OXAZEPAM
(ox-a'ze-pam)
Ox-Pam , Serax, Zapex 
Classifications: central nervous system agent; anxiolytic; sedative-hypnotic; benzodiazepine
Prototype: Lorazepam
Pregnancy Category: C
Controlled Substance: Schedule IV

Availability

10 mg, 15 mg, 30 mg capsules; 15 mg tablets

Actions

Benzodiazepine derivative related to lorazepam. Effects are mediated by the inhibitory neurotransmitter GABA. Acts on the thalamic, hypothalamic, and limbic levels of CNS.

Therapeutic Effects

Has anxiolytic, sedative, hypnotic, and skeletal muscle relaxant effects.

Uses

Management of anxiety and tension associated with a wide range of emotional disturbances. Also to control acute withdrawal symptoms in chronic alcoholism.

Contraindications

Hypersensitivity to oxazepam and other benzodiazepines; psychoses, pregnancy (category C), lactation, children <12 y; acute-angle glaucoma, acute alcohol intoxication.

Cautious Use

Older adult and debilitated patients; impaired kidney and liver function; addiction-prone patients; COPD; mental depression.

Route & Dosage

Anxiety
Adult: PO 10–30 mg t.i.d. or q.i.d.

Acute Alcohol Withdrawal
Adult: PO 15–30 mg t.i.d. or q.i.d.

Administration

Oral

Adverse Effects (1%)

CNS: Drowsiness, dizziness, mental confusion, vertigo, ataxia, headache, lethargy, syncope, tremor, slurred speech, paradoxic reaction (euphoria, excitement). GI: Nausea, xerostomia, jaundice. Skin: Skin rash, edema. CV: Hypotension, edema. Hematologic: Leukopenia. Urogenital: Altered libido.

Interactions

Drug: Alcohol, cns depressants, anticonvulsants potentiate CNS depression; cimetidine increases oxazepam plasma levels, increasing its toxicity; may decrease antiparkinsonism effects of levodopa; may increase phenytoin levels; smoking decreases sedative and antianxiety effects. Herbal: Kava-kava, valerian may potentiate sedation.

Pharmacokinetics

Absorption: Readily absorbed from GI tract. Peak: 2–3 h. Distribution: Crosses placenta; distributed into breast milk. Metabolism: Metabolized in liver. Elimination: Primarily excreted in urine, some in feces. Half-Life: 2–8 h.

Nursing Implications

Assessment & Drug Effects

Patient & Family Education


Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug