據報導，它可以在 30 到 60 分鐘內起作用，使睡眠持續 6 到 8 個小時。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam tablet 5 mg<br /> |NITR01<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物。<br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> {| class = &quot;wikitable&quot;<br /> !失眠（短期使用）<br /> |口服<br /> 成人：臨睡前一次，每次 5-10mg<br /> <br /> 老年人和虛弱的患者：臨睡前一次，每次 2.5-5mg<br /> |}<br /> <br /> 苯二氮䓬類藥物有時用於癲癇的治療中，但是長期使用這類藥物的可引起鎮靜，依賴性和抗癲癇作用耐受性, 所以使用受到限制。<br /> <br /> 硝西泮已用於治療嬰兒痙攣症（例如在韋氏綜合症中）和所謂的嬰兒性肌陣攣性癲癇發作。<br /> <br /> 通常的口服劑量：每日 3 次, 每次 0.3 - 1 mg / kg。<br /> <br /> ==副作用==<br /> 硝西泮不合適年長患者使用，原因是：<br /> *夜間醒來的人的身體平衡和站立穩定性受損 <br /> *結果導致跌倒和髖部骨折<br /> *它引起一般的精神惡化<br /> *不能走路<br /> *失禁<br /> *混亂和迷失方向<br /> <br /> 硝西泮誘發的症狀可能導致癡呆症的誤診。 <br /> <br /> 老年人更容易出現鎮靜和協調能力下降。應在盡可能短的時間內使用最低有效劑量。<br /> <br /> 可能的副作用包括：<br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率&gt; 10％）或常見（發生率 1-10％）<br /> |行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *麻木的情緒<br /> *警覺性降低<br /> *肌肉無力<br /> *攻擊性反常增加<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 -1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *低溫<br /> *失禁<br /> *流口水，吞嚥障礙和吸入性肺炎<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt;0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> <br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> ===逆向反應===<br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |口服給藥後硝西泮吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |攝入後約2至3小時出現血漿峰值濃度。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |硝西泮從尿中排出。口服劑量的約20％ 中從糞便中排出<br /> <br /> 硝西泮的半衰期在16.5至48.3小時之間。在年輕人中，<br /> <br /> 硝西泮的半衰期約為29小時，而老年人的半衰期則更長，為40小時。<br /> <br /> 硝西泮在腦脊液中的半衰期為68小時，這表明其從腦脊液中的清除非常緩慢。<br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議血壓，脈搏和呼吸頻率<br /> *老年人可能對硝西泮的作用敏感。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的潛在癡呆。<br /> *硝西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *一些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過 4 星期以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對硝西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> <br /> ===藥物相互影響=== <br /> 與硝西泮相互作用的藥物可能 <br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與硝西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，西酞普蘭，帕羅西汀，舍曲林，阿米替林））<br /> <br /> 鎮靜劑組胺（例如扑爾敏，苯海拉明，苯海拉明）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平，氟哌啶醇，氯氮平，喹硫平，利培酮）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> |抑制硝西泮的代謝，從而延長其作用。<br /> |-<br /> |酒精<br /> |可能導致硝西泮和酒精的降壓作用協同增強<br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥會明顯減少硝西泮的清除，從而延長硝西泮的作用<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> |所有這些藥物都會增加硝西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加硝西泮的代謝，從而降低硝西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制硝西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |硝西泮可能會阻斷左旋多巴治療帕金森氏病的作用。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> 應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電999<br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E7%A1%9D%E8%A5%BF%E6%B3%AE&diff=2693 2020-10-20T06:01:36Z

<p>Ctol2: /* 藥物相互影響 */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''硝西泮''' (English: [[Nitrazepam]]) 是長效苯二氮䓬類藥物。它用作安眠藥短期治療失眠。據報導，它可以在 30 到 60 分鐘內起作用，使睡眠持續 6 到 8 個小時。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam tablet 5 mg<br /> |NITR01<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物。<br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> {| class = &quot;wikitable&quot;<br /> !失眠（短期使用）<br /> |口服<br /> 成人：臨睡前一次，每次 5-10mg<br /> <br /> 老年人和虛弱的患者：臨睡前一次，每次 2.5-5mg<br /> |}<br /> <br /> 苯二氮䓬類藥物有時用於癲癇的治療中，但是長期使用這類藥物的可引起鎮靜，依賴性和抗癲癇作用耐受性, 所以使用受到限制。<br /> <br /> 硝西泮已用於治療嬰兒痙攣症（例如在韋氏綜合症中）和所謂的嬰兒性肌陣攣性癲癇發作。<br /> <br /> 通常的口服劑量：每日 3 次, 每次 0.3 - 1 mg / kg。<br /> <br /> ==副作用==<br /> 硝西泮不合適年長患者使用，原因是：<br /> *夜間醒來的人的身體平衡和站立穩定性受損 <br /> *結果導致跌倒和髖部骨折<br /> *它引起一般的精神惡化<br /> *不能走路<br /> *失禁<br /> *混亂和迷失方向<br /> <br /> 硝西泮誘發的症狀可能導致癡呆症的誤診。 <br /> <br /> 老年人更容易出現鎮靜和協調能力下降。應在盡可能短的時間內使用最低有效劑量。<br /> <br /> 可能的副作用包括：<br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率&gt; 10％）或常見（發生率 1-10％）<br /> |行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *麻木的情緒<br /> *警覺性降低<br /> *肌肉無力<br /> *攻擊性反常增加<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 -1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *低溫<br /> *失禁<br /> *流口水，吞嚥障礙和吸入性肺炎<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt;0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> <br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> ===逆向反應===<br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |口服給藥後硝西泮吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |攝入後約2至3小時出現血漿峰值濃度。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |硝西泮從尿中排出。口服劑量的約20％ 中從糞便中排出<br /> <br /> 硝西泮的半衰期在16.5至48.3小時之間。在年輕人中，<br /> <br /> 硝西泮的半衰期約為29小時，而老年人的半衰期則更長，為40小時。<br /> <br /> 硝西泮在腦脊液中的半衰期為68小時，這表明其從腦脊液中的清除非常緩慢。<br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議血壓，脈搏和呼吸頻率<br /> *老年人可能對硝西泮的作用敏感。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的潛在癡呆。<br /> *硝西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *一些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過 4 星期以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對硝西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> <br /> ===藥物相互影響=== <br /> 與硝西泮相互作用的藥物可能 <br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與硝西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，西酞普蘭，帕羅西汀，舍曲林，阿米替林））<br /> <br /> 鎮靜劑組胺（例如扑爾敏，苯海拉明，苯海拉明）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平，氟哌啶醇，氯氮平，喹硫平，利培酮）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> |抑制硝西泮的代謝，從而延長其作用。<br /> |-<br /> |酒精<br /> |可能導致硝西泮和酒精的降壓作用協同增強<br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥會明顯減少硝西泮的清除，從而延長硝西泮的作用<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> |所有這些藥物都會增加硝西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加硝西泮的代謝，從而降低硝西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制硝西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |硝西泮可能會阻斷左旋多巴治療帕金森氏病的作用。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電999<br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E7%A1%9D%E8%A5%BF%E6%B3%AE&diff=2692 2020-10-20T06:01:15Z

<p>Ctol2: /* 藥物依賴與戒斷 */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''硝西泮''' (English: [[Nitrazepam]]) 是長效苯二氮䓬類藥物。它用作安眠藥短期治療失眠。據報導，它可以在 30 到 60 分鐘內起作用，使睡眠持續 6 到 8 個小時。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam tablet 5 mg<br /> |NITR01<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物。<br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> {| class = &quot;wikitable&quot;<br /> !失眠（短期使用）<br /> |口服<br /> 成人：臨睡前一次，每次 5-10mg<br /> <br /> 老年人和虛弱的患者：臨睡前一次，每次 2.5-5mg<br /> |}<br /> <br /> 苯二氮䓬類藥物有時用於癲癇的治療中，但是長期使用這類藥物的可引起鎮靜，依賴性和抗癲癇作用耐受性, 所以使用受到限制。<br /> <br /> 硝西泮已用於治療嬰兒痙攣症（例如在韋氏綜合症中）和所謂的嬰兒性肌陣攣性癲癇發作。<br /> <br /> 通常的口服劑量：每日 3 次, 每次 0.3 - 1 mg / kg。<br /> <br /> ==副作用==<br /> 硝西泮不合適年長患者使用，原因是：<br /> *夜間醒來的人的身體平衡和站立穩定性受損 <br /> *結果導致跌倒和髖部骨折<br /> *它引起一般的精神惡化<br /> *不能走路<br /> *失禁<br /> *混亂和迷失方向<br /> <br /> 硝西泮誘發的症狀可能導致癡呆症的誤診。 <br /> <br /> 老年人更容易出現鎮靜和協調能力下降。應在盡可能短的時間內使用最低有效劑量。<br /> <br /> 可能的副作用包括：<br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率&gt; 10％）或常見（發生率 1-10％）<br /> |行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *麻木的情緒<br /> *警覺性降低<br /> *肌肉無力<br /> *攻擊性反常增加<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 -1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *低溫<br /> *失禁<br /> *流口水，吞嚥障礙和吸入性肺炎<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt;0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> <br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> ===逆向反應===<br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |口服給藥後硝西泮吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |攝入後約2至3小時出現血漿峰值濃度。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |硝西泮從尿中排出。口服劑量的約20％ 中從糞便中排出<br /> <br /> 硝西泮的半衰期在16.5至48.3小時之間。在年輕人中，<br /> <br /> 硝西泮的半衰期約為29小時，而老年人的半衰期則更長，為40小時。<br /> <br /> 硝西泮在腦脊液中的半衰期為68小時，這表明其從腦脊液中的清除非常緩慢。<br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議血壓，脈搏和呼吸頻率<br /> *老年人可能對硝西泮的作用敏感。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的潛在癡呆。<br /> *硝西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *一些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過 4 星期以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對硝西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> <br /> ===藥物相互影響=== <br /> 與硝西泮相互作用的藥物可能 <br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與硝西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，西酞普蘭，帕羅西汀，舍曲林，阿米替林））<br /> <br /> 鎮靜劑組胺（例如扑爾敏，苯海拉明，苯海拉明）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平，氟哌啶醇，氯氮平，喹硫平，利培酮）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> <br /> |抑制硝西泮的代謝，從而延長其作用。<br /> <br /> |-<br /> |酒精<br /> |可能導致硝西泮和酒精的降壓作用協同增強<br /> <br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥會明顯減少硝西泮的清除，從而延長硝西泮的作用<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> <br /> <br /> |所有這些藥物都會增加硝西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加硝西泮的代謝，從而降低硝西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制硝西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |硝西泮可能會阻斷左旋多巴治療帕金森氏病的作用。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電999<br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E7%A1%9D%E8%A5%BF%E6%B3%AE&diff=2691 2020-10-20T06:00:33Z

<p>Ctol2: /* 藥物依賴與戒斷 */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''硝西泮''' (English: [[Nitrazepam]]) 是長效苯二氮䓬類藥物。它用作安眠藥短期治療失眠。據報導，它可以在 30 到 60 分鐘內起作用，使睡眠持續 6 到 8 個小時。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam tablet 5 mg<br /> |NITR01<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物。<br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> {| class = &quot;wikitable&quot;<br /> !失眠（短期使用）<br /> |口服<br /> 成人：臨睡前一次，每次 5-10mg<br /> <br /> 老年人和虛弱的患者：臨睡前一次，每次 2.5-5mg<br /> |}<br /> <br /> 苯二氮䓬類藥物有時用於癲癇的治療中，但是長期使用這類藥物的可引起鎮靜，依賴性和抗癲癇作用耐受性, 所以使用受到限制。<br /> <br /> 硝西泮已用於治療嬰兒痙攣症（例如在韋氏綜合症中）和所謂的嬰兒性肌陣攣性癲癇發作。<br /> <br /> 通常的口服劑量：每日 3 次, 每次 0.3 - 1 mg / kg。<br /> <br /> ==副作用==<br /> 硝西泮不合適年長患者使用，原因是：<br /> *夜間醒來的人的身體平衡和站立穩定性受損 <br /> *結果導致跌倒和髖部骨折<br /> *它引起一般的精神惡化<br /> *不能走路<br /> *失禁<br /> *混亂和迷失方向<br /> <br /> 硝西泮誘發的症狀可能導致癡呆症的誤診。 <br /> <br /> 老年人更容易出現鎮靜和協調能力下降。應在盡可能短的時間內使用最低有效劑量。<br /> <br /> 可能的副作用包括：<br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率&gt; 10％）或常見（發生率 1-10％）<br /> |行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *麻木的情緒<br /> *警覺性降低<br /> *肌肉無力<br /> *攻擊性反常增加<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 -1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *低溫<br /> *失禁<br /> *流口水，吞嚥障礙和吸入性肺炎<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt;0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> <br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> ===逆向反應===<br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |口服給藥後硝西泮吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |攝入後約2至3小時出現血漿峰值濃度。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |硝西泮從尿中排出。口服劑量的約20％ 中從糞便中排出<br /> <br /> 硝西泮的半衰期在16.5至48.3小時之間。在年輕人中，<br /> <br /> 硝西泮的半衰期約為29小時，而老年人的半衰期則更長，為40小時。<br /> <br /> 硝西泮在腦脊液中的半衰期為68小時，這表明其從腦脊液中的清除非常緩慢。<br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議血壓，脈搏和呼吸頻率<br /> *老年人可能對硝西泮的作用敏感。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的潛在癡呆。<br /> *硝西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *一些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過 4 星以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對硝西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> <br /> ===藥物相互影響=== <br /> 與硝西泮相互作用的藥物可能 <br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與硝西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，西酞普蘭，帕羅西汀，舍曲林，阿米替林））<br /> <br /> 鎮靜劑組胺（例如扑爾敏，苯海拉明，苯海拉明）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平，氟哌啶醇，氯氮平，喹硫平，利培酮）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> <br /> |抑制硝西泮的代謝，從而延長其作用。<br /> <br /> |-<br /> |酒精<br /> |可能導致硝西泮和酒精的降壓作用協同增強<br /> <br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥會明顯減少硝西泮的清除，從而延長硝西泮的作用<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> <br /> <br /> |所有這些藥物都會增加硝西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加硝西泮的代謝，從而降低硝西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制硝西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |硝西泮可能會阻斷左旋多巴治療帕金森氏病的作用。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電999<br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E7%A1%9D%E8%A5%BF%E6%B3%AE&diff=2690 2020-10-20T06:00:04Z

<p>Ctol2: /* 副作用 */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''硝西泮''' (English: [[Nitrazepam]]) 是長效苯二氮䓬類藥物。它用作安眠藥短期治療失眠。據報導，它可以在 30 到 60 分鐘內起作用，使睡眠持續 6 到 8 個小時。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam tablet 5 mg<br /> |NITR01<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物。<br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> {| class = &quot;wikitable&quot;<br /> !失眠（短期使用）<br /> |口服<br /> 成人：臨睡前一次，每次 5-10mg<br /> <br /> 老年人和虛弱的患者：臨睡前一次，每次 2.5-5mg<br /> |}<br /> <br /> 苯二氮䓬類藥物有時用於癲癇的治療中，但是長期使用這類藥物的可引起鎮靜，依賴性和抗癲癇作用耐受性, 所以使用受到限制。<br /> <br /> 硝西泮已用於治療嬰兒痙攣症（例如在韋氏綜合症中）和所謂的嬰兒性肌陣攣性癲癇發作。<br /> <br /> 通常的口服劑量：每日 3 次, 每次 0.3 - 1 mg / kg。<br /> <br /> ==副作用==<br /> 硝西泮不合適年長患者使用，原因是：<br /> *夜間醒來的人的身體平衡和站立穩定性受損 <br /> *結果導致跌倒和髖部骨折<br /> *它引起一般的精神惡化<br /> *不能走路<br /> *失禁<br /> *混亂和迷失方向<br /> <br /> 硝西泮誘發的症狀可能導致癡呆症的誤診。 <br /> <br /> 老年人更容易出現鎮靜和協調能力下降。應在盡可能短的時間內使用最低有效劑量。<br /> <br /> 可能的副作用包括：<br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率&gt; 10％）或常見（發生率 1-10％）<br /> |行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *麻木的情緒<br /> *警覺性降低<br /> *肌肉無力<br /> *攻擊性反常增加<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 -1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *低溫<br /> *失禁<br /> *流口水，吞嚥障礙和吸入性肺炎<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt;0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> <br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> ===逆向反應===<br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |口服給藥後硝西泮吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |攝入後約2至3小時出現血漿峰值濃度。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |硝西泮從尿中排出。口服劑量的約20％ 中從糞便中排出<br /> <br /> 硝西泮的半衰期在16.5至48.3小時之間。在年輕人中，<br /> <br /> 硝西泮的半衰期約為29小時，而老年人的半衰期則更長，為40小時。<br /> <br /> 硝西泮在腦脊液中的半衰期為68小時，這表明其從腦脊液中的清除非常緩慢。<br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議血壓，脈搏和呼吸頻率<br /> *老年人可能對硝西泮的作用敏感。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的潛在癡呆。<br /> *硝西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *一些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過4星以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對硝西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> <br /> ===藥物相互影響=== <br /> 與硝西泮相互作用的藥物可能 <br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與硝西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，西酞普蘭，帕羅西汀，舍曲林，阿米替林））<br /> <br /> 鎮靜劑組胺（例如扑爾敏，苯海拉明，苯海拉明）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平，氟哌啶醇，氯氮平，喹硫平，利培酮）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> <br /> |抑制硝西泮的代謝，從而延長其作用。<br /> <br /> |-<br /> |酒精<br /> |可能導致硝西泮和酒精的降壓作用協同增強<br /> <br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥會明顯減少硝西泮的清除，從而延長硝西泮的作用<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> <br /> <br /> |所有這些藥物都會增加硝西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加硝西泮的代謝，從而降低硝西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制硝西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |硝西泮可能會阻斷左旋多巴治療帕金森氏病的作用。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電999<br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E7%A1%9D%E8%A5%BF%E6%B3%AE&diff=2689 2020-10-20T05:50:09Z

