Home Drug Guide Chlordiazepoxide Hydrochloride

Drug Guide

Generic Name

Chlordiazepoxide Hydrochloride

Brand Names Librium, Chlordiazachel, Lygen, A-poxide

Classification

Therapeutic: Anxiolytic, Sedative, Hypnotic

Pharmacological: Benzodiazepine

FDA Approved Indications

  • Anxiety disorder
  • Alcohol withdrawal syndrome
  • Preoperative sedation

Mechanism of Action

Enhances the effect of gamma-aminobutyric acid (GABA) at GABA-A receptors, resulting in sedative, anxiolytic, anticonvulsant, and muscle relaxant properties.

Dosage and Administration

Adult: Typically 5-25 mg 3-4 times daily, adjusted based on response and tolerability.

Pediatric: Use not generally recommended due to safety concerns.

Geriatric: Start at lower doses (e.g., 5 mg) and titrate carefully.

Renal Impairment: Use with caution; dose adjustments may be necessary.

Hepatic Impairment: Use with caution; metabolic clearance may be reduced.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed, crosses the blood-brain barrier.

Metabolism: Primarily metabolized in the liver via hydroxylation and conjugation.

Excretion: Renally excreted as active and inactive metabolites.

Half Life: About 5-30 hours, variable depending on individual factors.

Contraindications

  • Hypersensitivity to benzodiazepines.
  • Acute narrow-angle glaucoma.
  • réputiny Disorder
  • Pregnancy Category D/S

Precautions

  • History of substance abuse.
  • Respiratory insufficiency.
  • Liver disease.
  • Use with caution in the elderly; risk of falls and cognitive impairment.

Adverse Reactions - Common

  • Drowsiness (Common)
  • Dizziness (Common)
  • Ataxia (Less common)

Adverse Reactions - Serious

  • Respiratory depression (Rare)
  • Paradoxical reactions (e.g., agitation, aggression) (Rare)
  • Dependence and withdrawal symptoms (Serious with long-term use)

Drug-Drug Interactions

  • CNS depressants (opioids, alcohol, other sedatives) — increased sedation and respiratory depression.
  • Antifungals (ketoconazole, itraconazole) — decreased metabolism of chlordiazepoxide.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of excessive sedation, confusion, or respiratory depression.

Diagnoses:

  • Risk for injury from falls due to sedation.
  • Impaired cognition or coordination.

Implementation: Administer dose exactly as prescribed. Use caution in activities requiring alertness.

Evaluation: Assess effectiveness in alleviating anxiety or alcohol withdrawal symptoms.

Patient/Family Teaching

  • Do not drink alcohol while on this medication.
  • Avoid operating heavy machinery or driving until response is known.
  • Inform about potential for dependence and withdrawal symptoms.
  • Take medication exactly as prescribed; do not increase dose without medical advice.

Special Considerations

Black Box Warnings:

  • Risks of respiratory depression, coma, and death when used with opioids.
  • Risks of dependence, abuse, and withdrawal reactions.

Genetic Factors: Genetic variation may affect metabolism, especially CYP450 enzymes.

Lab Test Interference: No significant interference noted.

Overdose Management

Signs/Symptoms: Excessive sedation, confusion, hypotension, respiratory depression, coma.

Treatment: Supportive care, airway management, activated charcoal if recent ingestion, flumazenil may be used as antidote in certain cases under supervision.

Storage and Handling

Storage: Store at room temperature, away from light and moisture.

Stability: Stable under recommended conditions for prescribed duration.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.