GENERIC NAME: Alprazolam DRUG CLASS: Benzodiazepine, Anxiolytic PHARMACODYNAMICS: Exact mechanisms of action not understood; main sites

of action may be the limbic system and reticular formation; increases the effects of gamma-aminobutyrate, an inhibitory neurotransmitter; anxiety blocking effects occur at doses well below those necessary to cause sedation, ataxia DOSAGE: Usual Adult Dose of Alprazolam for Depression: Immediate-release tablets, orally disintegrating tablets, oral concentrate: Initial dose: 0.5 mg orally 3 times a day Usual Geriatric Dose of Alprazolam for Anxiety: Immediate-release tablets, orally disintegrating tablets, oral concentrate: Initial dose: 0.25 mg orally 2 to 3 times a day in elderly or debilitated patients INDICATIONS: -Management of anxiety disorders, short-term relief of symptoms of anxiety; anxiety associated with depression. -Treatment of panic attacks with or without agoraphobia -Unlabeled uses: Social phobia, premenstrual syndrome, depression CONTRAINDICATIONS: Contraindicated with hypersensitivity to benzodiazepines, psychoses, acute narrow-angle glaucoma, shock, coma, acute alcoholic intoxication with depression of vital signs, pregnancy (crosses the placenta; risk of congenital malformations, neonatal withdrawal syndrome), labor and delivery ("floppy infant" syndrome), lactation (secreted in breast milk; infants become lethargic and lose weight). Use cautiously with impaired liver or kidney function, debilitation ADVERSE EFFECTS: CNS: Transient, mild drowsiness initially; sedation, depression, lethargy, apathy, fatigue, lightheadedness, disorientation, anger. CV: Bradycardia, tachycardia, CV collapse,hypertension, hypotension, palpitations, edema Dermatologic: Urticaria, pruritus, rash, dermatitis EENT: Visual and auditory disturbances, diplopia, nystagmus, depressed hearing, nasal congestion GI: Constipation, diarrhea, dry mouth, salivation, nausea, anorexia, vomiting, difficulty in swallowing, gastric disorders, hepatic dysfunction GU: Incontinence, changes in libido, urinary retention, menstrual irregularities NURSING RESPONSIBILITIES: Take this drug exactly as prescribed; take extended-release form once a day in the AM; place rapidly disintegrating tablet on top of tongue, where it will disintegrate and can be swallowed with saliva. Do not drink grapefruit juice while on this drug. Do not stop taking drug (in long-term therapy)without consulting health care provider. Avoid alcohol, sleep-inducing, or over-the-counter drugs.