<p>Ctol2: /* 副作用 */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''硝西泮''' (English: [[Nitrazepam]]) 是長效苯二氮䓬類藥物。它用作安眠藥短期治療失眠。據報導，它可以在 30 到 60 分鐘內起作用，使睡眠持續 6 到 8 個小時。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam tablet 5 mg<br /> |NITR01<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物。<br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> {| class = &quot;wikitable&quot;<br /> !失眠（短期使用）<br /> |口服<br /> 成人：臨睡前一次，每次 5-10mg<br /> <br /> 老年人和虛弱的患者：臨睡前一次，每次 2.5-5mg<br /> |}<br /> <br /> 苯二氮䓬類藥物有時用於癲癇的治療中，但是長期使用這類藥物的可引起鎮靜，依賴性和抗癲癇作用耐受性, 所以使用受到限制。<br /> <br /> 硝西泮已用於治療嬰兒痙攣症（例如在韋氏綜合症中）和所謂的嬰兒性肌陣攣性癲癇發作。<br /> <br /> 通常的口服劑量：每日 3 次, 每次 0.3 - 1 mg / kg。<br /> <br /> ==副作用==<br /> 硝西泮不合適年長患者使用，原因是：<br /> *夜間醒來的人的身體平衡和站立穩定性受損 <br /> *結果導致跌倒和髖部骨折<br /> *它引起一般的精神惡化<br /> *不能走路<br /> *失禁<br /> *混亂和迷失方向<br /> <br /> 硝西泮誘發的症狀可能導致癡呆症的誤診。 <br /> <br /> 老年人更容易出現鎮靜和協調能力下降。應在盡可能短的時間內使用最低有效劑量。<br /> <br /> 可能的副作用包括：<br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率&gt; 10％）或常見（發生率 1-10％）<br /> |行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *麻木的情緒<br /> *警覺性降低<br /> *肌肉無力<br /> *攻擊性反常增加<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 -1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *低溫<br /> *失禁<br /> *流口水，吞嚥障礙和吸入性肺炎<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt;0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> <br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> 逆向反應 <br /> <br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |口服給藥後硝西泮吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |攝入後約2至3小時出現血漿峰值濃度。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |硝西泮從尿中排出。口服劑量的約20％ 中從糞便中排出<br /> <br /> 硝西泮的半衰期在16.5至48.3小時之間。在年輕人中，<br /> <br /> 硝西泮的半衰期約為29小時，而老年人的半衰期則更長，為40小時。<br /> <br /> 硝西泮在腦脊液中的半衰期為68小時，這表明其從腦脊液中的清除非常緩慢。<br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議血壓，脈搏和呼吸頻率<br /> *老年人可能對硝西泮的作用敏感。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的潛在癡呆。<br /> *硝西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *一些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過4星以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對硝西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> <br /> ===藥物相互影響=== <br /> 與硝西泮相互作用的藥物可能 <br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與硝西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，西酞普蘭，帕羅西汀，舍曲林，阿米替林））<br /> <br /> 鎮靜劑組胺（例如扑爾敏，苯海拉明，苯海拉明）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平，氟哌啶醇，氯氮平，喹硫平，利培酮）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> <br /> |抑制硝西泮的代謝，從而延長其作用。<br /> <br /> |-<br /> |酒精<br /> |可能導致硝西泮和酒精的降壓作用協同增強<br /> <br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥會明顯減少硝西泮的清除，從而延長硝西泮的作用<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> <br /> <br /> |所有這些藥物都會增加硝西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加硝西泮的代謝，從而降低硝西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制硝西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |硝西泮可能會阻斷左旋多巴治療帕金森氏病的作用。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電999<br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E7%A1%9D%E8%A5%BF%E6%B3%AE&diff=2688 2020-10-20T05:49:45Z

<p>Ctol2: /* 劑量 */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''硝西泮''' (English: [[Nitrazepam]]) 是長效苯二氮䓬類藥物。它用作安眠藥短期治療失眠。據報導，它可以在 30 到 60 分鐘內起作用，使睡眠持續 6 到 8 個小時。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam tablet 5 mg<br /> |NITR01<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物。<br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> {| class = &quot;wikitable&quot;<br /> !失眠（短期使用）<br /> |口服<br /> 成人：臨睡前一次，每次 5-10mg<br /> <br /> 老年人和虛弱的患者：臨睡前一次，每次 2.5-5mg<br /> |}<br /> <br /> 苯二氮䓬類藥物有時用於癲癇的治療中，但是長期使用這類藥物的可引起鎮靜，依賴性和抗癲癇作用耐受性, 所以使用受到限制。<br /> <br /> 硝西泮已用於治療嬰兒痙攣症（例如在韋氏綜合症中）和所謂的嬰兒性肌陣攣性癲癇發作。<br /> <br /> 通常的口服劑量：每日 3 次, 每次 0.3 - 1 mg / kg。<br /> <br /> ==副作用==<br /> 硝西泮不合適年長患者使用，原因是：<br /> *夜間醒來的人的身體平衡和站立穩定性受損 <br /> *結果導致跌倒和髖部骨折<br /> *它引起一般的精神惡化<br /> *不能走路<br /> *失禁<br /> *混亂和迷失方向<br /> <br /> 硝西泮誘發的症狀可能導致癡呆症的誤診。 <br /> 老年人更容易出現鎮靜和協調能力下降。應在盡可能短的時間內使用最低有效劑量。<br /> <br /> 可能的副作用包括：<br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率&gt; 10％）或常見（發生率 1-10％）<br /> |行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *麻木的情緒<br /> *警覺性降低<br /> *肌肉無力<br /> *攻擊性反常增加<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 -1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *低溫<br /> *失禁<br /> *流口水，吞嚥障礙和吸入性肺炎<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt;0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> <br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> 逆向反應 <br /> <br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |口服給藥後硝西泮吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |攝入後約2至3小時出現血漿峰值濃度。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |硝西泮從尿中排出。口服劑量的約20％ 中從糞便中排出<br /> <br /> 硝西泮的半衰期在16.5至48.3小時之間。在年輕人中，<br /> <br /> 硝西泮的半衰期約為29小時，而老年人的半衰期則更長，為40小時。<br /> <br /> 硝西泮在腦脊液中的半衰期為68小時，這表明其從腦脊液中的清除非常緩慢。<br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議血壓，脈搏和呼吸頻率<br /> *老年人可能對硝西泮的作用敏感。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的潛在癡呆。<br /> *硝西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *一些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過4星以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對硝西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> <br /> ===藥物相互影響=== <br /> 與硝西泮相互作用的藥物可能 <br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與硝西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，西酞普蘭，帕羅西汀，舍曲林，阿米替林））<br /> <br /> 鎮靜劑組胺（例如扑爾敏，苯海拉明，苯海拉明）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平，氟哌啶醇，氯氮平，喹硫平，利培酮）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> <br /> |抑制硝西泮的代謝，從而延長其作用。<br /> <br /> |-<br /> |酒精<br /> |可能導致硝西泮和酒精的降壓作用協同增強<br /> <br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥會明顯減少硝西泮的清除，從而延長硝西泮的作用<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> <br /> <br /> |所有這些藥物都會增加硝西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加硝西泮的代謝，從而降低硝西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制硝西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |硝西泮可能會阻斷左旋多巴治療帕金森氏病的作用。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電999<br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E7%A1%9D%E8%A5%BF%E6%B3%AE&diff=2687 2020-10-20T05:49:36Z

<p>Ctol2: /* 劑量 */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''硝西泮''' (English: [[Nitrazepam]]) 是長效苯二氮䓬類藥物。它用作安眠藥短期治療失眠。據報導，它可以在 30 到 60 分鐘內起作用，使睡眠持續 6 到 8 個小時。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam tablet 5 mg<br /> |NITR01<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物。<br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> {| class = &quot;wikitable&quot;<br /> !失眠（短期使用）<br /> |口服<br /> 成人：臨睡前一次，每次 5-10mg<br /> <br /> 老年人和虛弱的患者：臨睡前一次，每次 2.5-5mg<br /> |}<br /> <br /> 苯二氮䓬類藥物有時用於癲癇的治療中，但是長期使用這類藥物的可引起鎮靜，依賴性和抗癲癇作用耐受性, 所以使用受到限制。<br /> <br /> 硝西泮已用於治療嬰兒痙攣症（例如在韋氏綜合症中）和所謂的嬰兒性肌陣攣性癲癇發作。<br /> <br /> 通常的口服劑量：每日 3 次, 每次 0.3 - 1 mg / kg<br /> <br /> ==副作用==<br /> 硝西泮不合適年長患者使用，原因是：<br /> *夜間醒來的人的身體平衡和站立穩定性受損 <br /> *結果導致跌倒和髖部骨折<br /> *它引起一般的精神惡化<br /> *不能走路<br /> *失禁<br /> *混亂和迷失方向<br /> <br /> 硝西泮誘發的症狀可能導致癡呆症的誤診。 <br /> 老年人更容易出現鎮靜和協調能力下降。應在盡可能短的時間內使用最低有效劑量。<br /> <br /> 可能的副作用包括：<br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率&gt; 10％）或常見（發生率 1-10％）<br /> |行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *麻木的情緒<br /> *警覺性降低<br /> *肌肉無力<br /> *攻擊性反常增加<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 -1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *低溫<br /> *失禁<br /> *流口水，吞嚥障礙和吸入性肺炎<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt;0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> <br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> 逆向反應 <br /> <br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |口服給藥後硝西泮吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |攝入後約2至3小時出現血漿峰值濃度。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |硝西泮從尿中排出。口服劑量的約20％ 中從糞便中排出<br /> <br /> 硝西泮的半衰期在16.5至48.3小時之間。在年輕人中，<br /> <br /> 硝西泮的半衰期約為29小時，而老年人的半衰期則更長，為40小時。<br /> <br /> 硝西泮在腦脊液中的半衰期為68小時，這表明其從腦脊液中的清除非常緩慢。<br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議血壓，脈搏和呼吸頻率<br /> *老年人可能對硝西泮的作用敏感。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的潛在癡呆。<br /> *硝西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *一些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過4星以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對硝西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> <br /> ===藥物相互影響=== <br /> 與硝西泮相互作用的藥物可能 <br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與硝西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，西酞普蘭，帕羅西汀，舍曲林，阿米替林））<br /> <br /> 鎮靜劑組胺（例如扑爾敏，苯海拉明，苯海拉明）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平，氟哌啶醇，氯氮平，喹硫平，利培酮）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> <br /> |抑制硝西泮的代謝，從而延長其作用。<br /> <br /> |-<br /> |酒精<br /> |可能導致硝西泮和酒精的降壓作用協同增強<br /> <br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥會明顯減少硝西泮的清除，從而延長硝西泮的作用<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> <br /> <br /> |所有這些藥物都會增加硝西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加硝西泮的代謝，從而降低硝西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制硝西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |硝西泮可能會阻斷左旋多巴治療帕金森氏病的作用。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電999<br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E7%A1%9D%E8%A5%BF%E6%B3%AE&diff=2686 2020-10-20T05:49:20Z

<p>Ctol2: /* 劑量 */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''硝西泮''' (English: [[Nitrazepam]]) 是長效苯二氮䓬類藥物。它用作安眠藥短期治療失眠。據報導，它可以在 30 到 60 分鐘內起作用，使睡眠持續 6 到 8 個小時。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam tablet 5 mg<br /> |NITR01<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物。<br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> {| class = &quot;wikitable&quot;<br /> !失眠（短期使用）<br /> |口服<br /> 成人：臨睡前一次，每次 5-10mg<br /> <br /> 老年人和虛弱的患者：臨睡前一次，每次 2.5-5mg<br /> |}<br /> <br /> 苯二氮䓬類藥物有時用於癲癇的治療中，但是長期使用這類藥物的可引起鎮靜，依賴性和抗癲癇作用耐受性, 所以使用受到限制.<br /> <br /> 硝西泮已用於治療嬰兒痙攣症（例如在韋氏綜合症中）和所謂的嬰兒性肌陣攣性癲癇發作。<br /> <br /> 通常的口服劑量：每日 3 次, 每次 0.3 - 1 mg / kg<br /> <br /> ==副作用==<br /> 硝西泮不合適年長患者使用，原因是：<br /> *夜間醒來的人的身體平衡和站立穩定性受損 <br /> *結果導致跌倒和髖部骨折<br /> *它引起一般的精神惡化<br /> *不能走路<br /> *失禁<br /> *混亂和迷失方向<br /> <br /> 硝西泮誘發的症狀可能導致癡呆症的誤診。 <br /> 老年人更容易出現鎮靜和協調能力下降。應在盡可能短的時間內使用最低有效劑量。<br /> <br /> 可能的副作用包括：<br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率&gt; 10％）或常見（發生率 1-10％）<br /> |行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *麻木的情緒<br /> *警覺性降低<br /> *肌肉無力<br /> *攻擊性反常增加<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 -1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *低溫<br /> *失禁<br /> *流口水，吞嚥障礙和吸入性肺炎<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt;0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> <br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> 逆向反應 <br /> <br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |口服給藥後硝西泮吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |攝入後約2至3小時出現血漿峰值濃度。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |硝西泮從尿中排出。口服劑量的約20％ 中從糞便中排出<br /> <br /> 硝西泮的半衰期在16.5至48.3小時之間。在年輕人中，<br /> <br /> 硝西泮的半衰期約為29小時，而老年人的半衰期則更長，為40小時。<br /> <br /> 硝西泮在腦脊液中的半衰期為68小時，這表明其從腦脊液中的清除非常緩慢。<br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議血壓，脈搏和呼吸頻率<br /> *老年人可能對硝西泮的作用敏感。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的潛在癡呆。<br /> *硝西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *一些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過4星以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對硝西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> <br /> ===藥物相互影響=== <br /> 與硝西泮相互作用的藥物可能 <br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與硝西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，西酞普蘭，帕羅西汀，舍曲林，阿米替林））<br /> <br /> 鎮靜劑組胺（例如扑爾敏，苯海拉明，苯海拉明）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平，氟哌啶醇，氯氮平，喹硫平，利培酮）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> <br /> |抑制硝西泮的代謝，從而延長其作用。<br /> <br /> |-<br /> |酒精<br /> |可能導致硝西泮和酒精的降壓作用協同增強<br /> <br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥會明顯減少硝西泮的清除，從而延長硝西泮的作用<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> <br /> <br /> |所有這些藥物都會增加硝西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加硝西泮的代謝，從而降低硝西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制硝西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |硝西泮可能會阻斷左旋多巴治療帕金森氏病的作用。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電999<br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E7%A1%9D%E8%A5%BF%E6%B3%AE&diff=2685 2020-10-20T05:48:55Z

<p>Ctol2: /* 劑量 */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''硝西泮''' (English: [[Nitrazepam]]) 是長效苯二氮䓬類藥物。它用作安眠藥短期治療失眠。據報導，它可以在 30 到 60 分鐘內起作用，使睡眠持續 6 到 8 個小時。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam tablet 5 mg<br /> |NITR01<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物。<br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> {| class = &quot;wikitable&quot;<br /> !失眠（短期使用）<br /> |口服<br /> 成人：臨睡前一次，每次 5-10mg<br /> <br /> 老年人和虛弱的患者：臨睡前一次，每次 2.5-5mg<br /> |}<br /> <br /> 苯二氮䓬類藥物有時用於癲癇的治療中，但是長期使用這類藥物的可引起鎮靜，依賴性和抗癲癇作用耐受性, 所以使用受到限制.<br /> 硝西泮已用於治療嬰兒痙攣症（例如在韋氏綜合症中）和所謂的嬰兒性肌陣攣性癲癇發作。<br /> 通常的口服劑量：每日 3 次, 每次 0.3-1 mg / kg<br /> <br /> ==副作用==<br /> 硝西泮不合適年長患者使用，原因是：<br /> *夜間醒來的人的身體平衡和站立穩定性受損 <br /> *結果導致跌倒和髖部骨折<br /> *它引起一般的精神惡化<br /> *不能走路<br /> *失禁<br /> *混亂和迷失方向<br /> <br /> 硝西泮誘發的症狀可能導致癡呆症的誤診。 <br /> 老年人更容易出現鎮靜和協調能力下降。應在盡可能短的時間內使用最低有效劑量。<br /> <br /> 可能的副作用包括：<br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率&gt; 10％）或常見（發生率 1-10％）<br /> |行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *麻木的情緒<br /> *警覺性降低<br /> *肌肉無力<br /> *攻擊性反常增加<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 -1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *低溫<br /> *失禁<br /> *流口水，吞嚥障礙和吸入性肺炎<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt;0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> <br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> 逆向反應 <br /> <br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |口服給藥後硝西泮吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |攝入後約2至3小時出現血漿峰值濃度。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |硝西泮從尿中排出。口服劑量的約20％ 中從糞便中排出<br /> <br /> 硝西泮的半衰期在16.5至48.3小時之間。在年輕人中，<br /> <br /> 硝西泮的半衰期約為29小時，而老年人的半衰期則更長，為40小時。<br /> <br /> 硝西泮在腦脊液中的半衰期為68小時，這表明其從腦脊液中的清除非常緩慢。<br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議血壓，脈搏和呼吸頻率<br /> *老年人可能對硝西泮的作用敏感。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的潛在癡呆。<br /> *硝西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *一些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過4星以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對硝西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> <br /> ===藥物相互影響=== <br /> 與硝西泮相互作用的藥物可能 <br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與硝西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，西酞普蘭，帕羅西汀，舍曲林，阿米替林））<br /> <br /> 鎮靜劑組胺（例如扑爾敏，苯海拉明，苯海拉明）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平，氟哌啶醇，氯氮平，喹硫平，利培酮）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> <br /> |抑制硝西泮的代謝，從而延長其作用。<br /> <br /> |-<br /> |酒精<br /> |可能導致硝西泮和酒精的降壓作用協同增強<br /> <br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥會明顯減少硝西泮的清除，從而延長硝西泮的作用<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> <br /> <br /> |所有這些藥物都會增加硝西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加硝西泮的代謝，從而降低硝西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制硝西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |硝西泮可能會阻斷左旋多巴治療帕金森氏病的作用。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電999<br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E7%A1%9D%E8%A5%BF%E6%B3%AE&diff=2684 2020-10-20T05:48:31Z

