turlough's version from 2017-10-30 12:18


Question Answer
Mention 2 licensed and one off-label uses of alprazolam 1) Anxiety. 2) Panic disorder. 3) Alcohol withdrawal syndrome
What is the typical starting dose of alprazolam for anxiety? 0.25 to 1 mg daily in divided doses.
What is the max recommended dose of alprazolam? 4 g daily in divided doses.
Mention two reasons for starting with a lower initial dose of alprazolam 1) Advanced age. 2) Advanced liver disease.
How should patients be weaned off of alprazolam? Reduce the daily dose of alprazolam by no more than 0.5 mg every three days
Is it okay to use alprazolam in pregnancy? What about breast-feeding? No to both
5 contra-indications to the use of alprazolam 1) Hypersensitivity to benzos. 2) Myasthenia gravis. 3) Sleep apnoea syndrome. 4) Severe hepatic insufficiency. 5) Severe respiratory insufficiency.
Alprazolam is a major substrate of which enzyme? CYP3A4/5
5 interactions with alprazolam 1) CYP3A4 inhibitors especially itraconazole and ketoconazole. 2) CYP3A4 inducers. 3) CNS depressants including alcohol. 4) Digoxin. 5) Oral contraceptives.
Explain the interaction between alprazolam and digoxin and how it might be managed. Alprazolam reduces digoxin clearance which increases the risk of digoxin toxicity. Consider reducing the dose of digoxin.
Explain the interaction between alprazolam and oral contraceptives Estrogen-based oral contraceptives inhibit the metabolism of alprazolam, increasing the risk of side effects.
10 very common side effects of alprazolam Sedation, amnesia, dizziness, depression, ataxia, dry mouth, constipation, headache, irritability, fatigue (SAD DAD CHIF)
3 counselling points for alprazolam 1) Avoid driving or operating machinery. 2) Avoid alcohol. 3) Avoid stopping suddenly after prolonged use.

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