Home Drug Guide Prazepam

Drug Guide

Generic Name

Prazepam

Brand Names Centrax

Classification

Therapeutic: Anxiolytic, Benzodiazepine

Pharmacological: Benzodiazepine

FDA Approved Indications

  • Anxiety

Mechanism of Action

Prazepam enhances the effect of gamma-aminobutyric acid (GABA) at the GABA-A receptor, leading to sedative, anxiolytic, anticonvulsant, and muscle relaxant properties.

Dosage and Administration

Adult: Typically 5-20 mg two to three times daily, adjusted based on response and tolerability.

Pediatric: Not generally recommended for pediatric use.

Geriatric: Start with a lower dose, e.g., 5 mg daily, and titrate carefully due to increased sensitivity to benzodiazepines.

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

Hepatic Impairment: Use with caution; dose reduction recommended.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed in body tissues.

Metabolism: Metabolized in the liver to active metabolites, mainly desmethyldiazepam.

Excretion: Excreted primarily in urine.

Half Life: Long half-life, approximately 20-50 hours, contributing to sustained effects.

Contraindications

  • Hypersensitivity to prazepam or other benzodiazepines.
  • Respiratory depression.
  • Myasthenia gravis.
  • Acute narrow-angle glaucoma.

Precautions

  • History of substance abuse.
  • Liver impairment.
  • Pregnancy and lactation: Use only if potential benefit justifies the potential risk to fetus or nursing infant.

Adverse Reactions - Common

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

Adverse Reactions - Serious

  • Respiratory depression (Rare)
  • Anterograde amnesia (Less common)
  • Paradoxical reactions (e.g., agitation, increased anxiety) (Rare)

Drug-Drug Interactions

  • Other CNS depressants (alcohol, opioids, sedatives)
  • Cimetidine (may increase levels)
  • Rifampin (may decrease levels)

Drug-Food Interactions

  • Alcohol (enhanced sedative effect)

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Assess for history of substance abuse, respiratory status, and liver function.

Diagnoses:

  • Risk for injury due to sedation or impaired coordination.
  • Risk for addiction or dependence.

Implementation: Monitor for therapeutic effects and adverse reactions. Use lowest effective dose for shortest duration.

Evaluation: Effectiveness in reducing anxiety; absence of adverse effects or signs of dependence.

Patient/Family Teaching

  • Avoid alcohol and CNS depressants.
  • Do not operate heavy machinery until response is known.
  • Do not discontinue abruptly to prevent withdrawal.

Special Considerations

Black Box Warnings:

  • Potential for abuse, dependence, and withdrawal reactions.

Genetic Factors: Consider genetic variations affecting metabolism (e.g., CYP450 enzymes).

Lab Test Interference: None significant.

Overdose Management

Signs/Symptoms: Drowsiness, confusion, diminished reflexes, respiratory depression in severe cases.

Treatment: Supportive care, airway management, monitoring. Flumazenil may be used as an antagonist in specific cases, with caution.

Storage and Handling

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

Stability: Stable under recommended storage 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.