<p>Ctol2: /* 藥理 */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''硝西泮''' (English: [[Nitrazepam]]) 是長效苯二氮䓬類藥物。它用作安眠藥短期治療失眠。據報導，它可以在 30 到 60 分鐘內起作用，使睡眠持續 6 到 8 個小時。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam tablet 5 mg<br /> |NITR01<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物。<br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> {| class = &quot;wikitable&quot;<br /> !失眠（短期使用）<br /> |口服<br /> 成人：臨睡前一次，每次5-10mg<br /> <br /> 老年人和虛弱的患者：臨睡前一次，每次2.5-5mg<br /> |}<br /> <br /> 苯二氮䓬類藥物有時用於癲癇的治療中，但是長期使用這類藥物的可引起鎮靜，依賴性和抗癲癇作用耐受性, 所以使用受到限制.<br /> 硝西泮已用於治療嬰兒痙攣症（例如在韋氏綜合症中）和所謂的嬰兒性肌陣攣性癲癇發作。<br /> 通常的口服劑量：每日3次, 每次0.3-1 mg / kg<br /> <br /> ==副作用==<br /> 硝西泮不合適年長患者使用，原因是：<br /> *夜間醒來的人的身體平衡和站立穩定性受損 <br /> *結果導致跌倒和髖部骨折<br /> *它引起一般的精神惡化<br /> *不能走路<br /> *失禁<br /> *混亂和迷失方向<br /> <br /> 硝西泮誘發的症狀可能導致癡呆症的誤診。 <br /> 老年人更容易出現鎮靜和協調能力下降。應在盡可能短的時間內使用最低有效劑量。<br /> <br /> 可能的副作用包括：<br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率&gt; 10％）或常見（發生率 1-10％）<br /> |行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *麻木的情緒<br /> *警覺性降低<br /> *肌肉無力<br /> *攻擊性反常增加<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 -1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *低溫<br /> *失禁<br /> *流口水，吞嚥障礙和吸入性肺炎<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt;0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> <br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> 逆向反應 <br /> <br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |口服給藥後硝西泮吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |攝入後約2至3小時出現血漿峰值濃度。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |硝西泮從尿中排出。口服劑量的約20％ 中從糞便中排出<br /> <br /> 硝西泮的半衰期在16.5至48.3小時之間。在年輕人中，<br /> <br /> 硝西泮的半衰期約為29小時，而老年人的半衰期則更長，為40小時。<br /> <br /> 硝西泮在腦脊液中的半衰期為68小時，這表明其從腦脊液中的清除非常緩慢。<br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議血壓，脈搏和呼吸頻率<br /> *老年人可能對硝西泮的作用敏感。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的潛在癡呆。<br /> *硝西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *一些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過4星以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對硝西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> <br /> ===藥物相互影響=== <br /> 與硝西泮相互作用的藥物可能 <br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與硝西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，西酞普蘭，帕羅西汀，舍曲林，阿米替林））<br /> <br /> 鎮靜劑組胺（例如扑爾敏，苯海拉明，苯海拉明）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平，氟哌啶醇，氯氮平，喹硫平，利培酮）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> <br /> |抑制硝西泮的代謝，從而延長其作用。<br /> <br /> |-<br /> |酒精<br /> |可能導致硝西泮和酒精的降壓作用協同增強<br /> <br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥會明顯減少硝西泮的清除，從而延長硝西泮的作用<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> <br /> <br /> |所有這些藥物都會增加硝西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加硝西泮的代謝，從而降低硝西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制硝西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |硝西泮可能會阻斷左旋多巴治療帕金森氏病的作用。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電999<br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E7%A1%9D%E8%A5%BF%E6%B3%AE&diff=2683 2020-10-20T05:48:21Z

<p>Ctol2: /* 藥理 */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''硝西泮''' (English: [[Nitrazepam]]) 是長效苯二氮䓬類藥物。它用作安眠藥短期治療失眠。據報導，它可以在 30 到 60 分鐘內起作用，使睡眠持續 6 到 8 個小時。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam tablet 5 mg<br /> |NITR01<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物。<br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致GABA-苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> {| class = &quot;wikitable&quot;<br /> !失眠（短期使用）<br /> |口服<br /> 成人：臨睡前一次，每次5-10mg<br /> <br /> 老年人和虛弱的患者：臨睡前一次，每次2.5-5mg<br /> |}<br /> <br /> 苯二氮䓬類藥物有時用於癲癇的治療中，但是長期使用這類藥物的可引起鎮靜，依賴性和抗癲癇作用耐受性, 所以使用受到限制.<br /> 硝西泮已用於治療嬰兒痙攣症（例如在韋氏綜合症中）和所謂的嬰兒性肌陣攣性癲癇發作。<br /> 通常的口服劑量：每日3次, 每次0.3-1 mg / kg<br /> <br /> ==副作用==<br /> 硝西泮不合適年長患者使用，原因是：<br /> *夜間醒來的人的身體平衡和站立穩定性受損 <br /> *結果導致跌倒和髖部骨折<br /> *它引起一般的精神惡化<br /> *不能走路<br /> *失禁<br /> *混亂和迷失方向<br /> <br /> 硝西泮誘發的症狀可能導致癡呆症的誤診。 <br /> 老年人更容易出現鎮靜和協調能力下降。應在盡可能短的時間內使用最低有效劑量。<br /> <br /> 可能的副作用包括：<br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率&gt; 10％）或常見（發生率 1-10％）<br /> |行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *麻木的情緒<br /> *警覺性降低<br /> *肌肉無力<br /> *攻擊性反常增加<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 -1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *低溫<br /> *失禁<br /> *流口水，吞嚥障礙和吸入性肺炎<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt;0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> <br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> 逆向反應 <br /> <br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |口服給藥後硝西泮吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |攝入後約2至3小時出現血漿峰值濃度。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |硝西泮從尿中排出。口服劑量的約20％ 中從糞便中排出<br /> <br /> 硝西泮的半衰期在16.5至48.3小時之間。在年輕人中，<br /> <br /> 硝西泮的半衰期約為29小時，而老年人的半衰期則更長，為40小時。<br /> <br /> 硝西泮在腦脊液中的半衰期為68小時，這表明其從腦脊液中的清除非常緩慢。<br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議血壓，脈搏和呼吸頻率<br /> *老年人可能對硝西泮的作用敏感。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的潛在癡呆。<br /> *硝西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *一些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過4星以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對硝西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> <br /> ===藥物相互影響=== <br /> 與硝西泮相互作用的藥物可能 <br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與硝西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，西酞普蘭，帕羅西汀，舍曲林，阿米替林））<br /> <br /> 鎮靜劑組胺（例如扑爾敏，苯海拉明，苯海拉明）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平，氟哌啶醇，氯氮平，喹硫平，利培酮）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> <br /> |抑制硝西泮的代謝，從而延長其作用。<br /> <br /> |-<br /> |酒精<br /> |可能導致硝西泮和酒精的降壓作用協同增強<br /> <br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥會明顯減少硝西泮的清除，從而延長硝西泮的作用<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> <br /> <br /> |所有這些藥物都會增加硝西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加硝西泮的代謝，從而降低硝西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制硝西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |硝西泮可能會阻斷左旋多巴治療帕金森氏病的作用。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電999<br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E7%A1%9D%E8%A5%BF%E6%B3%AE&diff=2682 2020-10-20T05:47:47Z

<p>Ctol2: /* 藥名 */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''硝西泮''' (English: [[Nitrazepam]]) 是長效苯二氮䓬類藥物。它用作安眠藥短期治療失眠。據報導，它可以在 30 到 60 分鐘內起作用，使睡眠持續 6 到 8 個小時。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Nitrazepam tablet 5 mg<br /> |NITR01<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物 <br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致GABA-苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> {| class = &quot;wikitable&quot;<br /> !失眠（短期使用）<br /> |口服<br /> 成人：臨睡前一次，每次5-10mg<br /> <br /> 老年人和虛弱的患者：臨睡前一次，每次2.5-5mg<br /> |}<br /> <br /> 苯二氮䓬類藥物有時用於癲癇的治療中，但是長期使用這類藥物的可引起鎮靜，依賴性和抗癲癇作用耐受性, 所以使用受到限制.<br /> 硝西泮已用於治療嬰兒痙攣症（例如在韋氏綜合症中）和所謂的嬰兒性肌陣攣性癲癇發作。<br /> 通常的口服劑量：每日3次, 每次0.3-1 mg / kg<br /> <br /> ==副作用==<br /> 硝西泮不合適年長患者使用，原因是：<br /> *夜間醒來的人的身體平衡和站立穩定性受損 <br /> *結果導致跌倒和髖部骨折<br /> *它引起一般的精神惡化<br /> *不能走路<br /> *失禁<br /> *混亂和迷失方向<br /> <br /> 硝西泮誘發的症狀可能導致癡呆症的誤診。 <br /> 老年人更容易出現鎮靜和協調能力下降。應在盡可能短的時間內使用最低有效劑量。<br /> <br /> 可能的副作用包括：<br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率&gt; 10％）或常見（發生率 1-10％）<br /> |行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *麻木的情緒<br /> *警覺性降低<br /> *肌肉無力<br /> *攻擊性反常增加<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 -1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *低溫<br /> *失禁<br /> *流口水，吞嚥障礙和吸入性肺炎<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt;0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> <br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> 逆向反應 <br /> <br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |口服給藥後硝西泮吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |攝入後約2至3小時出現血漿峰值濃度。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |硝西泮從尿中排出。口服劑量的約20％ 中從糞便中排出<br /> <br /> 硝西泮的半衰期在16.5至48.3小時之間。在年輕人中，<br /> <br /> 硝西泮的半衰期約為29小時，而老年人的半衰期則更長，為40小時。<br /> <br /> 硝西泮在腦脊液中的半衰期為68小時，這表明其從腦脊液中的清除非常緩慢。<br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議血壓，脈搏和呼吸頻率<br /> *老年人可能對硝西泮的作用敏感。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的潛在癡呆。<br /> *硝西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *一些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過4星以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對硝西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> <br /> ===藥物相互影響=== <br /> 與硝西泮相互作用的藥物可能 <br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與硝西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，西酞普蘭，帕羅西汀，舍曲林，阿米替林））<br /> <br /> 鎮靜劑組胺（例如扑爾敏，苯海拉明，苯海拉明）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平，氟哌啶醇，氯氮平，喹硫平，利培酮）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> <br /> |抑制硝西泮的代謝，從而延長其作用。<br /> <br /> |-<br /> |酒精<br /> |可能導致硝西泮和酒精的降壓作用協同增強<br /> <br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥會明顯減少硝西泮的清除，從而延長硝西泮的作用<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> <br /> <br /> |所有這些藥物都會增加硝西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加硝西泮的代謝，從而降低硝西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制硝西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |硝西泮可能會阻斷左旋多巴治療帕金森氏病的作用。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電999<br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E7%A1%9D%E8%A5%BF%E6%B3%AE&diff=2681 2020-10-20T05:47:32Z

<p>Ctol2: </p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''硝西泮''' (English: [[Nitrazepam]]) 是長效苯二氮䓬類藥物。它用作安眠藥短期治療失眠。據報導，它可以在 30 到 60 分鐘內起作用，使睡眠持續 6 到 8 個小時。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification藥物分類<br /> |-<br /> |Nitrazepam tablet 5 mg<br /> |NITR01<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物 <br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致GABA-苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> {| class = &quot;wikitable&quot;<br /> !失眠（短期使用）<br /> |口服<br /> 成人：臨睡前一次，每次5-10mg<br /> <br /> 老年人和虛弱的患者：臨睡前一次，每次2.5-5mg<br /> |}<br /> <br /> 苯二氮䓬類藥物有時用於癲癇的治療中，但是長期使用這類藥物的可引起鎮靜，依賴性和抗癲癇作用耐受性, 所以使用受到限制.<br /> 硝西泮已用於治療嬰兒痙攣症（例如在韋氏綜合症中）和所謂的嬰兒性肌陣攣性癲癇發作。<br /> 通常的口服劑量：每日3次, 每次0.3-1 mg / kg<br /> <br /> ==副作用==<br /> 硝西泮不合適年長患者使用，原因是：<br /> *夜間醒來的人的身體平衡和站立穩定性受損 <br /> *結果導致跌倒和髖部骨折<br /> *它引起一般的精神惡化<br /> *不能走路<br /> *失禁<br /> *混亂和迷失方向<br /> <br /> 硝西泮誘發的症狀可能導致癡呆症的誤診。 <br /> 老年人更容易出現鎮靜和協調能力下降。應在盡可能短的時間內使用最低有效劑量。<br /> <br /> 可能的副作用包括：<br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率&gt; 10％）或常見（發生率 1-10％）<br /> |行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *麻木的情緒<br /> *警覺性降低<br /> *肌肉無力<br /> *攻擊性反常增加<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 -1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *低溫<br /> *失禁<br /> *流口水，吞嚥障礙和吸入性肺炎<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> <br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt;0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> <br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> 逆向反應 <br /> <br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |口服給藥後硝西泮吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |攝入後約2至3小時出現血漿峰值濃度。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |硝西泮從尿中排出。口服劑量的約20％ 中從糞便中排出<br /> <br /> 硝西泮的半衰期在16.5至48.3小時之間。在年輕人中，<br /> <br /> 硝西泮的半衰期約為29小時，而老年人的半衰期則更長，為40小時。<br /> <br /> 硝西泮在腦脊液中的半衰期為68小時，這表明其從腦脊液中的清除非常緩慢。<br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議血壓，脈搏和呼吸頻率<br /> *老年人可能對硝西泮的作用敏感。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的潛在癡呆。<br /> *硝西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *一些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過4星以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對硝西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> <br /> ===藥物相互影響=== <br /> 與硝西泮相互作用的藥物可能 <br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與硝西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，西酞普蘭，帕羅西汀，舍曲林，阿米替林））<br /> <br /> 鎮靜劑組胺（例如扑爾敏，苯海拉明，苯海拉明）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平，氟哌啶醇，氯氮平，喹硫平，利培酮）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> <br /> |抑制硝西泮的代謝，從而延長其作用。<br /> <br /> |-<br /> |酒精<br /> |可能導致硝西泮和酒精的降壓作用協同增強<br /> <br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥會明顯減少硝西泮的清除，從而延長硝西泮的作用<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> <br /> <br /> |所有這些藥物都會增加硝西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加硝西泮的代謝，從而降低硝西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制硝西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |硝西泮可能會阻斷左旋多巴治療帕金森氏病的作用。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電999<br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E5%9C%B0%E8%A5%BF%E6%B3%AE&diff=2680 2020-10-20T05:46:38Z

<p>Ctol2: </p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''地西泮''' (English: [[Diazepam]]) 是一種長效苯二氮䓬類藥物，具有抗癲癇，抗焦慮，鎮靜，肌肉鬆弛的特性。它用於：<br /> *在嚴重焦慮症的短期治療中;<br /> *作為短期失眠的催眠藥;<br /> *作為鎮靜劑;<br /> *作為抗驚厥藥（特別是在癲癇持續狀態和高熱驚厥的治療中）;<br /> *控制肌肉痙攣;<br /> *酒精或苯二氮卓戒斷綜合症。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Diazepam Tablet 2 mg<br /> |DIAZ01<br /> |DDA<br /> |-<br /> |Diazepam Tablet 5 mg<br /> |DIAZ02<br /> |DDA<br /> |-<br /> |Diazepam Rectal Solution 2mg/ml (2.5ml/tube)<br /> |DIAZ10<br /> |DDA<br /> |-<br /> |Diazepam Rectal Solution 4mg/ml (2.5ml/tube)<br /> |DIAZ11<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物 <br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> 地西泮可以口服，直腸和注射型式給藥，由於其此藥的依賴性極大; 所以也影響了治療的劑量和持續時間。<br /> 治療過程應短，通常不超過4週，地西泮應逐漸停用。<br /> 老年人和虛弱的患者應服用成人劑量的一半以下<br /> <br /> {| class = &quot;wikitable&quot;<br /> !焦慮<br /> |口服<br /> 成人：每日 3 次，每次 2mg，然後根據需要增加至<br /> 每日 15 – 30mg。<br /> <br /> 年長患者：每日 3 次，每次 1mg，然後根據需要增加至<br /> 每日 7.5 – 15mg。<br /> <br /> 虛弱的患者：使用老年人劑量<br /> |-<br /> !用於全身麻醉前的用藥 <br /> |口服<br /> 成人： 一次 5 – 10mg，在手術前 1-2 小時服用<br /> <br /> 年長患者 : 一次 2.5 – 5mg，在手術前 1-2 小時服用<br /> <br /> 虛弱的患者：使用老年人劑量<br /> |-<br /> ! 用於小手術期間的鎮靜<br /> |口服<br /> 成人：每次最多 20mg，在手術前 1-2 小時服用<br /> |-<br /> !癲癇持續狀態<br /> 發熱性癲癇<br /> 中毒引起的抽搐<br /> |直腸栓劑<br /> 兒童 1 個月至 1 歲：使用一次 5mg，如果需要，則在 10 分鐘後再使用 5mg。<br /> <br /> 2-11 歲兒童：使用一次 5mg-10mg，如果需要，則在 10 分鐘後再使用 5mg-10mg。<br /> <br /> 12 至 17 歲兒童：使用一次 10mg-20mg，如果需要，則在 10分鐘後再使用 10mg-20mg。<br /> <br /> 成人：使用一次 10mg-20mg，如果需要，則在 10 分鐘後再使用 10mg-20mg。<br /> <br /> 老年人：使用一次 10mg 如果需要，則在 10 分鐘後再使用 10mg。<br /> <br /> |-<br /> !呼吸困難與姑息治療中的焦慮症相關<br /> 呼吸困難<br /> <br /> |口服<br /> 成人：每天 5 – 10mg<br /> <br /> |-<br /> !姑息治療中肌肉痙攣的疼痛<br /> |口服<br /> 成人：每日 5 – 10mg<br /> |-<br /> !肌肉痙攣<br /> |口服<br /> 成人：分劑量每日 2 – 15mg，然後根據需要增加至每日 60mg。<br /> |-<br /> !戒酒綜合徵<br /> |口服<br /> 成人 : 每次 5 至 20mg，必要時在 2 至 4 小時後重複；<br /> <br /> 或在第一天服用三至四次 10mg，減少至<br /> <br /> 每天三至四次，每次 5mg。<br /> <br /> |}<br /> 地西泮很少用於癲癇的長期治療，因為其抗驚厥作用的耐受性通常在治療後6到12個月內形成。為此，實際上使其變得無用。<br /> <br /> ==副作用==<br /> 包括[[阿普唑侖]]在內的鎮靜藥與死亡風險增加有關。<br /> <br /> 可能的副作用包括： <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率 &gt; 10％）或常見（發生率 1-10％）<br /> |<br /> *行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *有睡意<br /> *鎮靜<br /> *肌肉無力<br /> *攻擊性反常增加<br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 - 1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *失禁<br /> *尿滯留<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt; 0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> *自殺意念<br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> ===逆向反應===<br /> <br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |地西泮口服後吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |口服後 30 至 90 分鐘之間及使用直腸溶液 10 至 30 分鐘後血漿濃度達到峰值。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |地西泮通過尿液排出體外。<br /> <br /> 地西泮的半衰期一般為 30 – 56 小時。<br /> <br /> 地西泮的雙相半衰期約為 1 至 2 天，其主要活性代謝產物為 2 至 5 天。 <br /> <br /> 地西泮和活尸性代謝產物的消除半衰期在老年人中顯著增加，這可能導致藥物作用延長並在體內積聚。<br /> <br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議檢查血壓，脈搏和呼吸頻率。<br /> *老年人對地西泮的藥物敏。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的癡呆症狀。<br /> *地西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *有些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查。<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過4星以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對地西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> *耐受性增強了地西泮的抗癲癇作用。<br /> <br /> ===藥物相互影響=== <br /> 與地西泮相互作用的藥物可能:<br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與地西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，阿米替林）<br /> <br /> 鎮靜劑組胺（例如異丙嗪）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> |抑制地西泮的消除,從而引至地西泮的藥效延長<br /> <br /> |-<br /> |醇<br /> |可能導致勞拉西泮和酒精的降壓作用增強<br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥明顯減少了地西泮的消除，因此延長了地西泮的藥效<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> |所有這些藥物都會增加地西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加地西泮的代謝，從而降低地西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制地西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |地西泮可能會阻斷左旋多巴在帕金森氏病治療中的作用。<br /> |-<br /> |使尿液酸化的食物 <br /> |可以導致更快地吸收和消除地西泮，從而降低藥物水平和效果。<br /> |-<br /> |使尿液鹼化的食物<br /> |可能導致地西泮吸收減慢和消除，增加了地西泮的血漿水平和藥效。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> 應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電 999。<br /> <br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E5%9C%B0%E8%A5%BF%E6%B3%AE&diff=2679 2020-10-20T05:46:10Z

