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Drugs Affecting the Central Nervous System
Published in Radhwan Nidal Al-Zidan, Drugs in Pregnancy, 2020
Risk Summary: It is better to be avoided in pregnancy because the pregnancy experience in humans is limited and the reproduction studies in animals have shown the risk of increased resorptions associated with the use of Temazepam.
Pharmacological Approaches To Behavioral Symptoms In Alzheimer’s Disease
Published in Zaven S. Khachaturian, Teresa S. Radebaugh, Alzheimer’s Disease, 2019
Sleep research has demonstrated that the structure of sleep breaks down in association with aging and especially affects patients with AD. Although many ingenious interventions have been developed to entrain patients to more regular sleep-wake cycles, including bright light therapy and careful scheduling of daytime activity, at times medications are needed. The earliest sedative drugs included long-acting benzodiazepines and barbiturates. Although effective for short-term use, they produced drowsiness that carried over into daytime, and impaired gait and balance, predisposing patients to falls. These long-acting agents are therefore contraindicated in AD. Of the older sedatives, chloral hydrate remains in current use, usually on an intermittent dosing schedule. Newer approaches to pharmacological management include using short-acting benzodiazepines, such as lorazepam or temazepam. These medications have not been rigorously studied for treating insomnia in patients with AD, although several short-term studies have reported on their use to control agitation. All benzodiazepines can produce confusion and cognitive worsening in patients with AD, and low doses should be used whenever possible. When benzodiazepines are used chronically, tolerance frequently develops, with declining effects of a previously stable dose. To counteract the development of tolerance, an important recommendation is to use benzodiazepines discontinuously; for example, temazepam should be given no more than 4 to 5 days per week. Another popular medication for treating insomnia is trazodone, a cyclic antidepressant with sedating properties.
Fatigue and countermeasures
Published in Nicholas Green, Steven Gaydos, Hutchison Ewan, Edward Nicol, Handbook of Aviation and Space Medicine, 2019
Nicholas Green, Steven Gaydos, Hutchison Ewan, Edward Nicol
Sleep-promoting compounds: Helpful for minimising sleep loss and subsequent fatigue; half-life of each compound should be matched to length of available sleep opportunity in order to promote sleep and minimise hangover effects; national military policies vary but the following compounds have been used: Temazepam: Useful for maintaining relatively long periods of night-time sleep for day workers or daytime sleep for night workers.Zolpidem or zaleplon: Good choices for initiating sleep and/or for shorter sleep periods.Eszopiclone: Option for intermediate-length sleep opportunities.
The Experiences of Older Adults with Dual Diagnosis in an Inner Melbourne Community Mental Health Service
Published in Issues in Mental Health Nursing, 2018
Adam Searby, Phillip Maude, Ian McGrath
A participant with a history of heavy alcohol use described adapting his use to that which he described as “medicinal,” drinking brandy to control ruminant thoughts and attain sleep. Interestingly, this participant describes being wary of temazepam as forming dependence during his discussion of his alcohol use: Well, what it did do for me, it [drinking] helped me sleep. And to compensate for that in recent times I've uh, got from the doctor temazepam. But what I've found after having that for so long is that you become immune to it, it doesn't knock you out like it should. Build up tolerance to it. In which case is why I find in the evening now I've got to have a shot of brandy. I do that mainly because it helps me go to sleep, where the temazepam did, and helps me stay asleep. And have a restful night's sleep… Whether it's psychological, or it's the alcohol content itself is… what helps me go to sleep rather than temazepam. I used to like the temazepam too but without a tolerance to it I could go to sleep very well. But… now I find these days I've got to have the brandy. (P6)
Unraveling enhanced brain delivery of paliperidone-loaded lipid nanoconstructs: pharmacokinetic, behavioral, biochemical, and histological aspects
Published in Drug Delivery, 2022
Saleha Rehman, Bushra Nabi, Amaan Javed, Tahira Khan, Ashif Iqubal, Mohammad Javed Ansari, Sanjula Baboota, Javed Ali
Drug concentration in plasma and brain of Wistar rats is shown in Figure 2. The pharmacokinetic parameters are compiled in Table 1. At each time point, the brain drug concentration for the LNC group was significantly (p < .01) higher than drug suspension (Figure 2A). Cmax in the brain for the PPD-LNC group (724.16 ± 84.28 ng/mL) was 2.63-folds greater than the drug suspension group (275.87 ± 51.93 ng/mL). However, for both the groups, Tmax remained the same, i.e. 2 h. There was also a substantial increase in AUC0-48 of PPD-LNC (19597.11 ± 416.07 ng.h/mL) than drug suspension (5666.04 ± 81.16 ng.h/mL). The relative bioavailability for PPD-LNC was 3.46-folds greater than the drug suspension. Other pharmacokinetic parameters also showed a significant increase for LNC, thus signifying the superiority of LNC in effectively delivering the drugs to the brain. The molecular dispersion of PPD in the lipid milieu of LNC might be responsible for the improved drug concentration in the brain (Eleraky et al., 2020). The results are in harmony with the findings of Eleraky et al. where significantly superior drug concentration in the brain after oral administration of temazepam was obtained at all time points, as compared to the drug suspension (p < .05) (Eleraky et al., 2020). Further, higher AUC and sustained effect of PPD-NLC could be attributed to the steric stabilization effect of the surfactants, which protects NLCs from opsonization. Yu et al. also reported the reason for higher AUC and reduced elimination of miltefosine-loaded NLC as steric stabilization effect of the incorporated stearic acid, leading to the improved efficacy of miltefosine, which may result in dose reductions (Yu et al., 2021).
Calculating and using the drug burden index score in research and practice
Published in Expert Review of Clinical Pharmacology, 2018
Using different estimates of DR50 has a moderate effect on the size of the contribution of a drug to a patient’s DBI. Consider the example of a patient who takes 10 mg temazepam each night. Using the minimum licensed dose on the US Food and Drug Administration label of 7.5 mg gives a DBI of 0.57 (10/ (10 + 7.5)); using the minimum licensed dose by the Australian Therapeutic Goods Administration of 10 mg gives a DBI of 0.50 (10/ (10 + 10)); using the WHO DDD of 20 mg gives a DBI of 0.33 (10/ (10 + 20)); and using the minimum dose from the Australian Medicines Handbook Aged Care Companion of 5 mg gives a DBI of 0.67 (10/ (10 + 5)).