Temazepam

A to Z Drug Facts

Temazepam

	Action
	Indications
	Contraindications
	Route/Dosage
	Interactions
	Lab Test Interferences
	Adverse Reactions
	Precautions
Patient Care Considerations
	Administration/Storage
	Assessment/Interventions
	Patient/Family Education

(tem-AZE-uh-pam)

Restoril, Apo-Temazepam, Dom-Temazepam, Gen-Temazepam, Novo-Temazepam, Nu-Temazepam, PMS-Temazepam

Class: Sedative Hypnotic/Benzodiazepine

Action Potentiates action of GABA (gamma-aminobutyric acid), an inhibitory neurotransmitter, resulting in increased neuronal inhibition and CNS depression, especially in limbic system and reticular formation.

Indications Short-term management of insomnia.

Contraindications Hypersensitivity to benzodiazepines; pregnancy.

Route/Dosage

ADULTS: PO 7.5–30 mg at bedtime; individualize. ELDERLY OR DEBILITATED PATIENTS: PO 15 mg until individual response is determined.

Interactions

Alcohol, other CNS depressants: Additive CNS depressant effects. Digoxin: Serum digoxin concentrations may increase. Theophylline: May antagonize sedative effects.

Lab Test Interferences None well documented.

Adverse Reactions

CV: Palpitations; tachycardia. CNS: Drowsiness; dizziness; lethargy; confusion; euphoria; weakness; falling; ataxia; hallucinations; paradoxical reactions (eg, excitement, agitation); headache; memory impairment. EENT: Blurred vision; difficulty focusing. GI: Anorexia; diarrhea; abdominal cramping; constipation; nausea; vomiting. HEMA; Leukopenia; agranulocytopenia. OTHER: Tolerance; physical and psychological dependence; slurred speech; elevated AST, ALT, bilirubin.

Precautions

Pregnancy: Category X. Lactation: Similar drugs excreted in breast milk. Children: Not for use in children < 18 yr. Elderly/debilitated: Increased side effects; start with lowest dose. Anterograde amnesia: Has occurred with similar drugs. Alcohol may increase risk. Dependence/withdrawal: Prolonged use can lead to psychological or physical dependence. Withdrawal syndrome may occur; dose must be tapered gradually. Renal or hepatic impairment: Observe caution. Abnormal liver function test results and blood dyscrasias have occurred.

PATIENT CARE CONSIDERATIONS

Administration/Storage

Administer ½ hr before bedtime with full glass of water.
If GI upset occurs, administer with food.
Store in tightly closed container at cool temperature.

Assessment/Interventions

Obtain patient history, including drug history and any known allergies. Note drug dependence and potential for suicide.
Assess type of sleep difficulty (eg, falling asleep, remaining asleep, etc.).
Provide safety measures (siderails up, nightlight, call bell accessible) and assist with ambulation.
Carefully document response to initial dose; dose may be increased to 30 mg.
Assess results of baseline liver and kidney function test and complete blood count with differential. Periodically reevaluate these values throughout long-term therapy.
Assess and document mental and psychological parameters such as hallucinations, dreaming and nightmares, depression, euphoria, apprehension affect, mood and memory. Report potential problems to physician.
Notify physician if any of these symptoms occur: palpitations, increased heart rate, visual disturbances along with nausea and vomiting or headache, excitation, dermatitis, sweating, flushing, pruritus, body or joint pain, tinnitus and nasal congestion.

OVERDOSAGE: SIGNS & SYMPTOMS
	Symptoms of decreased CNS function: somnolence, confusion, respiratory depression; decreased blood pressure; seizures, coma, impaired coordination, slurred speech

Patient/Family Education

Caution patient that this medication must not be taken during pregnancy or when pregnancy is possible. Advise patient to use reliable form of birth control while taking this drug.
Discuss with patient ways to facilitate sleep: quiet, avoidance of caffeine and nicotine, warm baths, deep breathing, relaxation techniques.
Explain that disturbed nocturnal sleep may occur for first or second night after discontinuing use.
Tell patient not to discontinue medication abruptly after prolonged therapy (> 2 wk).
Explain safety precautions with regard to falls, especially for elderly and debilitated patients.
Instruct patient to report these symptoms to physician: visual disturbances, abdominal pain or palpitations, fever, sore throat, bruising, rash, jaundice, unusual bleeding.
Advise patient to avoid intake of alcoholic beverages or other CNS depressants.
Caution patient that drug may cause drowsiness and to use caution while driving or performing other tasks requiring mental alertness.