<p>Ctol2: /* 如果服藥過量怎麼辦？ */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''地西泮''' (English: [[diazepam]]) 是一種長效苯二氮䓬類藥物，具有抗癲癇，抗焦慮，鎮靜，肌肉鬆弛的特性。它用於：<br /> *在嚴重焦慮症的短期治療中;<br /> *作為短期失眠的催眠藥;<br /> *作為鎮靜劑;<br /> *作為抗驚厥藥（特別是在癲癇持續狀態和高熱驚厥的治療中）;<br /> *控制肌肉痙攣;<br /> *酒精或苯二氮卓戒斷綜合症。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Diazepam Tablet 2 mg<br /> |DIAZ01<br /> |DDA<br /> |-<br /> |Diazepam Tablet 5 mg<br /> |DIAZ02<br /> |DDA<br /> |-<br /> |Diazepam Rectal Solution 2mg/ml (2.5ml/tube)<br /> |DIAZ10<br /> |DDA<br /> |-<br /> |Diazepam Rectal Solution 4mg/ml (2.5ml/tube)<br /> |DIAZ11<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物 <br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> 地西泮可以口服，直腸和注射型式給藥，由於其此藥的依賴性極大; 所以也影響了治療的劑量和持續時間。<br /> 治療過程應短，通常不超過4週，地西泮應逐漸停用。<br /> 老年人和虛弱的患者應服用成人劑量的一半以下<br /> <br /> {| class = &quot;wikitable&quot;<br /> !焦慮<br /> |口服<br /> 成人：每日 3 次，每次 2mg，然後根據需要增加至<br /> 每日 15 – 30mg。<br /> <br /> 年長患者：每日 3 次，每次 1mg，然後根據需要增加至<br /> 每日 7.5 – 15mg。<br /> <br /> 虛弱的患者：使用老年人劑量<br /> |-<br /> !用於全身麻醉前的用藥 <br /> |口服<br /> 成人： 一次 5 – 10mg，在手術前 1-2 小時服用<br /> <br /> 年長患者 : 一次 2.5 – 5mg，在手術前 1-2 小時服用<br /> <br /> 虛弱的患者：使用老年人劑量<br /> |-<br /> ! 用於小手術期間的鎮靜<br /> |口服<br /> 成人：每次最多 20mg，在手術前 1-2 小時服用<br /> |-<br /> !癲癇持續狀態<br /> 發熱性癲癇<br /> 中毒引起的抽搐<br /> |直腸栓劑<br /> 兒童 1 個月至 1 歲：使用一次 5mg，如果需要，則在 10 分鐘後再使用 5mg。<br /> <br /> 2-11 歲兒童：使用一次 5mg-10mg，如果需要，則在 10 分鐘後再使用 5mg-10mg。<br /> <br /> 12 至 17 歲兒童：使用一次 10mg-20mg，如果需要，則在 10分鐘後再使用 10mg-20mg。<br /> <br /> 成人：使用一次 10mg-20mg，如果需要，則在 10 分鐘後再使用 10mg-20mg。<br /> <br /> 老年人：使用一次 10mg 如果需要，則在 10 分鐘後再使用 10mg。<br /> <br /> |-<br /> !呼吸困難與姑息治療中的焦慮症相關<br /> 呼吸困難<br /> <br /> |口服<br /> 成人：每天 5 – 10mg<br /> <br /> |-<br /> !姑息治療中肌肉痙攣的疼痛<br /> |口服<br /> 成人：每日 5 – 10mg<br /> |-<br /> !肌肉痙攣<br /> |口服<br /> 成人：分劑量每日 2 – 15mg，然後根據需要增加至每日 60mg。<br /> |-<br /> !戒酒綜合徵<br /> |口服<br /> 成人 : 每次 5 至 20mg，必要時在 2 至 4 小時後重複；<br /> <br /> 或在第一天服用三至四次 10mg，減少至<br /> <br /> 每天三至四次，每次 5mg。<br /> <br /> |}<br /> 地西泮很少用於癲癇的長期治療，因為其抗驚厥作用的耐受性通常在治療後6到12個月內形成。為此，實際上使其變得無用。<br /> <br /> ==副作用==<br /> 包括[[阿普唑侖]]在內的鎮靜藥與死亡風險增加有關。<br /> <br /> 可能的副作用包括： <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率 &gt; 10％）或常見（發生率 1-10％）<br /> |<br /> *行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *有睡意<br /> *鎮靜<br /> *肌肉無力<br /> *攻擊性反常增加<br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 - 1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *失禁<br /> *尿滯留<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt; 0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> *自殺意念<br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> ===逆向反應===<br /> <br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |地西泮口服後吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |口服後 30 至 90 分鐘之間及使用直腸溶液 10 至 30 分鐘後血漿濃度達到峰值。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |地西泮通過尿液排出體外。<br /> <br /> 地西泮的半衰期一般為 30 – 56 小時。<br /> <br /> 地西泮的雙相半衰期約為 1 至 2 天，其主要活性代謝產物為 2 至 5 天。 <br /> <br /> 地西泮和活尸性代謝產物的消除半衰期在老年人中顯著增加，這可能導致藥物作用延長並在體內積聚。<br /> <br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議檢查血壓，脈搏和呼吸頻率。<br /> *老年人對地西泮的藥物敏。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的癡呆症狀。<br /> *地西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *有些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查。<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過4星以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對地西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> *耐受性增強了地西泮的抗癲癇作用。<br /> <br /> ===藥物相互影響=== <br /> 與地西泮相互作用的藥物可能:<br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與地西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，阿米替林）<br /> <br /> 鎮靜劑組胺（例如異丙嗪）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> |抑制地西泮的消除,從而引至地西泮的藥效延長<br /> <br /> |-<br /> |醇<br /> |可能導致勞拉西泮和酒精的降壓作用增強<br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥明顯減少了地西泮的消除，因此延長了地西泮的藥效<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> |所有這些藥物都會增加地西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加地西泮的代謝，從而降低地西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制地西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |地西泮可能會阻斷左旋多巴在帕金森氏病治療中的作用。<br /> |-<br /> |使尿液酸化的食物 <br /> |可以導致更快地吸收和消除地西泮，從而降低藥物水平和效果。<br /> |-<br /> |使尿液鹼化的食物<br /> |可能導致地西泮吸收減慢和消除，增加了地西泮的血漿水平和藥效。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> 應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電 999。<br /> <br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E5%9C%B0%E8%A5%BF%E6%B3%AE&diff=2678 2020-10-20T05:45:55Z

<p>Ctol2: /* 腎功能不全 */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''地西泮''' (English: [[diazepam]]) 是一種長效苯二氮䓬類藥物，具有抗癲癇，抗焦慮，鎮靜，肌肉鬆弛的特性。它用於：<br /> *在嚴重焦慮症的短期治療中;<br /> *作為短期失眠的催眠藥;<br /> *作為鎮靜劑;<br /> *作為抗驚厥藥（特別是在癲癇持續狀態和高熱驚厥的治療中）;<br /> *控制肌肉痙攣;<br /> *酒精或苯二氮卓戒斷綜合症。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Diazepam Tablet 2 mg<br /> |DIAZ01<br /> |DDA<br /> |-<br /> |Diazepam Tablet 5 mg<br /> |DIAZ02<br /> |DDA<br /> |-<br /> |Diazepam Rectal Solution 2mg/ml (2.5ml/tube)<br /> |DIAZ10<br /> |DDA<br /> |-<br /> |Diazepam Rectal Solution 4mg/ml (2.5ml/tube)<br /> |DIAZ11<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物 <br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> 地西泮可以口服，直腸和注射型式給藥，由於其此藥的依賴性極大; 所以也影響了治療的劑量和持續時間。<br /> 治療過程應短，通常不超過4週，地西泮應逐漸停用。<br /> 老年人和虛弱的患者應服用成人劑量的一半以下<br /> <br /> {| class = &quot;wikitable&quot;<br /> !焦慮<br /> |口服<br /> 成人：每日 3 次，每次 2mg，然後根據需要增加至<br /> 每日 15 – 30mg。<br /> <br /> 年長患者：每日 3 次，每次 1mg，然後根據需要增加至<br /> 每日 7.5 – 15mg。<br /> <br /> 虛弱的患者：使用老年人劑量<br /> |-<br /> !用於全身麻醉前的用藥 <br /> |口服<br /> 成人： 一次 5 – 10mg，在手術前 1-2 小時服用<br /> <br /> 年長患者 : 一次 2.5 – 5mg，在手術前 1-2 小時服用<br /> <br /> 虛弱的患者：使用老年人劑量<br /> |-<br /> ! 用於小手術期間的鎮靜<br /> |口服<br /> 成人：每次最多 20mg，在手術前 1-2 小時服用<br /> |-<br /> !癲癇持續狀態<br /> 發熱性癲癇<br /> 中毒引起的抽搐<br /> |直腸栓劑<br /> 兒童 1 個月至 1 歲：使用一次 5mg，如果需要，則在 10 分鐘後再使用 5mg。<br /> <br /> 2-11 歲兒童：使用一次 5mg-10mg，如果需要，則在 10 分鐘後再使用 5mg-10mg。<br /> <br /> 12 至 17 歲兒童：使用一次 10mg-20mg，如果需要，則在 10分鐘後再使用 10mg-20mg。<br /> <br /> 成人：使用一次 10mg-20mg，如果需要，則在 10 分鐘後再使用 10mg-20mg。<br /> <br /> 老年人：使用一次 10mg 如果需要，則在 10 分鐘後再使用 10mg。<br /> <br /> |-<br /> !呼吸困難與姑息治療中的焦慮症相關<br /> 呼吸困難<br /> <br /> |口服<br /> 成人：每天 5 – 10mg<br /> <br /> |-<br /> !姑息治療中肌肉痙攣的疼痛<br /> |口服<br /> 成人：每日 5 – 10mg<br /> |-<br /> !肌肉痙攣<br /> |口服<br /> 成人：分劑量每日 2 – 15mg，然後根據需要增加至每日 60mg。<br /> |-<br /> !戒酒綜合徵<br /> |口服<br /> 成人 : 每次 5 至 20mg，必要時在 2 至 4 小時後重複；<br /> <br /> 或在第一天服用三至四次 10mg，減少至<br /> <br /> 每天三至四次，每次 5mg。<br /> <br /> |}<br /> 地西泮很少用於癲癇的長期治療，因為其抗驚厥作用的耐受性通常在治療後6到12個月內形成。為此，實際上使其變得無用。<br /> <br /> ==副作用==<br /> 包括[[阿普唑侖]]在內的鎮靜藥與死亡風險增加有關。<br /> <br /> 可能的副作用包括： <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率 &gt; 10％）或常見（發生率 1-10％）<br /> |<br /> *行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *有睡意<br /> *鎮靜<br /> *肌肉無力<br /> *攻擊性反常增加<br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 - 1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *失禁<br /> *尿滯留<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt; 0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> *自殺意念<br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> ===逆向反應===<br /> <br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |地西泮口服後吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |口服後 30 至 90 分鐘之間及使用直腸溶液 10 至 30 分鐘後血漿濃度達到峰值。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |地西泮通過尿液排出體外。<br /> <br /> 地西泮的半衰期一般為 30 – 56 小時。<br /> <br /> 地西泮的雙相半衰期約為 1 至 2 天，其主要活性代謝產物為 2 至 5 天。 <br /> <br /> 地西泮和活尸性代謝產物的消除半衰期在老年人中顯著增加，這可能導致藥物作用延長並在體內積聚。<br /> <br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議檢查血壓，脈搏和呼吸頻率。<br /> *老年人對地西泮的藥物敏。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的癡呆症狀。<br /> *地西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *有些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查。<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過4星以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對地西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> *耐受性增強了地西泮的抗癲癇作用。<br /> <br /> ===藥物相互影響=== <br /> 與地西泮相互作用的藥物可能:<br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與地西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，阿米替林）<br /> <br /> 鎮靜劑組胺（例如異丙嗪）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> |抑制地西泮的消除,從而引至地西泮的藥效延長<br /> <br /> |-<br /> |醇<br /> |可能導致勞拉西泮和酒精的降壓作用增強<br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥明顯減少了地西泮的消除，因此延長了地西泮的藥效<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> |所有這些藥物都會增加地西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加地西泮的代謝，從而降低地西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制地西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |地西泮可能會阻斷左旋多巴在帕金森氏病治療中的作用。<br /> |-<br /> |使尿液酸化的食物 <br /> |可以導致更快地吸收和消除地西泮，從而降低藥物水平和效果。<br /> |-<br /> |使尿液鹼化的食物<br /> |可能導致地西泮吸收減慢和消除，增加了地西泮的血漿水平和藥效。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> 應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電999<br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E5%9C%B0%E8%A5%BF%E6%B3%AE&diff=2677 2020-10-20T05:45:39Z

<p>Ctol2: /* 藥物資訊 */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''地西泮''' (English: [[diazepam]]) 是一種長效苯二氮䓬類藥物，具有抗癲癇，抗焦慮，鎮靜，肌肉鬆弛的特性。它用於：<br /> *在嚴重焦慮症的短期治療中;<br /> *作為短期失眠的催眠藥;<br /> *作為鎮靜劑;<br /> *作為抗驚厥藥（特別是在癲癇持續狀態和高熱驚厥的治療中）;<br /> *控制肌肉痙攣;<br /> *酒精或苯二氮卓戒斷綜合症。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Diazepam Tablet 2 mg<br /> |DIAZ01<br /> |DDA<br /> |-<br /> |Diazepam Tablet 5 mg<br /> |DIAZ02<br /> |DDA<br /> |-<br /> |Diazepam Rectal Solution 2mg/ml (2.5ml/tube)<br /> |DIAZ10<br /> |DDA<br /> |-<br /> |Diazepam Rectal Solution 4mg/ml (2.5ml/tube)<br /> |DIAZ11<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物 <br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> 地西泮可以口服，直腸和注射型式給藥，由於其此藥的依賴性極大; 所以也影響了治療的劑量和持續時間。<br /> 治療過程應短，通常不超過4週，地西泮應逐漸停用。<br /> 老年人和虛弱的患者應服用成人劑量的一半以下<br /> <br /> {| class = &quot;wikitable&quot;<br /> !焦慮<br /> |口服<br /> 成人：每日 3 次，每次 2mg，然後根據需要增加至<br /> 每日 15 – 30mg。<br /> <br /> 年長患者：每日 3 次，每次 1mg，然後根據需要增加至<br /> 每日 7.5 – 15mg。<br /> <br /> 虛弱的患者：使用老年人劑量<br /> |-<br /> !用於全身麻醉前的用藥 <br /> |口服<br /> 成人： 一次 5 – 10mg，在手術前 1-2 小時服用<br /> <br /> 年長患者 : 一次 2.5 – 5mg，在手術前 1-2 小時服用<br /> <br /> 虛弱的患者：使用老年人劑量<br /> |-<br /> ! 用於小手術期間的鎮靜<br /> |口服<br /> 成人：每次最多 20mg，在手術前 1-2 小時服用<br /> |-<br /> !癲癇持續狀態<br /> 發熱性癲癇<br /> 中毒引起的抽搐<br /> |直腸栓劑<br /> 兒童 1 個月至 1 歲：使用一次 5mg，如果需要，則在 10 分鐘後再使用 5mg。<br /> <br /> 2-11 歲兒童：使用一次 5mg-10mg，如果需要，則在 10 分鐘後再使用 5mg-10mg。<br /> <br /> 12 至 17 歲兒童：使用一次 10mg-20mg，如果需要，則在 10分鐘後再使用 10mg-20mg。<br /> <br /> 成人：使用一次 10mg-20mg，如果需要，則在 10 分鐘後再使用 10mg-20mg。<br /> <br /> 老年人：使用一次 10mg 如果需要，則在 10 分鐘後再使用 10mg。<br /> <br /> |-<br /> !呼吸困難與姑息治療中的焦慮症相關<br /> 呼吸困難<br /> <br /> |口服<br /> 成人：每天 5 – 10mg<br /> <br /> |-<br /> !姑息治療中肌肉痙攣的疼痛<br /> |口服<br /> 成人：每日 5 – 10mg<br /> |-<br /> !肌肉痙攣<br /> |口服<br /> 成人：分劑量每日 2 – 15mg，然後根據需要增加至每日 60mg。<br /> |-<br /> !戒酒綜合徵<br /> |口服<br /> 成人 : 每次 5 至 20mg，必要時在 2 至 4 小時後重複；<br /> <br /> 或在第一天服用三至四次 10mg，減少至<br /> <br /> 每天三至四次，每次 5mg。<br /> <br /> |}<br /> 地西泮很少用於癲癇的長期治療，因為其抗驚厥作用的耐受性通常在治療後6到12個月內形成。為此，實際上使其變得無用。<br /> <br /> ==副作用==<br /> 包括[[阿普唑侖]]在內的鎮靜藥與死亡風險增加有關。<br /> <br /> 可能的副作用包括： <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率 &gt; 10％）或常見（發生率 1-10％）<br /> |<br /> *行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *有睡意<br /> *鎮靜<br /> *肌肉無力<br /> *攻擊性反常增加<br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 - 1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *失禁<br /> *尿滯留<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt; 0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> *自殺意念<br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> ===逆向反應===<br /> <br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |地西泮口服後吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |口服後 30 至 90 分鐘之間及使用直腸溶液 10 至 30 分鐘後血漿濃度達到峰值。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |地西泮通過尿液排出體外。<br /> <br /> 地西泮的半衰期一般為 30 – 56 小時。<br /> <br /> 地西泮的雙相半衰期約為 1 至 2 天，其主要活性代謝產物為 2 至 5 天。 <br /> <br /> 地西泮和活尸性代謝產物的消除半衰期在老年人中顯著增加，這可能導致藥物作用延長並在體內積聚。<br /> <br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議檢查血壓，脈搏和呼吸頻率。<br /> *老年人對地西泮的藥物敏。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的癡呆症狀。<br /> *地西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *有些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查。<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過4星以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對地西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> *耐受性增強了地西泮的抗癲癇作用。<br /> <br /> ===藥物相互影響=== <br /> 與地西泮相互作用的藥物可能:<br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與地西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，阿米替林）<br /> <br /> 鎮靜劑組胺（例如異丙嗪）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> |抑制地西泮的消除,從而引至地西泮的藥效延長<br /> <br /> |-<br /> |醇<br /> |可能導致勞拉西泮和酒精的降壓作用增強<br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥明顯減少了地西泮的消除，因此延長了地西泮的藥效<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> |所有這些藥物都會增加地西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加地西泮的代謝，從而降低地西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制地西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |地西泮可能會阻斷左旋多巴在帕金森氏病治療中的作用。<br /> |-<br /> |使尿液酸化的食物 <br /> |可以導致更快地吸收和消除地西泮，從而降低藥物水平和效果。<br /> |-<br /> |使尿液鹼化的食物<br /> |可能導致地西泮吸收減慢和消除，增加了地西泮的血漿水平和藥效。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電999<br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=Diazepam&diff=2676 2020-10-20T05:43:41Z

