Triazolam

A to Z Drug Facts

(try-AZE-oh-lam)

Halcion,  Alti-Triazolam, APO-Triazo, Gen-Triazolam, Novo-Triolam

Class: Sedative and 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 Treatment of insomnia.

 Contraindications Hypersensitivity to benzodiazepines; pregnancy.

 Route/Dosage

ADULTS: PO 0.125–0.5 mg at bedtime. ELDERLY OR DEBILITATED PATIENTS: Initiate with 0.125 mg until individual response is determined.

 Interactions

Alcohol, CNS depressants (eg, narcotic sedatives): May cause additive CNS depressant effects. Cimetidine, disulfiram, omeprazole, oral contraceptives: Triazolam effects may increase. Digoxin: Serum digoxin concentrations may be increased. Theophylline: May antagonize sedative effects.

 Lab Test Interferences None well documented.

 Adverse Reactions

CNS: Anterograde amnesia; headache; nervousness; drowsiness; confusion; talkativeness; pprehension; irritability; euphoria; weakness; tremor; incoordination; memory impairment; depression; ataxia; dizziness; dreaming/nightmares; hallucinations; aradoxical reactions (eg, anger, hostility, mania, muscle spasms). DERM: Rash; photosensitivity. EENT: Visual or auditory disturbances; depressed hearing; taste disturbances. GI: Heartburn; nausea; vomiting; diarrhea; constipation; dry mouth; anorexia. HEMA: Blood dyscrasias including agranulocytosis; anemia; thrombocytopenia; eukopenia; neutropenia. HEPA: Hepatic dysfunction including hepatitis and jaundice. OTHER: Dependence/withdrawal syndrome (eg, confusion; abnormal perception of movement; depersonalization; muscle twitching; psychosis; paranoid delusions; eizures). Rebound sleep disorder (recurrence of insomnia worse than before treatment) may occur during first 3 nights after abrupt discontinuation.

 Precautions

Pregnancy: Category X. Lactation: Undetermined. Children: Not for use in children < 18 yr. Special risk patients: Use drug with caution in elderly patients and patients with renal or hepatic impairment, depression or suicidal tendencies, drug abuse and dependence, chronic pulmonary insufficiency or apnea, seizure disorder. Dependence: Prolonged use (> 1–2 wk) can lead to dependence. Withdrawal syndrome may occur; taper dose gradually.

 Administration/Storage

• Administer at bedtime with full glass of water.
• Administer with food if GI upset occurs.
• Administer lowest dosage until response is determined.
• If patient exhibits possible suicidal tendencies, ensure that patient swallows drug and that patient does not have access to large quantities.
• Store at room temperature in a tight, light-resistant container.

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies. Identify potential for abuse and underlying depression.
• Assess usual sleep patterns and define type of sleep alteration, ie, insomnia. Assess for modifiable causes of sleep disturbance, such as environmental noise, daytime sleeping and caffeine use.
• Assess therapeutic response to therapy throughout usage.
• Implement safety precautions to prevent injury (eg, assist with ambulation), particularly during initial treatment until individual response is determined.
• Utilize general comfort measures to encourage sleep.
• Implement environmental control measures when appropriate to enhance sleep.
• Monitor for side effects, such as dizziness, drowsiness, headache, change in mood or mental status, GI disturbance, paradoxical excitation.
• Monitor for daytime drowsiness or lethargy.
• Assess for signs of dependence.

 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.
• Remind patient that medication should not be abruptly discontinued.
• Review with patient and family other general sleep promotion measures, as well as what to avoid, such as caffeine and excessive exercise at bedtime.
• Explain that medication may cause morning drowsiness or tiredness.
• Caution patient regarding dependence potential.
• Explain potential side effects and what to report to physician (onfusion, paradoxical excitement, headache, bleeding, recurrent sleep disorder).
• Instruct patient to avoid intake of alcoholic beverages or other CNS depressants.
• Advise patient to use caution while driving or performing other tasks requiring mental alertness.
• Instruct patient not to take otc medications without consulting physician.

Books@Ovid
Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts