Reaction Paper On Alprazolam

Peak concentrations in the plasma occur between one and two hours following administration. Plasma levels are proportionate to the dose given. Xanax has been used as a tranquilizer and was quite controversial in the 1960’s and 1970’s. Ironically enough, the controversy isn’t as prevalent with more than three million Americans using benzodiazepines daily within the last twelve months. Many years ago, before the rise in prescription medication being given by physicians many patients went through talk therapy and would talk in depth with their doctors about their feelings and emotions; this process had proven to be very expensive and time consuming and not even always effective. The notion that giving more drugs out for minor mental illnesses and anxiety being beneficial took a place in people’s lives and a revolution was born. Granted, talk therapy was still relative however prescribing medication for these ailments took off majorly and the rise in prescription use for Xanax

Tamazepam acts at many levels in the CNS, producing generalized depression. Effects may be mediated by GABA, an inhibitory neurotransmitter.

In this study, Avycaz (Ceftazidime/Avibactam) is an alternative option for treatment in complicated intraabdominal infections with metronidazole and in complicated urinary tract infections. 476 patients completed the study and received Ceftazidime-Avibactam and metronidazole. 477 patients completed the study and received meropenem. Patients with normal renal function received 2000 mg of Ceftazidime and 500mg Avibactam as a 2-hour intravenous infusion every 8 hours. This was followed by metronidazole 500 mg IV infusion every 8 hours. The meropenem group received 1000mg as a 30-minute intravenous infusion every 8 hours. Dosage adjustments were made for patients with a creatinine clearance30 to 50 ml/min. Patients requiring renal adjustments received 1000mg Ceftazidime plus 250 mg of Avibactam in a 2-hour intravenous infusion every 12 hours. Patients receiving meropenem with renal impairment received 1000mg, 30 minute infusions every 12 hours. The duration of treatment with meropenem was 8.3 days and for Ceftazidime-Avibactam plus metronidazole it was 8.0

The success of this process is predetermined in part by the livers’ ability to properly convert the drug into a less lipophilic form that cannot be reabsorbed. For alprazolam, the course of elimination relies heavily on the kidneys. Age related renal function must thereby be considered when administering alprazolam. The kidneys are responsible for removing the unbound drug in the plasma by glomerular filtration, proximal tubular secretion, and distal tubular reabsorption. The glomerular filtration rate (GFR) is roughly 20% of the renal plasma flow (Harvey, 2014). Drugs that exclusively rely on the kidneys for elimination can accumulate and have toxic effects with renal impairment. In older adults there is a progressive decline in GFR of 10% per decade following age 50 (Breenan, 2015). This change is age related, however like those with renal disease or injury, close monitoring and dosing adjustments must be carefully

Treatment for aloprazalam drug toxicity consists of cardiac monitoring and oxygen. Naloxone can be administered at a lower dose with a gradual increase if needed to reverse respiratory depression which happens in most patients. Another treatment is the use of flumazenil which is the specific antidote for benzodiazepines. (Gershman, 2014). However, the use of this drug is controversial and does have some contraindications. It is contraindicated in patients with long-term benzodiazepines, patients who have ingested a substance that lowers the seizure threshold, or in patients who have tachycardia. The contraindications increase risk of seizures, cardiac arrest and possibly death. Because of the contraindications, most of the time flumazenil is not used for the treatment of benzodiazepine overdose. Although flumazenil is contraindicated and not used often, it can be very effective in reversing central nervous system depression associated with benzodiazepine toxicity but not effective in reversing respiratory depression. Flumazenil has a short half life of less than one hour and multiple doses may be needed for treatment. When flumazenil is used risk can be reduced by a slow dose titration of the drug

Acetaminophen also known as paracetamol and APAP, is a prescription and over-the-counter drug that is used to treat moderate pain and reduce fever. It is also paired with other ingredients. For example, acetaminophen is mixed with guaifenesin and phenylephrine to make the allergy medication Mucinex, acetaminophen is also used in over 600 other medications. When mixed with an opioid, such as, tramadol, it can be used to treat more severe pain. It is usually taken through the mouth but it can also be taken through injection and as a

Benzodiazepine receptors are linked mainly to γ amino butyric acid (GABA) receptors, which sensitize benzodiazepine receptors to the neurotransmitter GABA, the most prominent inhibitory neurotransmitter in the central nervous system.