<p>Ctol2: </p> <hr /> <div>[[Category: Drugs]][[Category:benzodiazepine]]<br /> '''Diazepam''' (中文: [[地西泮]]) is a long-acting benzodiazepine with anticonvulsant, anxiolytic, sedative, muscle relaxant properties. It is used:<br /> *In the short-term treatment of severe anxiety disorders;<br /> *As a hypnotic in the short-term treatment of insomnia;<br /> *As a sedative<br /> *As an anticonvulsant (particularly in the management of status epilepticus and febrile convulsions)<br /> *In the control of muscle spasms<br /> *In the management of alcohol, or benzodiazepine withdrawal syndrome.<br /> <br /> ==Pronunciation==<br /> ===Diazepam 2mg===<br /> [[File:Diazepam 2mg.mp3]]<br /> <br /> ===Diazepam 5mg===<br /> [[File:Diazepam 5mg.mp3]]<br /> <br /> ==Drug Names==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification藥物分類<br /> |-<br /> |Diazepam Tablet 2 mg<br /> |DIAZ01<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |-<br /> |Diazepam Tablet 5 mg<br /> |DIAZ02<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |-<br /> |Diazepam Rectal Solution 2mg/ml (2.5ml/tube)<br /> |DIAZ10<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |-<br /> |Diazepam Rectal Solution 4mg/ml (2.5ml/tube)<br /> |DIAZ11<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |}<br /> <br /> ==Mechanism of Action==<br /> *Diazepam is a benzodiazepine. <br /> *Gama-Aminobutyric acid (GABA) is an inhibitory neurotransmitter, acting on the GABA receptors in the central nervous system (CNS), thus inhibiting the nerve impulses. <br /> *It acts on the benzodiazepine receptors in the brain and the spinal cord. Benzodiazepine receptors in the CNS are linked with GABA receptors as a complex. <br /> *Diazepam by binding to the benzodiazepine receptors results in activation of the GABA-benzodiazepine receptor complex, resulting in inhibition of nerve impulses, overall depression of brain and spinal cord.<br /> *Thus, Diazepam helps to promote muscle relaxation, reduce anxiety, control of convulsions and promote sleep.<br /> <br /> ==Dosage==<br /> *Diazepam is administered orally, rectally, and parenterally with the risk of dependence very much influencing the dose and duration of treatment.<br /> *Courses of treatment should be short, not normally exceeding 4 weeks, with diazepam being withdrawal gradually.<br /> *Elderly and debilitated patients should be given not more than one-half the usual adult dose<br /> <br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Anxiety<br /> |By ''mouth<br /> ADULT: <br /> *2 mg three times a day, then increased if necessary, to<br /> *15 – 30 mg daily in divided doses.<br /> ELDERLY: <br /> *1 mg three times a day, then increased if necessary to<br /> *7.5 – 15 mg daily in divided doses.<br /> Debilitated patients: use elderly dose<br /> |-<br /> !style=&quot;text-align: left&quot;| Insomnia associated with anxiety<br /> |By ''mouth<br /> ADULT: <br /> <br /> 5 – 15mg daily, to be taken at bedtime<br /> |-<br /> !style=&quot;text-align: left&quot;| For premedicationbefore general anaesthesia <br /> | By ''mouth<br /> ADULT: <br /> <br /> 5 – 10mg, to be given 1-2 hours before procedure<br /> ELDERLY: <br /> 2.5 – 5 mg, to be given 1-2 hours before procedure<br /> Debilitated patients: use elderly dose<br /> |-<br /> !style=&quot;text-align: left&quot;| For sedation during minor surgery<br /> |By ''mouth<br /> ADULT: <br /> <br /> Up to 20mg, to be given 1-2 hours before procedure<br /> |-<br /> !style=&quot;text-align: left&quot;| Status epilepticus<br /> <br /> Febrile convulsions<br /> <br /> Convulsions due to poisoning<br /> | By ''rectum<br /> CHILD 1 month – 1 years: 5 mg, then 5 mg after 10 minutes if required.<br /> <br /> CHILD 2 – 11 years: 5 – 10 mg, the 5 – 10 mg after 10 minutes if required.<br /> <br /> CHILD 12 – 17 years: 10 – 20 mg, then 10 – 20 mg after 10 minutes if required<br /> ADULT: <br /> <br /> 10 – 20 mg, then 10 – 20 mg after 10 – 15 minutes if required<br /> ELDERLY: <br /> 10mg, then 10 mg after 10 – 15 minutes if required<br /> |-<br /> !style=&quot;text-align: left&quot;| Dyspnoea associated with anxiety in palliative care<br /> | By ''mouth<br /> ADULTS:<br /> 5 – 10mg daily<br /> |-<br /> !style=&quot;text-align: left&quot;| Pain of muscle spasm in palliative care<br /> | By ''mouth<br /> ADULTS:<br /> 5 – 10mg daily<br /> |-<br /> !style=&quot;text-align: left&quot;| Muscle spasm<br /> | By ''mouth<br /> ADULTS:<br /> 2 – 15mg daily in divided doses, then increased if necessary to 60 mg daily.<br /> |-<br /> !style=&quot;text-align: left&quot;| Alcohol withdrawal syndrome<br /> | By ''mouth<br /> ADULTS:<br /> *5 to 20 mg, repeated if necessary after 2 to 4 hours;<br /> *Or 10 mg three or four times on the first day, reducing to<br /> *5 mg three or four times daily as required.<br /> |}<br /> <br /> Diazepam is rarely used for the long-term treatment of epilepsy because tolerance to its anticonvulsant effects usually develops within 6 to 12 months of treatment. Effectively rendering it useless for that purpose.<br /> <br /> ==Side Effects==<br /> <br /> Sedative drugs, including alprazolam, have been associated with an increased risk of death.<br /> <br /> Possible side effects include:<br /> <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Very common (&gt;10% of incidence) <br /> or Common(1-10% of incidence)<br /> |<br /> *Shakiness and unsteady walk (especially in the elderly)<br /> *Trembling, and other problems with muscle control or coordination<br /> *Confusion (especially in the elderly)<br /> *Amnesia<br /> *Drowsiness the next day<br /> *sedation<br /> *Muscle weakness<br /> *Paradoxical increase in aggression<br /> |-<br /> !style=&quot;text-align: left&quot;| Infrequent (0.1 -1% of incidence)<br /> |<br /> *Dysarthria<br /> *Gastro-intestinal disturbances<br /> *Gynaecomastia<br /> *Low blood pressure<br /> *Incontinence<br /> *Urinary retention<br /> *Slurred speech<br /> *Tremor<br /> *Vertigo<br /> *Visual disturbances<br /> |-<br /> !style=&quot;text-align: left&quot;| Rare (&lt;0.1% of incidence)<br /> |<br /> *Apnoea<br /> *Blood disorders<br /> *Jaundice<br /> *Respiratory depression<br /> *hypersensitivity reactions<br /> *suicidal ideation<br /> |}<br /> <br /> '''Overdosage''' can produce CNS depression and coma.<br /> <br /> '''Paradoxical reactions (the opposite of what is to be expected) may occur'''. Symptoms include<br /> *aggression, rage<br /> *mania, agitation, and restlessness<br /> *hallucinations, inappropriate behavior<br /> *twitches and tremor<br /> <br /> ==Pharmacokinetics==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Oral bioavailability<br /> |Diazepam is well absorbed after oral doses.<br /> |-<br /> !style=&quot;text-align: left&quot;| Onset of action<br /> |Peak plasma concentrations occur between 30 and 90 minutes after an oral dose; and after 10 to 30 minutes when given as a rectal solution.<br /> |-<br /> !style=&quot;text-align: left&quot;| Metabolism<br /> |Diazepam is metabolized in the liver by the cytochrome P450 enzyme system. It has several active metabolites. Because of these active metabolites, the serum diazepam levels alone are not useful in predicting the effects of the drug. <br /> |-<br /> !style=&quot;text-align: left&quot;| Elimination half-life<br /> |<br /> Diazepam is excreted in the urine. <br /> The half-life of diazepam in general is 30 – 56 hours.<br /> Diazepam has a biphasic half-life of about 1 to 2 days, and 2 to 5 days for its principal active metabolite. <br /> The elimination half-life of diazepam and also the active metabolite increases significantly in the elderly, which may result in prolonged action and accumulation of the drug in the body. <br /> |}<br /> <br /> ==Drug Management==<br /> ====Monitoring====<br /> *Blood pressure, pulse and respiratory rate are recommended<br /> *Elderly may be sensitivity to diazepam’s effects. Impairment of memory, cognitive function, and psychomotor performance and behavior disinhibition may be common. Long-term use commonly exacerbates underlying dementia in elderly patients.<br /> *Diazepam may make elderly patients feel dizzy, increasing risk of falls, so fall prevention is needed<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended<br /> *changes in mood, the development or worsening depression, and/or any thoughts or behaviour of suicide.<br /> <br /> ===Dependence and Withdrawal===<br /> *One-third of individuals treated with benzodiazepines for longer than 4 weeks develop a dependence on the drug and experience a withdrawal syndrome on cessation.<br /> *Withdrawal symptoms can range from insomnia and anxiety to more serious symptoms, including seizures and psychosis.<br /> *Diazepam should therefore be withdrawn by tapering the dose to minimize occurrence of withdrawal symptoms. <br /> *Tolerance develops to the anticonvulsant effects of diazepam. <br /> <br /> ===Drug interaction===<br /> Medicines that interact with diazepam may either <br /> *Decrease its effect<br /> *Affect how long it works for<br /> *Increase side effects<br /> <br /> Common medications that may interact with diazepam include:<br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Drugs given with diazepam<br /> !style=&quot;text-align: left&quot;| Potential Effect<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Alcohol, <br /> Hypnotics/sedative (e.g. barbiturates)<br /> Antidepressants (e.g. fluoxetine, amitriptyline)<br /> Sedative histamines (e.g. promethazine)<br /> Antipsychotic (e.g. chlorpromazine, clozapine)<br /> |May worsens the side effects such as drowsiness , dizziness and respiratory depression<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Cimetidine <br /> Omeprazole<br /> Oxcarbazepine, topiramate, valproate<br /> Ketoconazole<br /> Itraconazole<br /> Isoniazid<br /> Erythromycin, ciprofloxacin<br /> Propranolol<br /> fluoxetine<br /> |'''Prolong the action''' of diazepam by inhibiting its elimination<br /> |-<br /> |style=&quot;text-align: left&quot;| Alcohol <br /> |May cause a synergistic enhancement of the hypotensive effect of diazepam and alcohol<br /> |-<br /> |style=&quot;text-align: left&quot;| Oral contraceptives<br /> |Oral contraceptives significant decrease the elimination of diazepam, so '''prolong the action of diazepam'''<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Rifampicin<br /> Phenytoin<br /> Carbamazepine<br /> phenobarbitone<br /> |All these drugs increase the metabolism of diazepam, thus decreasing drug levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Steroid (e.g. Dexamethasone)<br /> St John’s wort<br /> |Increase the metabolism of diazepam, thus decreasing diazepam plasma levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| Theophylline<br /> |May inhibit the action of diazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| Levodopa (e.g. Sinemet)<br /> |Diazepam may block the action of levodopa used in the treatment of Parkinson’s disease.<br /> |-<br /> |style=&quot;text-align: left&quot;|<br /> Foods that acidify the urine <br /> <br /> Food that alkalinize the urine<br /> |Can lead to faster absorption and elimination of diazepam, reducing drug levels and effects.<br /> Can lead to slower absorption and elimination of diazepam, increasing the diazepam plasma levels and effects.<br /> |}<br /> <br /> ===Caution===<br /> *particular care in pregnancy, <br /> *elderly, due to increased susceptibility to side-effects, especially loss of coordination and drowsiness<br /> *in patients with hepatic or renal impairment, who may require reduced doses<br /> *people with history of alcohol dependence or abuse<br /> *people with history of drug dependence or abuse<br /> *people with psychiatric disorders<br /> *avoid prolonged use and abrupt withdrawal thereafter<br /> <br /> ===Contra-indications===<br /> Use of diazepam should be avoided, when possible, in individuals with: <br /> *severe hepatic impairment<br /> *sleep apnoea <br /> *chronic obstructive airways disease (COPD) <br /> *Myasthenia gravis<br /> *Acute narrow-angle glaucoma<br /> *Chronic schizophrenia<br /> <br /> ===Hepatic impairment===<br /> *Start with smaller initial doses or reduce dose.<br /> *Can precipitate coma.<br /> *Avoid in severe impairment.<br /> <br /> ===Renal impairment===<br /> *Start with small doses in severe impairment.<br /> <br /> ===Pregnancy===<br /> Possible adverse effects of use of benzodiazepines such as diazepam during pregnancy include: miscarriage, malformation, intrauterine growth retardation, and function deficits. <br /> <br /> ===Breast-feeding===<br /> Use during breast feeding is not recommended.<br /> <br /> ===Driving and skilled tasks===<br /> May impair judgment and increase reaction time, and so affect ability to drive or operate machinery. Patients should be warned not to operate dangerous machinery or motor vehicles until it is known that they do not become drowsy from diazepam therapy. <br /> <br /> == FAQ ==<br /> === How should I take the tablet? ===<br /> May be taken with or without food. Swallow whole with a glass of water.<br /> === What should I avoid while taking? ===<br /> Do not eat grapefruit or drink grapefruit juice as it may increase blood levels of diazepam. <br /> <br /> Avoid drinking alcohol while taking diazepam because it may enhance the side effects of sedation and respiratory depression. <br /> <br /> Avoid driving or hazardous activity until you know how diazepam will affect you. <br /> ==== What happen if I overdose? ====<br /> Contact your primary care doctor.<br /> If emergency situation, call 999<br /> ==== What happen if I miss a dose? ====<br /> Take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=Diazepam&diff=2675 2020-10-20T05:43:31Z

