NITRAZEPAM
It acts preferentially on midbrain ascending reticular formation (which maintains wakefulness) and on limbic system (thought and mental functions). Muscle relaxation is produced by a primary medullary site of action and ataxia is due to action on cerebellum. Accumulation and residual effects can be avoided only if ingestion is occasional. Good for patients with frequent nocturnal awakenings, when some day time sedation is acceptable.Insomnia, chronic short term & transient sleep disturbances.Preanaesthetic medication.
5-10 mg before retiring to bed.
Acute narrow angle glaucoma, Myasthenia gravis.
Pregnancy, concurrent admin. of alcohol & C.N.S. depressants, respiratory insufficiency, hepatic or renal disorder. Paediatrics: Not usually prescribed. Pregnancy: Should not be used. Lactation: Should not be used. Elderly: Dose should be reduced.
Nightmares, behavioral alteration. Withdraw syndrome, paradoxical stimulation, irritability, sweating, weakness, blurring of vision, dry mouth, urinary incontinence.
CNS depressant effect enhanced by alcohol, barbiturates, tricyclic antidepressants, phenothiazines, morphine derivatives. Enhances effects of amitriptyline.
