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MEDICATION GUIDE RESTORIL™ (Res-Tə-Ril) (Temazepam) Capsules
MEDICATION GUIDE RESTORIL™ (res-tə-ril) (temazepam) Capsules, C-IV What is the most important information I should know about RESTORIL? RESTORIL is a benzodiazepine medicine. Taking benzodiazepines with opioid medicines, alcohol, or other central nervous system depressants (including street drugs) can cause severe drowsiness, breathing problems (respiratory depression), coma and death. After taking RESTORIL, you may get up out of bed while not being fully awake and do an activity that you do not know you are doing. The next morning, you may not remember that you did anything during the night. You have a higher chance for doing these activities if you drink alcohol or take other medicines that make you sleepy with RESTORIL. Reported activities include: o driving a car (“sleep-driving”) o making and eating food o talking on the phone o having sex o sleep-walking Call your healthcare provider right away if you find out that you have done any of the above activities after taking RESTORIL. Do not take RESTORIL unless you are able to stay in bed a full night (7 to 8 hours) before you must be active again. Do not take more RESTORIL than prescribed. What is RESTORIL? RESTORIL is a prescription sleep medicine. RESTORIL is used in adults for the short-term (usually 7 to 10 days) treatment of a sleep problem called insomnia. Symptoms of insomnia include trouble falling asleep and waking up often during the night. RESTORIL is a federal controlled substance (C-IV) because it can be abused or lead to dependence. Keep RESTORIL in a safe place to prevent misuse and abuse. -
(12) Patent Application Publication (10) Pub. No.: US 2004/0224012 A1 Suvanprakorn Et Al
US 2004O224012A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2004/0224012 A1 Suvanprakorn et al. (43) Pub. Date: Nov. 11, 2004 (54) TOPICAL APPLICATION AND METHODS Related U.S. Application Data FOR ADMINISTRATION OF ACTIVE AGENTS USING LIPOSOME MACRO-BEADS (63) Continuation-in-part of application No. 10/264,205, filed on Oct. 3, 2002. (76) Inventors: Pichit Suvanprakorn, Bangkok (TH); (60) Provisional application No. 60/327,643, filed on Oct. Tanusin Ploysangam, Bangkok (TH); 5, 2001. Lerson Tanasugarn, Bangkok (TH); Suwalee Chandrkrachang, Bangkok Publication Classification (TH); Nardo Zaias, Miami Beach, FL (US) (51) Int. CI.7. A61K 9/127; A61K 9/14 (52) U.S. Cl. ............................................ 424/450; 424/489 Correspondence Address: (57) ABSTRACT Eric G. Masamori 6520 Ridgewood Drive A topical application and methods for administration of Castro Valley, CA 94.552 (US) active agents encapsulated within non-permeable macro beads to enable a wider range of delivery vehicles, to provide longer product shelf-life, to allow multiple active (21) Appl. No.: 10/864,149 agents within the composition, to allow the controlled use of the active agents, to provide protected and designable release features and to provide visual inspection for damage (22) Filed: Jun. 9, 2004 and inconsistency. US 2004/0224012 A1 Nov. 11, 2004 TOPCAL APPLICATION AND METHODS FOR 0006 Various limitations on the shelf-life and use of ADMINISTRATION OF ACTIVE AGENTS USING liposome compounds exist due to the relatively fragile LPOSOME MACRO-BEADS nature of liposomes. Major problems encountered during liposome drug Storage in vesicular Suspension are the chemi CROSS REFERENCE TO OTHER cal alterations of the lipoSome compounds, Such as phos APPLICATIONS pholipids, cholesterols, ceramides, leading to potentially toxic degradation of the products, leakage of the drug from 0001) This application claims the benefit of U.S. -
Benzodiazepines: Uses and Risks Charlie Reznikoff, MD Hennepin Healthcare
Benzodiazepines: Uses and Risks Charlie Reznikoff, MD Hennepin healthcare 4/22/2020 Overview benzodiazepines • Examples of benzos and benzo like drugs • Indications for benzos • Pharmacology of benzos • Side effects and contraindications • Benzo withdrawal • Benzo tapers 12/06/2018 Sedative/Hypnotics • Benzodiazepines • Alcohol • Z-drugs (Benzo-like sleeping aids) • Barbiturates • GHB • Propofol • Some inhalants • Gabapentin? Pregabalin? 12/06/2018 Examples of benzodiazepines • Midazolam (Versed) • Triazolam (Halcion) • Alprazolam (Xanax) • Lorazepam (Ativan) • Temazepam (Restoril) • Oxazepam (Serax) • Clonazepam (Klonopin) • Diazepam (Valium) • Chlordiazepoxide (Librium) 4/22/2020 Sedatives: gaba stimulating drugs have incomplete “cross tolerance” 12/06/2018 Effects from sedative (Benzo) use • Euphoria/bliss • Suppresses seizures • Amnesia • Muscle relaxation • Clumsiness, visio-spatial impairment • Sleep inducing • Respiratory suppression • Anxiolysis/disinhibition 12/06/2018 Tolerance to benzo effects? • Effects quickly diminish with repeated use (weeks) • Euphoria/bliss • Suppresses seizures • Effects incompletely diminish with repeated use • Amnesia • Muscle relaxation • Clumsiness, visio-spatial impairment • Seep inducing • Durable effects with repeated use • Respiratory suppression • Anxiolysis/disinhibition 12/06/2018 If you understand this pharmacology you can figure out the rest... • Potency • 1 mg diazepam <<< 1 mg alprazolam • Duration of action • Half life differences • Onset of action • Euphoria, clinical utility in acute -