<p>Ctol2: </p> <hr /> <div>[[Category: Drugs]][[Category:benzodiazepine]]<br /> '''Diazepam''' (中文:[[地西泮]]) is a long-acting benzodiazepine with anticonvulsant, anxiolytic, sedative, muscle relaxant properties. It is used:<br /> *In the short-term treatment of severe anxiety disorders;<br /> *As a hypnotic in the short-term treatment of insomnia;<br /> *As a sedative<br /> *As an anticonvulsant (particularly in the management of status epilepticus and febrile convulsions)<br /> *In the control of muscle spasms<br /> *In the management of alcohol, or benzodiazepine withdrawal syndrome.<br /> <br /> ==Pronunciation==<br /> ===Diazepam 2mg===<br /> [[File:Diazepam 2mg.mp3]]<br /> <br /> ===Diazepam 5mg===<br /> [[File:Diazepam 5mg.mp3]]<br /> <br /> ==Drug Names==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification藥物分類<br /> |-<br /> |Diazepam Tablet 2 mg<br /> |DIAZ01<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |-<br /> |Diazepam Tablet 5 mg<br /> |DIAZ02<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |-<br /> |Diazepam Rectal Solution 2mg/ml (2.5ml/tube)<br /> |DIAZ10<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |-<br /> |Diazepam Rectal Solution 4mg/ml (2.5ml/tube)<br /> |DIAZ11<br /> |P1S1S3 &amp; Part 1 Dangerous Drug<br /> |}<br /> <br /> ==Mechanism of Action==<br /> *Diazepam is a benzodiazepine. <br /> *Gama-Aminobutyric acid (GABA) is an inhibitory neurotransmitter, acting on the GABA receptors in the central nervous system (CNS), thus inhibiting the nerve impulses. <br /> *It acts on the benzodiazepine receptors in the brain and the spinal cord. Benzodiazepine receptors in the CNS are linked with GABA receptors as a complex. <br /> *Diazepam by binding to the benzodiazepine receptors results in activation of the GABA-benzodiazepine receptor complex, resulting in inhibition of nerve impulses, overall depression of brain and spinal cord.<br /> *Thus, Diazepam helps to promote muscle relaxation, reduce anxiety, control of convulsions and promote sleep.<br /> <br /> ==Dosage==<br /> *Diazepam is administered orally, rectally, and parenterally with the risk of dependence very much influencing the dose and duration of treatment.<br /> *Courses of treatment should be short, not normally exceeding 4 weeks, with diazepam being withdrawal gradually.<br /> *Elderly and debilitated patients should be given not more than one-half the usual adult dose<br /> <br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Anxiety<br /> |By ''mouth<br /> ADULT: <br /> *2 mg three times a day, then increased if necessary, to<br /> *15 – 30 mg daily in divided doses.<br /> ELDERLY: <br /> *1 mg three times a day, then increased if necessary to<br /> *7.5 – 15 mg daily in divided doses.<br /> Debilitated patients: use elderly dose<br /> |-<br /> !style=&quot;text-align: left&quot;| Insomnia associated with anxiety<br /> |By ''mouth<br /> ADULT: <br /> <br /> 5 – 15mg daily, to be taken at bedtime<br /> |-<br /> !style=&quot;text-align: left&quot;| For premedicationbefore general anaesthesia <br /> | By ''mouth<br /> ADULT: <br /> <br /> 5 – 10mg, to be given 1-2 hours before procedure<br /> ELDERLY: <br /> 2.5 – 5 mg, to be given 1-2 hours before procedure<br /> Debilitated patients: use elderly dose<br /> |-<br /> !style=&quot;text-align: left&quot;| For sedation during minor surgery<br /> |By ''mouth<br /> ADULT: <br /> <br /> Up to 20mg, to be given 1-2 hours before procedure<br /> |-<br /> !style=&quot;text-align: left&quot;| Status epilepticus<br /> <br /> Febrile convulsions<br /> <br /> Convulsions due to poisoning<br /> | By ''rectum<br /> CHILD 1 month – 1 years: 5 mg, then 5 mg after 10 minutes if required.<br /> <br /> CHILD 2 – 11 years: 5 – 10 mg, the 5 – 10 mg after 10 minutes if required.<br /> <br /> CHILD 12 – 17 years: 10 – 20 mg, then 10 – 20 mg after 10 minutes if required<br /> ADULT: <br /> <br /> 10 – 20 mg, then 10 – 20 mg after 10 – 15 minutes if required<br /> ELDERLY: <br /> 10mg, then 10 mg after 10 – 15 minutes if required<br /> |-<br /> !style=&quot;text-align: left&quot;| Dyspnoea associated with anxiety in palliative care<br /> | By ''mouth<br /> ADULTS:<br /> 5 – 10mg daily<br /> |-<br /> !style=&quot;text-align: left&quot;| Pain of muscle spasm in palliative care<br /> | By ''mouth<br /> ADULTS:<br /> 5 – 10mg daily<br /> |-<br /> !style=&quot;text-align: left&quot;| Muscle spasm<br /> | By ''mouth<br /> ADULTS:<br /> 2 – 15mg daily in divided doses, then increased if necessary to 60 mg daily.<br /> |-<br /> !style=&quot;text-align: left&quot;| Alcohol withdrawal syndrome<br /> | By ''mouth<br /> ADULTS:<br /> *5 to 20 mg, repeated if necessary after 2 to 4 hours;<br /> *Or 10 mg three or four times on the first day, reducing to<br /> *5 mg three or four times daily as required.<br /> |}<br /> <br /> Diazepam is rarely used for the long-term treatment of epilepsy because tolerance to its anticonvulsant effects usually develops within 6 to 12 months of treatment. Effectively rendering it useless for that purpose.<br /> <br /> ==Side Effects==<br /> <br /> Sedative drugs, including alprazolam, have been associated with an increased risk of death.<br /> <br /> Possible side effects include:<br /> <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Very common (&gt;10% of incidence) <br /> or Common(1-10% of incidence)<br /> |<br /> *Shakiness and unsteady walk (especially in the elderly)<br /> *Trembling, and other problems with muscle control or coordination<br /> *Confusion (especially in the elderly)<br /> *Amnesia<br /> *Drowsiness the next day<br /> *sedation<br /> *Muscle weakness<br /> *Paradoxical increase in aggression<br /> |-<br /> !style=&quot;text-align: left&quot;| Infrequent (0.1 -1% of incidence)<br /> |<br /> *Dysarthria<br /> *Gastro-intestinal disturbances<br /> *Gynaecomastia<br /> *Low blood pressure<br /> *Incontinence<br /> *Urinary retention<br /> *Slurred speech<br /> *Tremor<br /> *Vertigo<br /> *Visual disturbances<br /> |-<br /> !style=&quot;text-align: left&quot;| Rare (&lt;0.1% of incidence)<br /> |<br /> *Apnoea<br /> *Blood disorders<br /> *Jaundice<br /> *Respiratory depression<br /> *hypersensitivity reactions<br /> *suicidal ideation<br /> |}<br /> <br /> '''Overdosage''' can produce CNS depression and coma.<br /> <br /> '''Paradoxical reactions (the opposite of what is to be expected) may occur'''. Symptoms include<br /> *aggression, rage<br /> *mania, agitation, and restlessness<br /> *hallucinations, inappropriate behavior<br /> *twitches and tremor<br /> <br /> ==Pharmacokinetics==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Oral bioavailability<br /> |Diazepam is well absorbed after oral doses.<br /> |-<br /> !style=&quot;text-align: left&quot;| Onset of action<br /> |Peak plasma concentrations occur between 30 and 90 minutes after an oral dose; and after 10 to 30 minutes when given as a rectal solution.<br /> |-<br /> !style=&quot;text-align: left&quot;| Metabolism<br /> |Diazepam is metabolized in the liver by the cytochrome P450 enzyme system. It has several active metabolites. Because of these active metabolites, the serum diazepam levels alone are not useful in predicting the effects of the drug. <br /> |-<br /> !style=&quot;text-align: left&quot;| Elimination half-life<br /> |<br /> Diazepam is excreted in the urine. <br /> The half-life of diazepam in general is 30 – 56 hours.<br /> Diazepam has a biphasic half-life of about 1 to 2 days, and 2 to 5 days for its principal active metabolite. <br /> The elimination half-life of diazepam and also the active metabolite increases significantly in the elderly, which may result in prolonged action and accumulation of the drug in the body. <br /> |}<br /> <br /> ==Drug Management==<br /> ====Monitoring====<br /> *Blood pressure, pulse and respiratory rate are recommended<br /> *Elderly may be sensitivity to diazepam’s effects. Impairment of memory, cognitive function, and psychomotor performance and behavior disinhibition may be common. Long-term use commonly exacerbates underlying dementia in elderly patients.<br /> *Diazepam may make elderly patients feel dizzy, increasing risk of falls, so fall prevention is needed<br /> *Some patients develop blood dyscrasias, and have raised liver enzymes, so periodic blood counts and liver function tests are recommended<br /> *changes in mood, the development or worsening depression, and/or any thoughts or behaviour of suicide.<br /> <br /> ===Dependence and Withdrawal===<br /> *One-third of individuals treated with benzodiazepines for longer than 4 weeks develop a dependence on the drug and experience a withdrawal syndrome on cessation.<br /> *Withdrawal symptoms can range from insomnia and anxiety to more serious symptoms, including seizures and psychosis.<br /> *Diazepam should therefore be withdrawn by tapering the dose to minimize occurrence of withdrawal symptoms. <br /> *Tolerance develops to the anticonvulsant effects of diazepam. <br /> <br /> ===Drug interaction===<br /> Medicines that interact with diazepam may either <br /> *Decrease its effect<br /> *Affect how long it works for<br /> *Increase side effects<br /> <br /> Common medications that may interact with diazepam include:<br /> {| class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| Drugs given with diazepam<br /> !style=&quot;text-align: left&quot;| Potential Effect<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Alcohol, <br /> Hypnotics/sedative (e.g. barbiturates)<br /> Antidepressants (e.g. fluoxetine, amitriptyline)<br /> Sedative histamines (e.g. promethazine)<br /> Antipsychotic (e.g. chlorpromazine, clozapine)<br /> |May worsens the side effects such as drowsiness , dizziness and respiratory depression<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Cimetidine <br /> Omeprazole<br /> Oxcarbazepine, topiramate, valproate<br /> Ketoconazole<br /> Itraconazole<br /> Isoniazid<br /> Erythromycin, ciprofloxacin<br /> Propranolol<br /> fluoxetine<br /> |'''Prolong the action''' of diazepam by inhibiting its elimination<br /> |-<br /> |style=&quot;text-align: left&quot;| Alcohol <br /> |May cause a synergistic enhancement of the hypotensive effect of diazepam and alcohol<br /> |-<br /> |style=&quot;text-align: left&quot;| Oral contraceptives<br /> |Oral contraceptives significant decrease the elimination of diazepam, so '''prolong the action of diazepam'''<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Rifampicin<br /> Phenytoin<br /> Carbamazepine<br /> phenobarbitone<br /> |All these drugs increase the metabolism of diazepam, thus decreasing drug levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| <br /> Steroid (e.g. Dexamethasone)<br /> St John’s wort<br /> |Increase the metabolism of diazepam, thus decreasing diazepam plasma levels and effects<br /> |-<br /> |style=&quot;text-align: left&quot;| Theophylline<br /> |May inhibit the action of diazepam<br /> |-<br /> |style=&quot;text-align: left&quot;| Levodopa (e.g. Sinemet)<br /> |Diazepam may block the action of levodopa used in the treatment of Parkinson’s disease.<br /> |-<br /> |style=&quot;text-align: left&quot;|<br /> Foods that acidify the urine <br /> <br /> Food that alkalinize the urine<br /> |Can lead to faster absorption and elimination of diazepam, reducing drug levels and effects.<br /> Can lead to slower absorption and elimination of diazepam, increasing the diazepam plasma levels and effects.<br /> |}<br /> <br /> ===Caution===<br /> *particular care in pregnancy, <br /> *elderly, due to increased susceptibility to side-effects, especially loss of coordination and drowsiness<br /> *in patients with hepatic or renal impairment, who may require reduced doses<br /> *people with history of alcohol dependence or abuse<br /> *people with history of drug dependence or abuse<br /> *people with psychiatric disorders<br /> *avoid prolonged use and abrupt withdrawal thereafter<br /> <br /> ===Contra-indications===<br /> Use of diazepam should be avoided, when possible, in individuals with: <br /> *severe hepatic impairment<br /> *sleep apnoea <br /> *chronic obstructive airways disease (COPD) <br /> *Myasthenia gravis<br /> *Acute narrow-angle glaucoma<br /> *Chronic schizophrenia<br /> <br /> ===Hepatic impairment===<br /> *Start with smaller initial doses or reduce dose.<br /> *Can precipitate coma.<br /> *Avoid in severe impairment.<br /> <br /> ===Renal impairment===<br /> *Start with small doses in severe impairment.<br /> <br /> ===Pregnancy===<br /> Possible adverse effects of use of benzodiazepines such as diazepam during pregnancy include: miscarriage, malformation, intrauterine growth retardation, and function deficits. <br /> <br /> ===Breast-feeding===<br /> Use during breast feeding is not recommended.<br /> <br /> ===Driving and skilled tasks===<br /> May impair judgment and increase reaction time, and so affect ability to drive or operate machinery. Patients should be warned not to operate dangerous machinery or motor vehicles until it is known that they do not become drowsy from diazepam therapy. <br /> <br /> == FAQ ==<br /> === How should I take the tablet? ===<br /> May be taken with or without food. Swallow whole with a glass of water.<br /> === What should I avoid while taking? ===<br /> Do not eat grapefruit or drink grapefruit juice as it may increase blood levels of diazepam. <br /> <br /> Avoid drinking alcohol while taking diazepam because it may enhance the side effects of sedation and respiratory depression. <br /> <br /> Avoid driving or hazardous activity until you know how diazepam will affect you. <br /> ==== What happen if I overdose? ====<br /> Contact your primary care doctor.<br /> If emergency situation, call 999<br /> ==== What happen if I miss a dose? ====<br /> Take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E5%9C%B0%E8%A5%BF%E6%B3%AE&diff=2674 2020-10-20T05:42:54Z

<p>Ctol2: </p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''地西泮''' (English: [[diazepam]]) 是一種長效苯二氮䓬類藥物，具有抗癲癇，抗焦慮，鎮靜，肌肉鬆弛的特性。它用於：<br /> *在嚴重焦慮症的短期治療中;<br /> *作為短期失眠的催眠藥;<br /> *作為鎮靜劑;<br /> *作為抗驚厥藥（特別是在癲癇持續狀態和高熱驚厥的治療中）;<br /> *控制肌肉痙攣;<br /> *酒精或苯二氮卓戒斷綜合症。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Diazepam Tablet 2 mg<br /> |DIAZ01<br /> |DDA<br /> |-<br /> |Diazepam Tablet 5 mg<br /> |DIAZ02<br /> |DDA<br /> |-<br /> |Diazepam Rectal Solution 2mg/ml (2.5ml/tube)<br /> |DIAZ10<br /> |DDA<br /> |-<br /> |Diazepam Rectal Solution 4mg/ml (2.5ml/tube)<br /> |DIAZ11<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物 <br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> 地西泮可以口服，直腸和注射型式給藥，由於其此藥的依賴性極大; 所以也影響了治療的劑量和持續時間。<br /> 治療過程應短，通常不超過4週，地西泮應逐漸停用。<br /> 老年人和虛弱的患者應服用成人劑量的一半以下<br /> <br /> {| class = &quot;wikitable&quot;<br /> !焦慮<br /> |口服<br /> 成人：每日 3 次，每次 2mg，然後根據需要增加至<br /> 每日 15 – 30mg。<br /> <br /> 年長患者：每日 3 次，每次 1mg，然後根據需要增加至<br /> 每日 7.5 – 15mg。<br /> <br /> 虛弱的患者：使用老年人劑量<br /> |-<br /> !用於全身麻醉前的用藥 <br /> |口服<br /> 成人： 一次 5 – 10mg，在手術前 1-2 小時服用<br /> <br /> 年長患者 : 一次 2.5 – 5mg，在手術前 1-2 小時服用<br /> <br /> 虛弱的患者：使用老年人劑量<br /> |-<br /> ! 用於小手術期間的鎮靜<br /> |口服<br /> 成人：每次最多 20mg，在手術前 1-2 小時服用<br /> |-<br /> !癲癇持續狀態<br /> 發熱性癲癇<br /> 中毒引起的抽搐<br /> |直腸栓劑<br /> 兒童 1 個月至 1 歲：使用一次 5mg，如果需要，則在 10 分鐘後再使用 5mg。<br /> <br /> 2-11 歲兒童：使用一次 5mg-10mg，如果需要，則在 10 分鐘後再使用 5mg-10mg。<br /> <br /> 12 至 17 歲兒童：使用一次 10mg-20mg，如果需要，則在 10分鐘後再使用 10mg-20mg。<br /> <br /> 成人：使用一次 10mg-20mg，如果需要，則在 10 分鐘後再使用 10mg-20mg。<br /> <br /> 老年人：使用一次 10mg 如果需要，則在 10 分鐘後再使用 10mg。<br /> <br /> |-<br /> !呼吸困難與姑息治療中的焦慮症相關<br /> 呼吸困難<br /> <br /> |口服<br /> 成人：每天 5 – 10mg<br /> <br /> |-<br /> !姑息治療中肌肉痙攣的疼痛<br /> |口服<br /> 成人：每日 5 – 10mg<br /> |-<br /> !肌肉痙攣<br /> |口服<br /> 成人：分劑量每日 2 – 15mg，然後根據需要增加至每日 60mg。<br /> |-<br /> !戒酒綜合徵<br /> |口服<br /> 成人 : 每次 5 至 20mg，必要時在 2 至 4 小時後重複；<br /> <br /> 或在第一天服用三至四次 10mg，減少至<br /> <br /> 每天三至四次，每次 5mg。<br /> <br /> |}<br /> 地西泮很少用於癲癇的長期治療，因為其抗驚厥作用的耐受性通常在治療後6到12個月內形成。為此，實際上使其變得無用。<br /> <br /> ==副作用==<br /> 包括[[阿普唑侖]]在內的鎮靜藥與死亡風險增加有關。<br /> <br /> 可能的副作用包括： <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率 &gt; 10％）或常見（發生率 1-10％）<br /> |<br /> *行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *有睡意<br /> *鎮靜<br /> *肌肉無力<br /> *攻擊性反常增加<br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 - 1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *失禁<br /> *尿滯留<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt; 0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> *自殺意念<br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> ===逆向反應===<br /> <br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |地西泮口服後吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |口服後 30 至 90 分鐘之間及使用直腸溶液 10 至 30 分鐘後血漿濃度達到峰值。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |地西泮通過尿液排出體外。<br /> <br /> 地西泮的半衰期一般為 30 – 56 小時。<br /> <br /> 地西泮的雙相半衰期約為 1 至 2 天，其主要活性代謝產物為 2 至 5 天。 <br /> <br /> 地西泮和活尸性代謝產物的消除半衰期在老年人中顯著增加，這可能導致藥物作用延長並在體內積聚。<br /> <br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議檢查血壓，脈搏和呼吸頻率。<br /> *老年人對地西泮的藥物敏。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的癡呆症狀。<br /> *地西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *有些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查。<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過4星以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對地西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> *耐受性增強了地西泮的抗癲癇作用。<br /> <br /> ===藥物相互影響=== <br /> 與地西泮相互作用的藥物可能:<br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與地西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，阿米替林）<br /> <br /> 鎮靜劑組胺（例如異丙嗪）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> <br /> |抑制地西泮的消除,從而引至地西泮的藥效延長<br /> <br /> |-<br /> |醇<br /> |可能導致勞拉西泮和酒精的降壓作用增強<br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥明顯減少了地西泮的消除，因此延長了地西泮的藥效<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> <br /> <br /> |所有這些藥物都會增加地西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加地西泮的代謝，從而降低地西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制地西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |地西泮可能會阻斷左旋多巴在帕金森氏病治療中的作用。<br /> |-<br /> |使尿液酸化的食物 <br /> |可以導致更快地吸收和消除地西泮，從而降低藥物水平和效果。<br /> |-<br /> |使尿液鹼化的食物<br /> |可能導致地西泮吸收減慢和消除，增加了地西泮的血漿水平和藥效。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電999<br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E5%9C%B0%E8%A5%BF%E6%B3%AE&diff=2673 2020-10-20T05:41:52Z

