Home Drug Guide Triazolam

Drug Guide

Generic Name

Triazolam

Brand Names Halcion

Classification

Therapeutic: Sedative/Hypnotic

Pharmacological: Benzodiazepine

FDA Approved Indications

  • Short-term treatment of insomnia, particularly sleep onset difficulties

Mechanism of Action

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

Dosage and Administration

Adult: 0.125 mg to 0.25 mg at bedtime; may be increased to 0.25 mg or decreased based on response and tolerability

Pediatric: Not approved for pediatric use

Geriatric: Lower starting doses are recommended, typically 0.125 mg due to increased sensitivity and risk of adverse effects

Renal Impairment: Use cautiously; no specific dose adjustment, but monitor for increased sedation

Hepatic Impairment: Use cautiously; start at lower doses, monitor for adverse effects.

Pharmacokinetics

Absorption: Rapidly absorbed after oral administration

Distribution: Widely distributed, crosses the blood-brain barrier

Metabolism: Primarily hepatic via CYP3A4 enzymes

Excretion: Renal and fecal routes

Half Life: 2 to 6 hours, longer in the elderly or hepatic impairment.

Contraindications

  • Hypersensitivity to triazolam or other benzodiazepines
  • Narrow-angle glaucoma

Precautions

  • History of substance abuse, psychiatric disorders, respiratory impairment, hepatic impairment, pregnancy, and lactation. Use with caution in elderly due to increased sensitivity to sedative effects.

Adverse Reactions - Common

  • Drowsiness (Very common)
  • Dizziness (Common)
  • Amnesia, especially anterograde (Common)
  • Gait disturbances (Less common)

Adverse Reactions - Serious

  • Complex sleep-related behaviors (e.g., sleepwalking, sleep driving, hallucinations) (Rare but serious)
  • Respiratory depression (Rare)
  • Allergic reactions (rash, angioedema) (Rare)

Drug-Drug Interactions

  • CNS depressants, including alcohol, opioid analgesics, and other sedatives/hypnotics; CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin)

Drug-Food Interactions

N/A

Drug-Herb Interactions

  • Kava, valerian, and other herbs with sedative properties

Nursing Implications

Assessment: Evaluate sleep patterns, mental status, and potential for substance abuse before initiation.

Diagnoses:

  • Risk for injury related to sedative effects
  • Impaired sleep pattern

Implementation: Administer at bedtime on an empty stomach if possible, monitor for effectiveness and adverse effects, particularly in elderly.

Evaluation: Assess improvements in sleep onset and quality, monitor for adverse effects.

Patient/Family Teaching

  • Take medication exactly as prescribed, usually immediately before bed.
  • Do not consume alcohol or other CNS depressants.
  • Avoid driving or operating heavy machinery until alertness is confirmed.
  • Inform about potential for amnesia and unusual behaviors.

Special Considerations

Black Box Warnings:

  • Potential for sleep-driving, sleep-related behaviors, and amnesia.
  • Risk of dependence, abuse, and withdrawal symptoms.

Genetic Factors: Genetic variations in CYP3A4 may affect metabolism and response.

Lab Test Interference: None typical.

Overdose Management

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

Treatment: Supportive care, airway management, monitoring vital signs, and administration of flumazenil (a benzodiazepine antagonist) in serious cases, with caution.

Storage and Handling

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

Stability: Stable under recommended conditions for the shelf life indicated by manufacturer.

🛡️ 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.