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- Pharmacology For Fluoxetine + Alprazolam
Fluoxetine + Alprazolam Pharmacology
Fluoxetine + Alprazolam
About Fluoxetine + AlprazolamN/AMechanism of Action of Fluoxetine + AlprazolamN/APharmacokinets of Fluoxetine + AlprazolamN/AOnset of Action for Fluoxetine + AlprazolamN/ADuration of Action for Fluoxetine + AlprazolamN/AHalf Life of Fluoxetine + AlprazolamN/ASide Effects of Fluoxetine + AlprazolamN/AContra-indications of Fluoxetine + AlprazolamN/ASpecial Precautions while taking Fluoxetine + AlprazolamN/APregnancy Related InformationContraindicatedOld Age Related InformationN/ABreast Feeding Related InformationContraindicatedChildren Related InformationN/AIndications for Fluoxetine + AlprazolamDepression, Panic disorderInteractions for Fluoxetine + AlprazolamN/ATypical Dosage for Fluoxetine + AlprazolamVaries with weight and severity of the disease.The dosage has to be decided by the treating specialist
Alprazolam: 0.25mg
Fluoxetine hydrochloride: 20mg
Schedule of Fluoxetine + AlprazolamN/AStorage Requirements for Fluoxetine + AlprazolamN/AEffects of Missed Dosage of Fluoxetine + AlprazolamN/AEffects of Overdose of Fluoxetine + AlprazolamN/AFluoxetine
About FluoxetineSelective Serotonin Reuptake Inhibitor, Antidepressant.Mechanism of Action of FluoxetineFluoxetine preferentially inhibits the re-uptake of Serotonin (5 HT) in the CNS nerve terminals .This will result in an increased concentration of neurotransmitter Serotonin in the synaptic cleft and produces antidepressant effect. Fluoxetine has only less affinity towards Dopaminergic, Cholinergic and Adrenergic receptors.Pharmacokinets of FluoxetineAbsorption: It is well absorbed after oral administration. Distribution: It is very widely distributed in the body in protein bound form. Metabolism: Fluoxetine is extensively metabolised in the liver to Norfluoxetine. Excretion: Excreted mainly through urine.Onset of Action for Fluoxetine2- 4 weeksDuration of Action for FluoxetineUp to 6 weeksHalf Life of Fluoxetine2 - 9 daysSide Effects of Fluoxetine1.Drowsiness
2.Headache
3.Nervousness
4.Insomnia
5.Anxiety
6.Dizziness
7.Tremor
8.Fatigue
9.Asthenia
10.Anorexia
11.Nausea
12.Diarrhoea
13.Dry mouth
14.Sweating
15.Pruritis
16.Rash.Contra-indications of FluoxetineHypersensitivity to FluoxetineSpecial Precautions while taking Fluoxetine1.Hepatic disease
2.Renal disease
3.Cardiovascular disease
4.Epilepsy
5 Diabetes mellitus
6.Patient on MAOI therapy (Discontinue the MAO inhibitor at least 2 weeks before Fluoxetine is started)
7.Alcoholics
8.Patient at high risk of suicide
9.Slowly withdraw the drug with caution
10.Patient should be cautioned against driving vehicle, operating machine and activities requiring mental alertness or judgment
Pregnancy Related InformationContraindicated.Old Age Related InformationUse with caution.Breast Feeding Related InformationContraindicated.Children Related InformationContraindicated.
NEONATES: contraindicated
Indications for Fluoxetine1.Depression
2.Panic disorder
3.Obsessive compulsive disorder
4.Obesity
5.Bulimia nervosa.Interactions for FluoxetineMAOIs: Serious life threatening reactions. At least 14 days should elapse after MAOIs withdrawal and initiation of fluoxentine. At least 5 weeks should elapse after fluoxentine withdrawal and initiation of the therapy with MAOIs.
Diazepam: Half-life of diazepam prolonged.
Haloperidol: Chances of severe extrapyramidal reactions.
Lithium: Serum lithium levels increased leading to toxicity.
TCAs: Efiicacy and toxic effects of TCAs enhanced.