<p>Ctol2: /* 藥物相互影響 */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''地西泮''' (English: [[diazapam]]) 是一種長效苯二氮䓬類藥物，具有抗癲癇，抗焦慮，鎮靜，肌肉鬆弛的特性。它用於：<br /> *在嚴重焦慮症的短期治療中;<br /> *作為短期失眠的催眠藥;<br /> *作為鎮靜劑;<br /> *作為抗驚厥藥（特別是在癲癇持續狀態和高熱驚厥的治療中）;<br /> *控制肌肉痙攣;<br /> *酒精或苯二氮卓戒斷綜合症。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Diazepam Tablet 2 mg<br /> |DIAZ01<br /> |DDA<br /> |-<br /> |Diazepam Tablet 5 mg<br /> |DIAZ02<br /> |DDA<br /> |-<br /> |Diazepam Rectal Solution 2mg/ml (2.5ml/tube)<br /> |DIAZ10<br /> |DDA<br /> |-<br /> |Diazepam Rectal Solution 4mg/ml (2.5ml/tube)<br /> |DIAZ11<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物 <br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> 地西泮可以口服，直腸和注射型式給藥，由於其此藥的依賴性極大; 所以也影響了治療的劑量和持續時間。<br /> 治療過程應短，通常不超過4週，地西泮應逐漸停用。<br /> 老年人和虛弱的患者應服用成人劑量的一半以下<br /> <br /> {| class = &quot;wikitable&quot;<br /> !焦慮<br /> |口服<br /> 成人：每日 3 次，每次 2mg，然後根據需要增加至<br /> 每日 15 – 30mg。<br /> <br /> 年長患者：每日 3 次，每次 1mg，然後根據需要增加至<br /> 每日 7.5 – 15mg。<br /> <br /> 虛弱的患者：使用老年人劑量<br /> |-<br /> !用於全身麻醉前的用藥 <br /> |口服<br /> 成人： 一次 5 – 10mg，在手術前 1-2 小時服用<br /> <br /> 年長患者 : 一次 2.5 – 5mg，在手術前 1-2 小時服用<br /> <br /> 虛弱的患者：使用老年人劑量<br /> |-<br /> ! 用於小手術期間的鎮靜<br /> |口服<br /> 成人：每次最多 20mg，在手術前 1-2 小時服用<br /> |-<br /> !癲癇持續狀態<br /> 發熱性癲癇<br /> 中毒引起的抽搐<br /> |直腸栓劑<br /> 兒童 1 個月至 1 歲：使用一次 5mg，如果需要，則在 10 分鐘後再使用 5mg。<br /> <br /> 2-11 歲兒童：使用一次 5mg-10mg，如果需要，則在 10 分鐘後再使用 5mg-10mg。<br /> <br /> 12 至 17 歲兒童：使用一次 10mg-20mg，如果需要，則在 10分鐘後再使用 10mg-20mg。<br /> <br /> 成人：使用一次 10mg-20mg，如果需要，則在 10 分鐘後再使用 10mg-20mg。<br /> <br /> 老年人：使用一次 10mg 如果需要，則在 10 分鐘後再使用 10mg。<br /> <br /> |-<br /> !呼吸困難與姑息治療中的焦慮症相關<br /> 呼吸困難<br /> <br /> |口服<br /> 成人：每天 5 – 10mg<br /> <br /> |-<br /> !姑息治療中肌肉痙攣的疼痛<br /> |口服<br /> 成人：每日 5 – 10mg<br /> |-<br /> !肌肉痙攣<br /> |口服<br /> 成人：分劑量每日 2 – 15mg，然後根據需要增加至每日 60mg。<br /> |-<br /> !戒酒綜合徵<br /> |口服<br /> 成人 : 每次 5 至 20mg，必要時在 2 至 4 小時後重複；<br /> <br /> 或在第一天服用三至四次 10mg，減少至<br /> <br /> 每天三至四次，每次 5mg。<br /> <br /> |}<br /> 地西泮很少用於癲癇的長期治療，因為其抗驚厥作用的耐受性通常在治療後6到12個月內形成。為此，實際上使其變得無用。<br /> <br /> ==副作用==<br /> 包括[[阿普唑侖]]在內的鎮靜藥與死亡風險增加有關。<br /> <br /> 可能的副作用包括： <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率 &gt; 10％）或常見（發生率 1-10％）<br /> |<br /> *行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *有睡意<br /> *鎮靜<br /> *肌肉無力<br /> *攻擊性反常增加<br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 - 1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *失禁<br /> *尿滯留<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt; 0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> *自殺意念<br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> ===逆向反應===<br /> <br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |地西泮口服後吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |口服後 30 至 90 分鐘之間及使用直腸溶液 10 至 30 分鐘後血漿濃度達到峰值。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |地西泮通過尿液排出體外。<br /> <br /> 地西泮的半衰期一般為 30 – 56 小時。<br /> <br /> 地西泮的雙相半衰期約為 1 至 2 天，其主要活性代謝產物為 2 至 5 天。 <br /> <br /> 地西泮和活尸性代謝產物的消除半衰期在老年人中顯著增加，這可能導致藥物作用延長並在體內積聚。<br /> <br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議檢查血壓，脈搏和呼吸頻率。<br /> *老年人對地西泮的藥物敏。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的癡呆症狀。<br /> *地西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *有些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查。<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過4星以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對地西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> *耐受性增強了地西泮的抗癲癇作用。<br /> <br /> ===藥物相互影響=== <br /> 與地西泮相互作用的藥物可能:<br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與地西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，阿米替林）<br /> <br /> 鎮靜劑組胺（例如異丙嗪）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> <br /> |抑制地西泮的消除,從而引至地西泮的藥效延長<br /> <br /> |-<br /> |醇<br /> |可能導致勞拉西泮和酒精的降壓作用增強<br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥明顯減少了地西泮的消除，因此延長了地西泮的藥效<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> <br /> <br /> |所有這些藥物都會增加地西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加地西泮的代謝，從而降低地西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制地西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |地西泮可能會阻斷左旋多巴在帕金森氏病治療中的作用。<br /> |-<br /> |使尿液酸化的食物 <br /> |可以導致更快地吸收和消除地西泮，從而降低藥物水平和效果。<br /> |-<br /> |使尿液鹼化的食物<br /> |可能導致地西泮吸收減慢和消除，增加了地西泮的血漿水平和藥效。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電999<br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E5%9C%B0%E8%A5%BF%E6%B3%AE&diff=2672 2020-10-20T05:41:33Z

<p>Ctol2: /* 監控 */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''地西泮''' (English: [[diazapam]]) 是一種長效苯二氮䓬類藥物，具有抗癲癇，抗焦慮，鎮靜，肌肉鬆弛的特性。它用於：<br /> *在嚴重焦慮症的短期治療中;<br /> *作為短期失眠的催眠藥;<br /> *作為鎮靜劑;<br /> *作為抗驚厥藥（特別是在癲癇持續狀態和高熱驚厥的治療中）;<br /> *控制肌肉痙攣;<br /> *酒精或苯二氮卓戒斷綜合症。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Diazepam Tablet 2 mg<br /> |DIAZ01<br /> |DDA<br /> |-<br /> |Diazepam Tablet 5 mg<br /> |DIAZ02<br /> |DDA<br /> |-<br /> |Diazepam Rectal Solution 2mg/ml (2.5ml/tube)<br /> |DIAZ10<br /> |DDA<br /> |-<br /> |Diazepam Rectal Solution 4mg/ml (2.5ml/tube)<br /> |DIAZ11<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物 <br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> 地西泮可以口服，直腸和注射型式給藥，由於其此藥的依賴性極大; 所以也影響了治療的劑量和持續時間。<br /> 治療過程應短，通常不超過4週，地西泮應逐漸停用。<br /> 老年人和虛弱的患者應服用成人劑量的一半以下<br /> <br /> {| class = &quot;wikitable&quot;<br /> !焦慮<br /> |口服<br /> 成人：每日 3 次，每次 2mg，然後根據需要增加至<br /> 每日 15 – 30mg。<br /> <br /> 年長患者：每日 3 次，每次 1mg，然後根據需要增加至<br /> 每日 7.5 – 15mg。<br /> <br /> 虛弱的患者：使用老年人劑量<br /> |-<br /> !用於全身麻醉前的用藥 <br /> |口服<br /> 成人： 一次 5 – 10mg，在手術前 1-2 小時服用<br /> <br /> 年長患者 : 一次 2.5 – 5mg，在手術前 1-2 小時服用<br /> <br /> 虛弱的患者：使用老年人劑量<br /> |-<br /> ! 用於小手術期間的鎮靜<br /> |口服<br /> 成人：每次最多 20mg，在手術前 1-2 小時服用<br /> |-<br /> !癲癇持續狀態<br /> 發熱性癲癇<br /> 中毒引起的抽搐<br /> |直腸栓劑<br /> 兒童 1 個月至 1 歲：使用一次 5mg，如果需要，則在 10 分鐘後再使用 5mg。<br /> <br /> 2-11 歲兒童：使用一次 5mg-10mg，如果需要，則在 10 分鐘後再使用 5mg-10mg。<br /> <br /> 12 至 17 歲兒童：使用一次 10mg-20mg，如果需要，則在 10分鐘後再使用 10mg-20mg。<br /> <br /> 成人：使用一次 10mg-20mg，如果需要，則在 10 分鐘後再使用 10mg-20mg。<br /> <br /> 老年人：使用一次 10mg 如果需要，則在 10 分鐘後再使用 10mg。<br /> <br /> |-<br /> !呼吸困難與姑息治療中的焦慮症相關<br /> 呼吸困難<br /> <br /> |口服<br /> 成人：每天 5 – 10mg<br /> <br /> |-<br /> !姑息治療中肌肉痙攣的疼痛<br /> |口服<br /> 成人：每日 5 – 10mg<br /> |-<br /> !肌肉痙攣<br /> |口服<br /> 成人：分劑量每日 2 – 15mg，然後根據需要增加至每日 60mg。<br /> |-<br /> !戒酒綜合徵<br /> |口服<br /> 成人 : 每次 5 至 20mg，必要時在 2 至 4 小時後重複；<br /> <br /> 或在第一天服用三至四次 10mg，減少至<br /> <br /> 每天三至四次，每次 5mg。<br /> <br /> |}<br /> 地西泮很少用於癲癇的長期治療，因為其抗驚厥作用的耐受性通常在治療後6到12個月內形成。為此，實際上使其變得無用。<br /> <br /> ==副作用==<br /> 包括[[阿普唑侖]]在內的鎮靜藥與死亡風險增加有關。<br /> <br /> 可能的副作用包括： <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率 &gt; 10％）或常見（發生率 1-10％）<br /> |<br /> *行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *有睡意<br /> *鎮靜<br /> *肌肉無力<br /> *攻擊性反常增加<br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 - 1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *失禁<br /> *尿滯留<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt; 0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> *自殺意念<br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> ===逆向反應===<br /> <br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |地西泮口服後吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |口服後 30 至 90 分鐘之間及使用直腸溶液 10 至 30 分鐘後血漿濃度達到峰值。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |地西泮通過尿液排出體外。<br /> <br /> 地西泮的半衰期一般為 30 – 56 小時。<br /> <br /> 地西泮的雙相半衰期約為 1 至 2 天，其主要活性代謝產物為 2 至 5 天。 <br /> <br /> 地西泮和活尸性代謝產物的消除半衰期在老年人中顯著增加，這可能導致藥物作用延長並在體內積聚。<br /> <br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議檢查血壓，脈搏和呼吸頻率。<br /> *老年人對地西泮的藥物敏。記憶力，認知功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的癡呆症狀。<br /> *地西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒。<br /> *有些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查。<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過4星以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對地西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> *耐受性增強了地西泮的抗癲癇作用。<br /> <br /> ===藥物相互影響=== <br /> 與地西泮相互作用的藥物可能 <br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與地西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，阿米替林）<br /> <br /> 鎮靜劑組胺（例如異丙嗪）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> <br /> |抑制地西泮的消除,從而引至地西泮的藥效延長<br /> <br /> |-<br /> |醇<br /> |可能導致勞拉西泮和酒精的降壓作用增強<br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥明顯減少了地西泮的消除，因此延長了地西泮的藥效<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> <br /> <br /> |所有這些藥物都會增加地西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加地西泮的代謝，從而降低地西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制地西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |地西泮可能會阻斷左旋多巴在帕金森氏病治療中的作用。<br /> |-<br /> |使尿液酸化的食物 <br /> |可以導致更快地吸收和消除地西泮，從而降低藥物水平和效果。<br /> |-<br /> |使尿液鹼化的食物<br /> |可能導致地西泮吸收減慢和消除，增加了地西泮的血漿水平和藥效。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電999<br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E5%9C%B0%E8%A5%BF%E6%B3%AE&diff=2671 2020-10-20T05:41:10Z

<p>Ctol2: /* 藥動力學 */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''地西泮''' (English: [[diazapam]]) 是一種長效苯二氮䓬類藥物，具有抗癲癇，抗焦慮，鎮靜，肌肉鬆弛的特性。它用於：<br /> *在嚴重焦慮症的短期治療中;<br /> *作為短期失眠的催眠藥;<br /> *作為鎮靜劑;<br /> *作為抗驚厥藥（特別是在癲癇持續狀態和高熱驚厥的治療中）;<br /> *控制肌肉痙攣;<br /> *酒精或苯二氮卓戒斷綜合症。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Diazepam Tablet 2 mg<br /> |DIAZ01<br /> |DDA<br /> |-<br /> |Diazepam Tablet 5 mg<br /> |DIAZ02<br /> |DDA<br /> |-<br /> |Diazepam Rectal Solution 2mg/ml (2.5ml/tube)<br /> |DIAZ10<br /> |DDA<br /> |-<br /> |Diazepam Rectal Solution 4mg/ml (2.5ml/tube)<br /> |DIAZ11<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物 <br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> 地西泮可以口服，直腸和注射型式給藥，由於其此藥的依賴性極大; 所以也影響了治療的劑量和持續時間。<br /> 治療過程應短，通常不超過4週，地西泮應逐漸停用。<br /> 老年人和虛弱的患者應服用成人劑量的一半以下<br /> <br /> {| class = &quot;wikitable&quot;<br /> !焦慮<br /> |口服<br /> 成人：每日 3 次，每次 2mg，然後根據需要增加至<br /> 每日 15 – 30mg。<br /> <br /> 年長患者：每日 3 次，每次 1mg，然後根據需要增加至<br /> 每日 7.5 – 15mg。<br /> <br /> 虛弱的患者：使用老年人劑量<br /> |-<br /> !用於全身麻醉前的用藥 <br /> |口服<br /> 成人： 一次 5 – 10mg，在手術前 1-2 小時服用<br /> <br /> 年長患者 : 一次 2.5 – 5mg，在手術前 1-2 小時服用<br /> <br /> 虛弱的患者：使用老年人劑量<br /> |-<br /> ! 用於小手術期間的鎮靜<br /> |口服<br /> 成人：每次最多 20mg，在手術前 1-2 小時服用<br /> |-<br /> !癲癇持續狀態<br /> 發熱性癲癇<br /> 中毒引起的抽搐<br /> |直腸栓劑<br /> 兒童 1 個月至 1 歲：使用一次 5mg，如果需要，則在 10 分鐘後再使用 5mg。<br /> <br /> 2-11 歲兒童：使用一次 5mg-10mg，如果需要，則在 10 分鐘後再使用 5mg-10mg。<br /> <br /> 12 至 17 歲兒童：使用一次 10mg-20mg，如果需要，則在 10分鐘後再使用 10mg-20mg。<br /> <br /> 成人：使用一次 10mg-20mg，如果需要，則在 10 分鐘後再使用 10mg-20mg。<br /> <br /> 老年人：使用一次 10mg 如果需要，則在 10 分鐘後再使用 10mg。<br /> <br /> |-<br /> !呼吸困難與姑息治療中的焦慮症相關<br /> 呼吸困難<br /> <br /> |口服<br /> 成人：每天 5 – 10mg<br /> <br /> |-<br /> !姑息治療中肌肉痙攣的疼痛<br /> |口服<br /> 成人：每日 5 – 10mg<br /> |-<br /> !肌肉痙攣<br /> |口服<br /> 成人：分劑量每日 2 – 15mg，然後根據需要增加至每日 60mg。<br /> |-<br /> !戒酒綜合徵<br /> |口服<br /> 成人 : 每次 5 至 20mg，必要時在 2 至 4 小時後重複；<br /> <br /> 或在第一天服用三至四次 10mg，減少至<br /> <br /> 每天三至四次，每次 5mg。<br /> <br /> |}<br /> 地西泮很少用於癲癇的長期治療，因為其抗驚厥作用的耐受性通常在治療後6到12個月內形成。為此，實際上使其變得無用。<br /> <br /> ==副作用==<br /> 包括[[阿普唑侖]]在內的鎮靜藥與死亡風險增加有關。<br /> <br /> 可能的副作用包括： <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率 &gt; 10％）或常見（發生率 1-10％）<br /> |<br /> *行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *有睡意<br /> *鎮靜<br /> *肌肉無力<br /> *攻擊性反常增加<br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 - 1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *失禁<br /> *尿滯留<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt; 0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> *自殺意念<br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> ===逆向反應===<br /> <br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |地西泮口服後吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |口服後 30 至 90 分鐘之間及使用直腸溶液 10 至 30 分鐘後血漿濃度達到峰值。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |地西泮通過尿液排出體外。<br /> <br /> 地西泮的半衰期一般為 30 – 56 小時。<br /> <br /> 地西泮的雙相半衰期約為 1 至 2 天，其主要活性代謝產物為 2 至 5 天。 <br /> <br /> 地西泮和活尸性代謝產物的消除半衰期在老年人中顯著增加，這可能導致藥物作用延長並在體內積聚。<br /> <br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議檢查血壓，脈搏和呼吸頻率<br /> *老年人對地西泮的藥物敏。記憶力，認<br /> 知<br /> 功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的癡呆症狀。<br /> *地西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒<br /> *有些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過4星以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對地西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> *耐受性增強了地西泮的抗癲癇作用。<br /> <br /> ===藥物相互影響=== <br /> 與地西泮相互作用的藥物可能 <br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與地西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，阿米替林）<br /> <br /> 鎮靜劑組胺（例如異丙嗪）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> <br /> |抑制地西泮的消除,從而引至地西泮的藥效延長<br /> <br /> |-<br /> |醇<br /> |可能導致勞拉西泮和酒精的降壓作用增強<br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥明顯減少了地西泮的消除，因此延長了地西泮的藥效<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> <br /> <br /> |所有這些藥物都會增加地西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加地西泮的代謝，從而降低地西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制地西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |地西泮可能會阻斷左旋多巴在帕金森氏病治療中的作用。<br /> |-<br /> |使尿液酸化的食物 <br /> |可以導致更快地吸收和消除地西泮，從而降低藥物水平和效果。<br /> |-<br /> |使尿液鹼化的食物<br /> |可能導致地西泮吸收減慢和消除，增加了地西泮的血漿水平和藥效。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電999<br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E5%9C%B0%E8%A5%BF%E6%B3%AE&diff=2670 2020-10-20T05:40:26Z

