Home Drug Guide Oxazepam

Drug Guide

Generic Name

Oxazepam

Brand Names Serax, Zaxopam

Classification

Therapeutic: Anxiolytic, Sedative

Pharmacological: Benzodiazepine

FDA Approved Indications

Anxiety disorders
Alcohol withdrawal symptoms

Mechanism of Action

Enhances the effect of gamma-aminobutyric acid (GABA) at the GABA-A receptor, producing sedative, anxiolytic, muscle relaxant, and anticonvulsant effects.

Dosage and Administration

Adult: Typically 10-30 mg 3-4 times daily, titrated based on response and tolerability.

Pediatric: Not commonly used in pediatric populations.

Geriatric: Start at lower doses due to increased sensitivity; monitor closely.

Renal Impairment: Adjust dosage accordingly, usually start at lower doses.

Hepatic Impairment: Use with caution; monitor for increased sedation due to decreased metabolism.

Pharmacokinetics

Absorption: Well absorbed orally with peak plasma concentrations in 1-2 hours.

Distribution: Widely distributed; crosses the blood-brain barrier.

Metabolism: Metabolized in the liver via conjugation to inactive metabolites.

Excretion: Excreted mainly in the urine.

Half Life: Approx. 8-12 hours, prolonged in elderly or hepatic impairment.

Contraindications

Hypersensitivity to oxazepam or other benzodiazepines.
Acute narrow-angle glaucoma.

Precautions

Use with caution in patients with a history of substance abuse, respiratory impairment, or depression.

Adverse Reactions - Common

Sedation (Common)
Dizziness (Common)
Fatigue (Common)

Adverse Reactions - Serious

Respiratory depression (Uncommon)
Dependence and withdrawal symptoms upon discontinuation (Uncommon)

Drug-Drug Interactions

CNS depressants (e.g., alcohol, opioids), other sedatives, antipsychotics

Drug-Food Interactions

Avoid alcohol

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of sedation, dependence, respiratory depression, and hepatic function.

Diagnoses:

Risk for falls due to sedation
Risk for dependence

Implementation: Administer as prescribed; monitor for adverse effects; educate patient about dependence.

Evaluation: Assess for efficacy in reducing anxiety or withdrawal symptoms, and monitor for adverse reactions.

Patient/Family Teaching

Do not operate heavy machinery or drive until you know how this medication affects you.
Avoid alcohol and other CNS depressants.
Do not discontinue abruptly to prevent withdrawal symptoms.
Report any excessive sedation, confusion, or difficulty breathing.

Special Considerations

Black Box Warnings:

Potential for abuse, misuse, and addiction.

Genetic Factors: Genetic variations may affect metabolism (CYP450 enzymes).

Lab Test Interference: May interfere with certain liver function tests.

Overdose Management

Signs/Symptoms: Excessive sedation, confusion, diminished reflexes, respiratory depression, coma.

Treatment: Supportive care, airway management, gastric lavage if recent ingestion, activated charcoal, flumazenil as an antidote if appropriate.

Storage and Handling

Storage: Store at room temperature away from light and moisture.

Stability: Stable under recommended conditions.