This medication is no longer considered the most common prescribed drug. Diazepam can be used “for the relief of anxiety, management of alcohol, reversal of status epileptics, preoperative sedation, and as an adjunct for the relief of skeletal muscle spasms” (Pharmacology and the Nursing Process, 2016). Diazepam is rapidly absorbed and this medications’ half-life can be anywhere from 10 on up to 100 hrs. Depending on several factors such as metabolic changes, kidney/liver problems, dosage of the medication, frequencies with which it is taken can in turn cause slower rates to eliminate from the body. Some side effects of Diazepam include dizziness, drowsiness, irritability, and nausea and muscle

Both Benzodiazepines and Barbiturates are sedatives. They both exert action at the GABA receptor complex. (Olsen RW, Yang J, King RG, Dilber A, Stauber GB, Ransom RW, 1986). The sad thing is that they can both be habit forming and very addicting. They alter the thinking process and decrease the activity of the brain if used improperly. Both have side effects. Benzodiazepines may cause dizziness, slurring of speech, confusion, headaches, blurry vision and make it difficult to concentrate. Barbiturates, however, cause agitation, irritability, aggression, hostility and impulsiveness.

This requires clinical, microbiological, and laboratory data. Signs and symptoms of superinfections should be noted. Nurses must also note signs and symptoms of hemolytic anemia. Urinalysis, BUN, and creatinine should be used to assess the patient’s renal function when they are on prolonged treatment. If impaired renal function is indicated the dosage should be decreased. Some cephalosporins affect blood clotting and require a baseline and assessment of prothrombin level (PT). These patients should also be monitored for disulfiram reactions. Nurses should also educate patients on administration, adverse reactions, side effects, and lifestyle management (Woo & Wynne,

Findings have implicated the role of opioid receptor activation-linked GABA inhibitory pathway to be involved in the pro convulsant effect of tramadol[10,

Phenobarbital activates inhibitory GABA receptors and inhibits excitatory glytamate receptors. This class of drug is considered a CNS depressant and at high doses can cause respiratory depression by suppressing the hypoxic drive to breathe. The oral LD50 for phenobarbital is 150 mg/kg in the dog. Clinical signs of toxicity include ataxia, recumbency, bradycardia or tachycardia, depression, coma, and even death. Differential diagnoses for CNS and respiratory depression include benzodiazepines, antiparasiticides (e.g., ivermectin), encephalopathies, ethanol, ethylene glycol, opioids, and hypoglycemia.7 For a recent ingestion it would be recommended to induce emesis if the patient is able to do so safely without aspiration. In cases where inducing emesis is not possible, gastric lavage should be performed followed by multi-dose administration of activated charcoal and a cathartic.

Clonazepam is administered orally and is rapidly absorbed within 1 to 4 hours. Within this time, it usually reaches 90% bioavailability. About 85% is bound in the plasma proteins. The half life for clonazepam ranges from 30-40 hours allowing this drug to provide its effect for a relatively long amount of time at a constant level. This drug is highly metabolized in the liver with less than 2% of it being unchanged and excreted into the urine.

Naproxen (Naprosyn) is a nonsteroidal anti-inflammatory drug (NSAIDs) used to treat joint pain. M.H. was previously prescribed Naproxen to reduce the bilateral wrist pain and associated inflammation. Naproxen is mainly used to reduce inflammation, stiffness, and pain. NSAIDs block the formation of prostaglandins. Prostaglandins are involved in the body’s normal function and inflammatory response. Proteins, Cox-1 and Cox-2, control these prostaglandins. Cox-1 controls the formation of the prostaglandins involved in the normal function of the body’s organs. Cox-2 controls the formation of the prostaglandins involved in the body’s inflammatory response. By preventing the body from producing prostaglandins, NSAIDs reduce swelling and pain.

The efficacy and safety of the drug in patients under the age of 18 years is not established. With renal / hepatic insufficiency and long-term treatment, control over the picture of peripheral blood and liver enzymes is necessary. Patients who did not take previously psychoactive drugs respond to the drug at lower doses compared to patients taking antidepressants, anxiolytics or alcohol. With endogenous depression, alprazolam can be used in combination with antidepressants. With the use of alprazolam, patients with depression have seen cases of hypomanic and manic development. Like other benzodiazepines, alprazolam has the ability to induce drug dependence in long-term admission in large doses (more than 4 mg / day). With a sudden discontinuation of alprazolam, there may be comeback syndromes, such as depression, irritability, insomnia, increased sweating, especially with prolonged admission (more than 8-12 weeks). When patients develop such unusual reactions as increased aggressiveness, acute excitations, feelings of fear, thoughts of suicide, hallucinations, increased muscle cramps, difficult sleep, superficial sleep, treatment should be discontinued. During pregnancy Xanax is very dangerous due to its toxic effect on the fetus and increases the risk of congenital malformations when applied in the first trimester of pregnancy. Admission of therapeutic doses in later periods