<p>Ctol2: /* 副作用 */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''地西泮''' (English: [[diazapam]]) 是一種長效苯二氮䓬類藥物，具有抗癲癇，抗焦慮，鎮靜，肌肉鬆弛的特性。它用於：<br /> *在嚴重焦慮症的短期治療中;<br /> *作為短期失眠的催眠藥;<br /> *作為鎮靜劑;<br /> *作為抗驚厥藥（特別是在癲癇持續狀態和高熱驚厥的治療中）;<br /> *控制肌肉痙攣;<br /> *酒精或苯二氮卓戒斷綜合症。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Diazepam Tablet 2 mg<br /> |DIAZ01<br /> |DDA<br /> |-<br /> |Diazepam Tablet 5 mg<br /> |DIAZ02<br /> |DDA<br /> |-<br /> |Diazepam Rectal Solution 2mg/ml (2.5ml/tube)<br /> |DIAZ10<br /> |DDA<br /> |-<br /> |Diazepam Rectal Solution 4mg/ml (2.5ml/tube)<br /> |DIAZ11<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物 <br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> 地西泮可以口服，直腸和注射型式給藥，由於其此藥的依賴性極大; 所以也影響了治療的劑量和持續時間。<br /> 治療過程應短，通常不超過4週，地西泮應逐漸停用。<br /> 老年人和虛弱的患者應服用成人劑量的一半以下<br /> <br /> {| class = &quot;wikitable&quot;<br /> !焦慮<br /> |口服<br /> 成人：每日 3 次，每次 2mg，然後根據需要增加至<br /> 每日 15 – 30mg。<br /> <br /> 年長患者：每日 3 次，每次 1mg，然後根據需要增加至<br /> 每日 7.5 – 15mg。<br /> <br /> 虛弱的患者：使用老年人劑量<br /> |-<br /> !用於全身麻醉前的用藥 <br /> |口服<br /> 成人： 一次 5 – 10mg，在手術前 1-2 小時服用<br /> <br /> 年長患者 : 一次 2.5 – 5mg，在手術前 1-2 小時服用<br /> <br /> 虛弱的患者：使用老年人劑量<br /> |-<br /> ! 用於小手術期間的鎮靜<br /> |口服<br /> 成人：每次最多 20mg，在手術前 1-2 小時服用<br /> |-<br /> !癲癇持續狀態<br /> 發熱性癲癇<br /> 中毒引起的抽搐<br /> |直腸栓劑<br /> 兒童 1 個月至 1 歲：使用一次 5mg，如果需要，則在 10 分鐘後再使用 5mg。<br /> <br /> 2-11 歲兒童：使用一次 5mg-10mg，如果需要，則在 10 分鐘後再使用 5mg-10mg。<br /> <br /> 12 至 17 歲兒童：使用一次 10mg-20mg，如果需要，則在 10分鐘後再使用 10mg-20mg。<br /> <br /> 成人：使用一次 10mg-20mg，如果需要，則在 10 分鐘後再使用 10mg-20mg。<br /> <br /> 老年人：使用一次 10mg 如果需要，則在 10 分鐘後再使用 10mg。<br /> <br /> |-<br /> !呼吸困難與姑息治療中的焦慮症相關<br /> 呼吸困難<br /> <br /> |口服<br /> 成人：每天 5 – 10mg<br /> <br /> |-<br /> !姑息治療中肌肉痙攣的疼痛<br /> |口服<br /> 成人：每日 5 – 10mg<br /> |-<br /> !肌肉痙攣<br /> |口服<br /> 成人：分劑量每日 2 – 15mg，然後根據需要增加至每日 60mg。<br /> |-<br /> !戒酒綜合徵<br /> |口服<br /> 成人 : 每次 5 至 20mg，必要時在 2 至 4 小時後重複；<br /> <br /> 或在第一天服用三至四次 10mg，減少至<br /> <br /> 每天三至四次，每次 5mg。<br /> <br /> |}<br /> 地西泮很少用於癲癇的長期治療，因為其抗驚厥作用的耐受性通常在治療後6到12個月內形成。為此，實際上使其變得無用。<br /> <br /> ==副作用==<br /> 包括[[阿普唑侖]]在內的鎮靜藥與死亡風險增加有關。<br /> <br /> 可能的副作用包括： <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率 &gt; 10％）或常見（發生率 1-10％）<br /> |<br /> *行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *有睡意<br /> *鎮靜<br /> *肌肉無力<br /> *攻擊性反常增加<br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 - 1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *失禁<br /> *尿滯留<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt; 0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> *自殺意念<br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> ===逆向反應===<br /> <br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |地西泮口服後吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |口服後30至90分鐘之間及使用直腸溶液10至30分鐘後血漿濃度達到峰值。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |地西泮通過尿液排出體外。<br /> <br /> 地西泮的半衰期一般為30 – 56小時。<br /> <br /> 地西泮的雙相半衰期約為1至2天，其主要活性代謝產物為2至5天。 <br /> <br /> 地西泮和活尸性代謝產物的消除半衰期在老年人中顯著增加，這可能導致藥物作用延長並在體內積聚。<br /> <br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議檢查血壓，脈搏和呼吸頻率<br /> *老年人對地西泮的藥物敏。記憶力，認<br /> 知<br /> 功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的癡呆症狀。<br /> *地西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒<br /> *有些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過4星以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對地西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> *耐受性增強了地西泮的抗癲癇作用。<br /> <br /> ===藥物相互影響=== <br /> 與地西泮相互作用的藥物可能 <br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與地西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，阿米替林）<br /> <br /> 鎮靜劑組胺（例如異丙嗪）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> <br /> |抑制地西泮的消除,從而引至地西泮的藥效延長<br /> <br /> |-<br /> |醇<br /> |可能導致勞拉西泮和酒精的降壓作用增強<br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥明顯減少了地西泮的消除，因此延長了地西泮的藥效<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> <br /> <br /> |所有這些藥物都會增加地西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加地西泮的代謝，從而降低地西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制地西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |地西泮可能會阻斷左旋多巴在帕金森氏病治療中的作用。<br /> |-<br /> |使尿液酸化的食物 <br /> |可以導致更快地吸收和消除地西泮，從而降低藥物水平和效果。<br /> |-<br /> |使尿液鹼化的食物<br /> |可能導致地西泮吸收減慢和消除，增加了地西泮的血漿水平和藥效。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電999<br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2 https://www.sehk-wiki.org/index.php?title=%E5%9C%B0%E8%A5%BF%E6%B3%AE&diff=2669 2020-10-20T05:40:03Z

<p>Ctol2: /* 副作用 */</p> <hr /> <div>[[Category: 藥物]] [[Category: 抗焦慮藥]]<br /> '''地西泮''' (English: [[diazapam]]) 是一種長效苯二氮䓬類藥物，具有抗癲癇，抗焦慮，鎮靜，肌肉鬆弛的特性。它用於：<br /> *在嚴重焦慮症的短期治療中;<br /> *作為短期失眠的催眠藥;<br /> *作為鎮靜劑;<br /> *作為抗驚厥藥（特別是在癲癇持續狀態和高熱驚厥的治療中）;<br /> *控制肌肉痙攣;<br /> *酒精或苯二氮卓戒斷綜合症。<br /> <br /> ==藥名==<br /> {| class=&quot;wikitable&quot;<br /> !Generic Name 藥名<br /> !HA Code 藥物代碼<br /> !Classification 藥物分類<br /> |-<br /> |Diazepam Tablet 2 mg<br /> |DIAZ01<br /> |DDA<br /> |-<br /> |Diazepam Tablet 5 mg<br /> |DIAZ02<br /> |DDA<br /> |-<br /> |Diazepam Rectal Solution 2mg/ml (2.5ml/tube)<br /> |DIAZ10<br /> |DDA<br /> |-<br /> |Diazepam Rectal Solution 4mg/ml (2.5ml/tube)<br /> |DIAZ11<br /> |DDA<br /> |}<br /> <br /> ==藥理==<br /> *勞拉西泮是苯二氮䓬類藥物 <br /> *γ-胺基丁酸（GABA）是一種抑制性神經遞質，用於中樞神經系統中的GABA受體，從而抑制了神經衝動。 <br /> *勞拉西泮用於大腦和脊髓中的苯二氮䓬受體。中樞神經系統中的苯二氮䓬受體與GABA受體形成複合物。<br /> *勞拉西泮通過與苯二氮䓬受體結合而導致 GABA- 苯二氮䓬受體複合物的活化，從而抑制神經衝動，導致大腦和脊髓的整體壓抑。勞拉西泮的抗癲癇特性來自與鈉通道的結合。<br /> *因此，地西泮有助於促進肌肉鬆弛，減輕焦慮，控制抽搐和促進睡眠。<br /> <br /> ==劑量==<br /> 地西泮可以口服，直腸和注射型式給藥，由於其此藥的依賴性極大; 所以也影響了治療的劑量和持續時間。<br /> 治療過程應短，通常不超過4週，地西泮應逐漸停用。<br /> 老年人和虛弱的患者應服用成人劑量的一半以下<br /> <br /> {| class = &quot;wikitable&quot;<br /> !焦慮<br /> |口服<br /> 成人：每日 3 次，每次 2mg，然後根據需要增加至<br /> 每日 15 – 30mg。<br /> <br /> 年長患者：每日 3 次，每次 1mg，然後根據需要增加至<br /> 每日 7.5 – 15mg。<br /> <br /> 虛弱的患者：使用老年人劑量<br /> |-<br /> !用於全身麻醉前的用藥 <br /> |口服<br /> 成人： 一次 5 – 10mg，在手術前 1-2 小時服用<br /> <br /> 年長患者 : 一次 2.5 – 5mg，在手術前 1-2 小時服用<br /> <br /> 虛弱的患者：使用老年人劑量<br /> |-<br /> ! 用於小手術期間的鎮靜<br /> |口服<br /> 成人：每次最多 20mg，在手術前 1-2 小時服用<br /> |-<br /> !癲癇持續狀態<br /> 發熱性癲癇<br /> 中毒引起的抽搐<br /> |直腸栓劑<br /> 兒童 1 個月至 1 歲：使用一次 5mg，如果需要，則在 10 分鐘後再使用 5mg。<br /> <br /> 2-11 歲兒童：使用一次 5mg-10mg，如果需要，則在 10 分鐘後再使用 5mg-10mg。<br /> <br /> 12 至 17 歲兒童：使用一次 10mg-20mg，如果需要，則在 10分鐘後再使用 10mg-20mg。<br /> <br /> 成人：使用一次 10mg-20mg，如果需要，則在 10 分鐘後再使用 10mg-20mg。<br /> <br /> 老年人：使用一次 10mg 如果需要，則在 10 分鐘後再使用 10mg。<br /> <br /> |-<br /> !呼吸困難與姑息治療中的焦慮症相關<br /> 呼吸困難<br /> <br /> |口服<br /> 成人：每天 5 – 10mg<br /> <br /> |-<br /> !姑息治療中肌肉痙攣的疼痛<br /> |口服<br /> 成人：每日 5 – 10mg<br /> |-<br /> !肌肉痙攣<br /> |口服<br /> 成人：分劑量每日 2 – 15mg，然後根據需要增加至每日 60mg。<br /> |-<br /> !戒酒綜合徵<br /> |口服<br /> 成人 : 每次 5 至 20mg，必要時在 2 至 4 小時後重複；<br /> <br /> 或在第一天服用三至四次 10mg，減少至<br /> <br /> 每天三至四次，每次 5mg。<br /> <br /> |}<br /> 地西泮很少用於癲癇的長期治療，因為其抗驚厥作用的耐受性通常在治療後6到12個月內形成。為此，實際上使其變得無用。<br /> <br /> ==副作用==<br /> 包括 [[阿普唑侖]] 在內的鎮靜藥與死亡風險增加有關。<br /> <br /> 可能的副作用包括： <br /> {| class = &quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 很常見 （發生率 &gt; 10％）或常見（發生率 1-10％）<br /> |<br /> *行走不穩定和晃動（尤其是老年人）<br /> *顫抖和其他肌肉控製或協調問題<br /> *混亂（尤其是老年人）<br /> *健忘症<br /> *第二天睡意<br /> *有睡意<br /> *鎮靜<br /> *肌肉無力<br /> *攻擊性反常增加<br /> |-<br /> !style=&quot;text-align: left&quot;| 不常見（發生率的 0.1 - 1％）<br /> |<br /> *構音障礙<br /> *腸胃不適<br /> *婦科<br /> *低血壓<br /> *失禁<br /> *尿滯留<br /> *言語不清<br /> *震顫<br /> *眩暈<br /> *視覺障礙<br /> |-<br /> !style=&quot;text-align: left&quot;| 稀有（發生率 &lt; 0.1％）<br /> |<br /> *呼吸暫停<br /> *血液異常<br /> *黃疸<br /> *抑制呼吸<br /> *過敏反應<br /> *自殺意念<br /> |}<br /> <br /> '''服用過量''' 會產生中樞神經系統的抑制及昏迷。<br /> <br /> ===逆向反應===<br /> <br /> 儘管不尋常，服用鎮靜藥有機會出現以下逆向反應：<br /> *侵略，憤怒<br /> *躁狂，躁動<br /> *憤怒<br /> *抽搐和震顫<br /> <br /> ==藥動力學==<br /> {|class=&quot;wikitable&quot;<br /> !style=&quot;text-align: left&quot;| 口服生物利用度<br /> |地西泮口服後吸收良好。<br /> |-<br /> !style=&quot;text-align: left&quot;| 行動開始<br /> |口服後30至90分鐘之間及使用直腸溶液10至30分鐘後血漿濃度達到峰值。<br /> |-<br /> !style=&quot;text-align: left&quot;| 消除半衰期<br /> |地西泮通過尿液排出體外。<br /> <br /> 地西泮的半衰期一般為30 – 56小時。<br /> <br /> 地西泮的雙相半衰期約為1至2天，其主要活性代謝產物為2至5天。 <br /> <br /> 地西泮和活尸性代謝產物的消除半衰期在老年人中顯著增加，這可能導致藥物作用延長並在體內積聚。<br /> <br /> <br /> |}<br /> <br /> ==藥物資訊==<br /> ===監控===<br /> *建議檢查血壓，脈搏和呼吸頻率<br /> *老年人對地西泮的藥物敏。記憶力，認<br /> 知<br /> 功能，精神運動表現和行為抑制障礙可能很常見。長期使用通常會加重老年患者的癡呆症狀。<br /> *地西泮可能會使老年患者感到頭暈，增加跌倒的風險，因此需要預防跌倒<br /> *有些患者會出現血液異常，並增加肝酶，因此建議定期進行血液計數和肝功能檢查<br /> *情緒變化，抑鬱症的發展或惡化，和/或任何自殺念頭或行為。<br /> <br /> ===藥物依賴與戒斷===<br /> *接受苯二氮卓類藥物治療超過4星以上的個體中，有三分之一對藥物產生依賴性，並且在降低劑量後會出現戒斷綜合徵。<br /> *戒斷症狀的範圍從失眠和焦慮到更嚴重的症狀，包括癲癇發作和精神病。<br /> *對地西泮的抗癲癇作用產生耐受性。<br /> *因此，應通過逐漸減少劑量停用勞拉西泮，以最大程度地減少戒斷症狀。<br /> *耐受性增強了地西泮的抗癲癇作用。<br /> <br /> ===藥物相互影響=== <br /> 與地西泮相互作用的藥物可能 <br /> *降低效果<br /> *影響有效期<br /> *增加副作用<br /> <br /> 可能與地西泮相互作用的常見藥物包括：<br /> {|class=&quot;wikitable&quot;<br /> <br /> !style=&quot;text-align: left&quot;| 藥物<br /> !潛在影響<br /> |-<br /> |style=&quot;text-align: left&quot;|酒精<br /> 催眠藥/鎮靜劑（例如巴比妥類藥物）<br /> <br /> 抗抑鬱藥（例如氟西汀，阿米替林）<br /> <br /> 鎮靜劑組胺（例如異丙嗪）<br /> <br /> 抗精神病藥（例如氯丙嗪，氯氮平）<br /> |可能使嗜睡，頭暈和抑制呼吸等副作用加重<br /> |-<br /> |style=&quot;text-align: left&quot;| 西咪替丁 <br /> <br /> 奧美拉唑<br /> <br /> 奧卡西平，托吡酯，丙戊酸鹽<br /> <br /> 酮康唑<br /> <br /> 伊曲康唑<br /> <br /> 異煙肼<br /> <br /> 紅黴素，環丙沙星<br /> <br /> 普萘洛爾<br /> <br /> 氟西汀<br /> <br /> |抑制地西泮的消除,從而引至地西泮的藥效延長<br /> <br /> |-<br /> |醇<br /> |可能導致勞拉西泮和酒精的降壓作用增強<br /> |-<br /> |style=&quot;text-align: left&quot;|口服避孕藥 <br /> |口服避孕藥明顯減少了地西泮的消除，因此延長了地西泮的藥效<br /> |-<br /> |style=&quot;text-align: left&quot;| 利福平<br /> <br /> 苯妥英<br /> <br /> 卡馬西平<br /> <br /> 苯巴比妥<br /> <br /> <br /> |所有這些藥物都會增加地西泮的代謝，從而降低藥物水平和藥效<br /> |-<br /> |類固醇（例如地塞米松）<br /> 聖約翰草<br /> |增加地西泮的代謝，從而降低地西泮的血漿水平和影響<br /> |-<br /> |style=&quot;text-align: left&quot;| 茶鹼<br /> |可能抑制地西泮的作用<br /> |-<br /> |左旋多巴（例如Sinemet）<br /> |地西泮可能會阻斷左旋多巴在帕金森氏病治療中的作用。<br /> |-<br /> |使尿液酸化的食物 <br /> |可以導致更快地吸收和消除地西泮，從而降低藥物水平和效果。<br /> |-<br /> |使尿液鹼化的食物<br /> |可能導致地西泮吸收減慢和消除，增加了地西泮的血漿水平和藥效。<br /> |}<br /> <br /> ===警告=== <br /> *懷孕期間要特別照顧 <br /> *老年人，由於對副作用的敏感性增加，尤其是失去協調性和嗜睡<br /> *有酗酒或酗酒史的人<br /> *有藥物依賴或濫用的患者<br /> *精神病患者<br /> *避免長時間使用和突然停藥<br /> <br /> ===禁忌===<br /> 如有可能，應避免在以下人群中使用地西泮： <br /> *嚴重肝功能不全<br /> *睡眠呼吸暫停 <br /> *慢性阻塞性氣道疾病（COPD） <br /> *重症肌無力<br /> *急性窄角型青光眼<br /> *慢性精神分裂症<br /> <br /> ===肝功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> *會引起昏迷<br /> *嚴重肝功能損害患者應避免使用<br /> <br /> ===腎功能不全===<br /> *應減少劑量或從較小的初始劑量開始<br /> <br /> ===懷孕 ===<br /> 懷孕期間使用苯二氮卓類藥物（例如勞拉西泮）可能產生的不良影響包括：流產，畸形，宮內發育遲緩和功能障礙。 <br /> <br /> ===哺乳===<br /> 不建議在母乳喂養期間使用。<br /> <br /> ===駕駛和技術性工作===<br /> 可能會削弱判斷力並增加反應時間，從而影響驅動或操作機械的能力。應警告患者不要操作危險的機械或機動車輛<br /> <br /> == 常問問題 ==<br /> === 如何服用此藥？===<br /> 遵照醫生的處方，應在進餐時或餐後服用阿普唑侖，以減輕對胃的刺激。<br /> === 服用時應避免什麼？===<br /> 避免飲酒或使用娛樂性藥物。<br /> 不要吃西柚或喝西柚汁。 <br /> === 如果服藥過量怎麼辦？===<br /> 請聯繫主診醫生。<br /> 如有緊急情況，請致電999<br /> === 如果錯過服藥時間怎麼辦？===<br /> 請立即服用，如果臨近下一次的服藥時間，只需服用下一劑的份量，切忌不要加倍。</div>

Ctol2