Nitrazepam

When ATH:
N05CD02

Characteristic.

Light yellow or light yellow with a greenish tinge crystalline powder. Practically insoluble in water, slightly soluble in ethanol and ether, hard soluble in chloroform.

Pharmacological action.
Snotvornoe, sedation, anticonvulsant, anxiolytic.

Application.

Sleep disorders of various origins, somnambulism, neurotic (neurosis) Disorder, psychopathy with a predominance of anxiety and worry; premedication before surgery and the postoperative period; as part of combination therapy in the treatment of schizophrenia, maniakalyno-depressivnogo psychosis (maniakalьnaя and gipomaniakalьnaя stage), in some organic CNS (trauma, disorders of cerebral circulation), for the relief of alcohol withdrawal syndrome; epilepsy, incl. epileptic encephalopathy (in combination with an anticonvulsant), lightning sternocleidomastoid salaamovy seizures (as the equivalent of an epileptic seizure) in infants and young children.

Contraindications.

Hypersensitivity (incl. other benzodiazepines, temporal lobe epilepsy, myasthenia gravis, acute respiratory failure, severe renal dysfunction and liver, zakrыtougolynaya glaucoma; drug, drug or alcohol dependence (except for the relief of alcohol withdrawal syndrome); poisoning tranquilizers, neuroleptics, hypnotics, ethyl alcohol, etc.. PM, CNS depressants; pregnancy (especially in the I trimester), lactation.

Restrictions apply.

Respiratory insufficiency, syndrome, sleep apnea, obstructive pulmonary disease, spinalynaya and mozzhechkovaya ataxia.

Pregnancy and breast-feeding.

Contraindicated in pregnancy (especially in the I trimester). At the time of treatment should stop breastfeeding.

Side effects.

From the nervous system and sensory organs: headache, dizziness, anterogradnaya amnesia, confusion, slackness, muscular weakness, mental retardation and motor responses, impaired concentration, feeling tired (the next day after administration), daytime sleepiness, disorientation (in elderly patients), dysarthria, ataxia, blurred vision (diplopia et al.), paradoxical reactions (increased aggressiveness, severe agitation, fear, hallucinations, worsening of suicidal thoughts in predisposed patients, sleep disturbance).

From the digestive tract: nausea, dry mouth, increased appetite, dyspepsia, enteroplegia (especially in children).

Other: tachycardia, hyperhidrosis, dysmenorrhoea, decreased libido, allergic reactions (rash, itch).

Perhaps the development of addiction, aftereffect syndrome, Drug Dependence (Physical and mental), withdrawal, rebound syndrome (cm. Precautions).

Cooperation.

Strengthens (mutually) the effect of analgesics, trankvilizatorov, tricyclic antidepressants, hypnotics, anesthesia, anticonvulsants, etc.. neurotropic drugs, incl. ethyl alcohol, muscle relaxants. Estrogensoderzhaschie cimetidine and oral contraceptives inhibit the metabolism and prolong T_1/2 Nitrazepam, with prolonged joint admission may increase the concentration in the blood nitrazepama.

Overdose.

Symptoms: oppression CNS varying degrees of symptoms — block, weakness, severe drowsiness, deep sleep, confusion, decreased response to pain stimuli; in more severe cases, ataxia, areflexia, gipotenziya, respiratory depression and cardiac activity, coma.

Treatment: induction of vomiting or gastric lavage, administration of activated charcoal, monitoring vital functions, simptomaticheskaya therapy, in / in a liquid, if necessary - IVL. As a specific antidote used benzodiazepine receptor antagonist flumazenil (in hospital).

Dosing and Administration.

Inside. As a sleep aid: 30-40 minutes before bedtime, adults — 5-10 mg, The maximum single dose - 20 mg, older and weakened patients is 2.5-5 mg, children (depending on the age) -1.25-5 mg. As an anxiolytic and anticonvulsant: adult for 5-10 mg 2-3 times a day (Most of the dose taken in the evening), The maximum daily dose - 30 mg, the elderly and debilitated patients designate smaller doses. Babies (epilepsy) the daily dose is calculated based on body weight and divided into 2-3 reception. The course of treatment is 30-45 days, in some cases, the duration of treatment can be increased.

Precautions.

It will be appreciated, nitrazepam that may delay muscle relaxation signet ring, exacerbating swallowing disorders in children. Be wary of the elderly because of the high risk of side effects, incl. paradoxical reactions.

Prolonged use may cause addiction (the effect can be somewhat weakened), as well as drug dependence. Abolition should be gradual, tk. the sudden cessation of treatment may develop withdrawal (headache and muscle pain, alarm, fear, voltage, sleep disturbance, nightmares and others.) and rebound-syndrome (strengthening of initial symptoms).

At the time of treatment should stop taking alcoholic beverages. Should not be used during the drivers of vehicles and people, skills relate to the high concentration of attention.

Cooperation