Home Drug Guide Estazolam

Drug Guide

Generic Name

Estazolam

Brand Names Prosom

Classification

Therapeutic: Antianxiety agent, Sedative/Hypnotic

Pharmacological: Benzodiazepine

FDA Approved Indications

  • Short-term treatment of insomnia

Mechanism of Action

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

Dosage and Administration

Adult: Initial dose of 1 mg before bedtime, may be increased to 2 mg if needed. Dose should be individualized.

Pediatric: Not approved for pediatric use.

Geriatric: Start at lower doses (e.g., 0.5 mg), monitor closely due to increased sensitivity.

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

Hepatic Impairment: Use with caution; lower initial doses recommended.

Pharmacokinetics

Absorption: Well absorbed orally.

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

Metabolism: Primarily hepatic via CYP3A4 enzyme pathway.

Excretion: Metabolites excreted renally.

Half Life: Approximately 6-12 hours.

Contraindications

  • Hypersensitivity to benzodiazepines.
  • Acute narrow-angle glaucoma.
  • Severe respiratory impairment.

Precautions

  • Use with caution in elderly, patients with liver impairment, history of drug abuse, or psychiatric disorders.
  • Potential for dependence, abuse, and Withdrawal symptoms.

Adverse Reactions - Common

  • Drowsiness (Common)
  • Dizziness (Common)
  • Cognitive impairment (Common)

Adverse Reactions - Serious

  • Respiratory depression (Rare but serious)
  • Anterograde amnesia (Rare)
  • Paradoxical reactions (e.g., agitation, aggression) (Rare)

Drug-Drug Interactions

  • Other CNS depressants (e.g., alcohol, opioids, other sedatives),
  • Theophylline (antagonist to benzodiazepines).

Drug-Food Interactions

  • Limited interactions reported.

Drug-Herb Interactions

  • Valerian, kava, and other herbal sedatives may increase CNS depression.

Nursing Implications

Assessment: Monitor mental status, level of sedation, respiratory function, and history of substance abuse.

Diagnoses:

  • Risk for sedation-related adverse effects.
  • Risk for dependence.

Implementation: Administer at bedtime, avoid alcohol and other CNS depressants, assess for effectiveness and adverse effects.

Evaluation: Assess sleep quality, sedation level, and adverse reactions regularly.

Patient/Family Teaching

  • Take the medication exactly as prescribed, only at bedtime.
  • Avoid alcohol, recreational drugs, and CNS depressants.
  • Caution when operating machinery or driving.
  • Notify healthcare provider if you experience excessive drowsiness, confusion, or difficulty breathing.

Special Considerations

Black Box Warnings:

  • Potential for dependence, abuse, and withdrawal reactions.
  • Use only for short-term management of insomnia.

Genetic Factors: No specific genetic considerations reported.

Lab Test Interference: May interfere with sleep studies or liver function tests.

Overdose Management

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

Treatment: Supportive care, airway management, activated charcoal if ingestion was recent, flumazenil as an antagonist in some cases under close monitoring.

Storage and Handling

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

Stability: Stable for use until expiration date on the package.

🛡️ 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.