Episode #50: alprazolam (Xanax) | Podcast Show Notes
alprazolam (al PRAY zoe lam)
Below will be links for the full Podcast and the Drug Card for alprazolam along with a brief summary of various points on alprazolam.Â
QUESTIONS:
- A patient with sleep apnea was prescribed alprazolam for their generalized anxiety disorder. Which of the following is appropriate for this patient. Select all that apply.
- A). 0.25 mg PO tid is appropriate dosing for this patient
- B). 0.25 mg PO qid is appropriate dosing for this patient
- C). 0.5 mg PO tid is appropriate dosing for this patient
- D). 2 mg PO qid is appropriate dosing for this patient
- E). This patient should not be on alprazolam
- True or False. A high fat meal will affect the time to peak for alprazolam.
- Which of the following is correct regarding contraindications and cautions for alprazolam.
- A). Avoid abrupt withdrawals
- B). Caution in smokers
- C). Caution is elderly
- D). Caution if patient has hx of seizures
- E). A, C, and D are correct. Smoking has no effect on alprazolam.
SUMMARY:
Alprazolam, or brand name Xanax, comes as an immediate release, orally disintegrating, or extended release tablet; as well as coming as a concentrated solution. This hypnotic benzodiazepine is commonly used to treat generalized anxiety and panic disorders. There is also an off label indication for treating vertigo. Alprazolam’s proposed effects comes from an increased inhibitory effect of GABA on neurons resulting in a less excitable state of hyperpolarization creating stabilization. Alprazolam is rapidly absorbed with a time to peak b/t 1-2 hours if an immediate release formulation is used or around 9 hours if an extended release formulation is used. The half-life elimination can be approximated between 11-21 hours based on age, dosage form, and if taken with or without food. There are several Black Box warnings which are at risk from concomitant opioid use, risks of addiction/abuse/misuse, and concerns over dependence and withdrawal reactions. Alprazolam can slow or stop breathing and should not be taken by those with breathing problems such as COPD or sleep apnea.
ANSWERS:Â Â
- E is correct. A patient with breathing problems such as sleep apnea should not be taking alprazolam. If the patient did not have a breathing issue, A and C are appropriate dosing regimens. B is incorrect due to qid frequency and D is incorrect due to exceeding max daily dose.Â
- True.
- A, B, C, and D are correct.
