Home Drug Guide Oxazepam

Drug Guide

Generic Name

Oxazepam

Brand Names Serax, Zaxopam

Classification

Therapeutic: Anxiolytic, Sedative

Pharmacological: Benzodiazepine

FDA Approved Indications

  • Anxiety disorders
  • Alcohol withdrawal symptoms

Mechanism of Action

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

Dosage and Administration

Adult: Typically 10-30 mg 3-4 times daily, titrated based on response and tolerability.

Pediatric: Not commonly used in pediatric populations.

Geriatric: Start at lower doses due to increased sensitivity; monitor closely.

Renal Impairment: Adjust dosage accordingly, usually start at lower doses.

Hepatic Impairment: Use with caution; monitor for increased sedation due to decreased metabolism.

Pharmacokinetics

Absorption: Well absorbed orally with peak plasma concentrations in 1-2 hours.

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

Metabolism: Metabolized in the liver via conjugation to inactive metabolites.

Excretion: Excreted mainly in the urine.

Half Life: Approx. 8-12 hours, prolonged in elderly or hepatic impairment.

Contraindications

  • Hypersensitivity to oxazepam or other benzodiazepines.
  • Acute narrow-angle glaucoma.

Precautions

  • Use with caution in patients with a history of substance abuse, respiratory impairment, or depression.

Adverse Reactions - Common

  • Sedation (Common)
  • Dizziness (Common)
  • Fatigue (Common)

Adverse Reactions - Serious

  • Respiratory depression (Uncommon)
  • Dependence and withdrawal symptoms upon discontinuation (Uncommon)

Drug-Drug Interactions

  • CNS depressants (e.g., alcohol, opioids), other sedatives, antipsychotics

Drug-Food Interactions

  • Avoid alcohol

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of sedation, dependence, respiratory depression, and hepatic function.

Diagnoses:

  • Risk for falls due to sedation
  • Risk for dependence

Implementation: Administer as prescribed; monitor for adverse effects; educate patient about dependence.

Evaluation: Assess for efficacy in reducing anxiety or withdrawal symptoms, and monitor for adverse reactions.

Patient/Family Teaching

  • Do not operate heavy machinery or drive until you know how this medication affects you.
  • Avoid alcohol and other CNS depressants.
  • Do not discontinue abruptly to prevent withdrawal symptoms.
  • Report any excessive sedation, confusion, or difficulty breathing.

Special Considerations

Black Box Warnings:

  • Potential for abuse, misuse, and addiction.

Genetic Factors: Genetic variations may affect metabolism (CYP450 enzymes).

Lab Test Interference: May interfere with certain liver function tests.

Overdose Management

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

Treatment: Supportive care, airway management, gastric lavage if recent ingestion, activated charcoal, flumazenil as an antidote if appropriate.

Storage and Handling

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

Stability: Stable under recommended conditions.

🛡️ 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.