Warfarin, Digoxin: Since tightly bound to plasma proteins, concomitant use of other drugs bound to plama proteins may cause shift in plasma concentration resulting in adverse effects.Typical Dosage for FluoxetineAdult:
Depression, Panic disorder: Initial dose: 20 mg in the morning for 1 month. Dose can be increased to 40 mg / day in two divided doses (20 mg at morning and 20 mg at noon) if sufficient response does not occur
Maximum dose: 80 mg / day
Obsessive compulsive disorder, Obesity: 20 - 60 mg / day
Bulimia nervosa: 60 - 80 mg / day
Schedule of FluoxetineHStorage Requirements for FluoxetineStore at 15 - 25 degree C. Keep out of the reach of children.Effects of Missed Dosage of FluoxetineTake the missed dose as soon as noticed and if it is the time to take the next dose then skip the missed dose.Effects of Overdose of FluoxetineGive supportive measures and symptomatic treatment. Gastric lavage can be done to eliminate the drug from the body. Charcoal can be given to reduce the absorption of the drug.Alprazolam
About AlprazolamBenzodiazepine derivative, Anti anxiety.Mechanism of Action of AlprazolamAlprazolam mainly acts on Limbic system and ascending reticular formation in the CNS and binds to the BZD receptor. The binding will facilitates GABA mediated chloride channel opening and produce hyperpolarisation. This will produce an increase in the concentration of the inhibitory neurotransmitter GABA and increase in chloride ions and decreases firing rate of neuron. This in turn alters normal functions of the body.Pharmacokinets of AlprazolamAbsorption: It is well absorbed after oral administration. Distribution: It is distributed widely in the body in protein bound form. Metabolism: It is metabolised to active and inactive metabolite in the liver. Excretion: Drug is excreted in urine.Onset of Action for Alprazolam15 - 30 minutesDuration of Action for Alprazolam12 - 16 hoursHalf Life of Alprazolam12 -15 hoursSide Effects of Alprazolam1.Ataxia
2.Drowsiness
3.Light headedness
4. Slurred speech
5.Nausea
6.Constipation or diarrhoea
7.Tremor
8.Dependence
9.Anorexia
0.Confusion
11.Light headedness
12.Mood changes
13.Muscle rigidity
14.AmnesiaContra-indications of Alprazolam1.Hypersensitivity to Benzodiazepines
2.Acute angle closure glaucomaSpecial Precautions while taking Alprazolam1.Renal impairment
2.Hepatic impairment
3.Pulmonary insufficiency
4.Drug abuse
5.Bipolar disorder
6.Driving vehicles and operating machines and people involving any other dangerous activitiesPregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationContraindicated
NEONATES- contraindicated
Indications for Alprazolam1.For the short-term management of anxiety,
2.Treatment of Panic disorder.Interactions for AlprazolamAlcohol & other CNS depressants: Enhanced CNS effects.
Aminophylline: Antagonizes the sedative effect.
Cimetidine, Oral contraceptives, Disulfiram, Fluoxetine, Isoniazid, Ketoconazole, Metoprolol, Propoxyphene, Propranolol,
Valproic Acid: Elimination of alprazolam decreased due to inhibition of hepatic metabolism leading to enhanced activity.
Digoxin: Increase in serum concentration of Digoxin.
Imipramine & Desipramine: Enhanced activity of these drugs.
Levodopa: Decrease in antiparkinsonism efficacy.
Rifampicine: Decreases efficacy.Typical Dosage for AlprazolamAdult:
Anxiety: 0.25 - 0.5 mg every 8 hours in a day. Depending on the severity of the disease the dose can be gradually increased every 3 or 4 days.
Maximum dose: 4 mg / day in divided dose.
Anxiety with depression: 0.5 mg every 8 hours in a day
Maintenance dose: 1.5 - 4.5 mg/ day in divided dose
Panic disorder: starting dose: 1.5 mg /day in 3 divided dose. Depending on the severity of the disease the dose can be gradually increased every 3 or 4 days.
Children: Not recommended
Schedule of AlprazolamHStorage Requirements for AlprazolamThe drug should be kept at 15 - 30 degree C in a tightly closed container. Keep out of the reach of childrenEffects of Missed Dosage of AlprazolamTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose.Effects of Overdose of AlprazolamGive supportive measures and symptomatic treatment. Flumazenil can be given as antagonist. Hypotension can be treated with vasopressors.If the patient is conscious induce emesis followed by charcoal administrationHome Delivery for Fluoxetine + Alprazolam in Your City
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