The Anxiolytic Etifoxine Protects Against Convulsant and Anxiogenic
Alcohol 43 (2009) 197e206 The anxiolytic etifoxine protects against convulsant and anxiogenic aspects of the alcohol withdrawal syndrome in mice Marc Verleye*, Isabelle Heulard, Jean-Marie Gillardin Biocodex-De´partement de Pharmacologie-Zac de Mercie`res, Chemin d’Armancourt 60200 Compie`gne, France Received 11 December 2008; received in revised form 3 February 2009; accepted 4 February 2009 Abstract Change in the function of g-aminobutyric acidA (GABAA) receptors attributable to alterations in receptor subunit composition is one of main molecular mechanisms with those affecting the glutamatergic system which accompany prolonged alcohol (ethanol) intake. These changes explain in part the central nervous system hyperexcitability consequently to ethanol administration cessation. Hyperexcitability associated with ethanol withdrawal is expressed by physical signs, such as tremors, convulsions, and heightened anxiety in animal models as well as in humans. The present work investigated the effects of anxiolytic compound etifoxine on ethanol-withdrawal paradigms in a mouse model. The benzodiazepine diazepam was chosen as reference compound. Ethanol was given to NMRI mice by a liquid diet at 3% for 8 days, then at 4% for 7 days. Under these conditions, ethanol blood level ranged between 0.5 and 2 g/L for a daily ethanol intake varying from 24 to 30 g/kg. These parameters permitted the emergence of ethanol-withdrawal symptoms once ethanol administration was terminated. Etifoxine (12.5e25 mg/kg) and diazepam (1e4 mg/kg) injected intraperitoneally 3 h 30 min after ethanol removal, decreased the severity in handling-induced tremors and convulsions in the period of 4e6 h after withdrawal from chronic ethanol treatment. -
Etifoxine Impairs Neither Alertness Nor Cognitive Functions of the Elderly: a Randomized, Double-Blind, Placebo-Controlled Crossover Study
ARTICLE IN PRESS JID: NEUPSY [m6+; June 28, 2018;22:42 ] European Neuropsychopharmacology (2018) 000, 1–8 www.elsevier.com/locate/euroneuro Etifoxine impairs neither alertness nor cognitive functions of the elderly: A randomized, double-blind, placebo-controlled crossover study a ,b , ∗ c b D. Deplanque , F. Machuron , N. Waucquier , b b b a E. Jozefowicz , S. Duhem , S. Somers , O. Colin , c a A. Duhamel , R. Bordet a Univ. Lille, Inserm, CHU Lille, U1171 - Degenerative & Vascular cognitive disorders, F-59000 Lille, France b Univ. Lille, Inserm, CHU Lille, CIC 1403 - Centre d’Investigation Clinique, F-59000 Lille, France c Univ. Lille, CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, F-59000 Lille, France Received 22 December 2017; received in revised form 4 May 2018; accepted 17 May 2018 Available online xxx KEYWORDS Abstract Etifoxine; Etifoxine hydrochloride (Stresam ®), a treatment indicated for psychosomatic manifestations of Benzodiazepines; anxiety, could be an alternative to benzodiazepines. While no impact on alertness and cognitive Anxiolytic; functions has been proven among youth, data on elderly are lacking. The primary objective of Cognition; this study was to measure the impact of etifoxine, lorazepam or placebo on alertness in the el- Elderly; derly. The secondary objectives were to evaluate cognitive performances and adverse effects. Geriatric psychiatry In this randomized, placebo-controlled, double-blind, 3-way crossover design, 30 healthy vol- unteers aged 65 to 75 years underwent three one-day sessions. After treatment intake, stan- dardized cognitive tests were conducted using the Cambridge Neuropsychological Test Auto- mated Batteries and other psychological tests (Stroop, Rey Auditory Verbal Learning Test, Digit R Registration: EudraCT 2012-005530-11 and NCT 02147548 ∗ Correspondence to: Department of medical Pharmacology, Faculty of Medicine, 1 place Verdun, 59045 Lille, France. -
Benzodiazepine Group ELISA Kit
Benzodiazepine Group ELISA Kit Benzodiazepine Background Since their introduction in the 1960s, benzodiazepines have been widely prescribed for the treatment of anxiety, insomnia, muscle spasms, alcohol withdrawal, and seizure-prevention as they are depressants of the central nervous system. Despite the fact that they are highly effective for their intended use, benzodiazepines are prescribed with caution as they can be highly addictive. In fact, researchers at NIDA (National Institute on Drug Abuse) have shown that addiction for benzodiazepines is similar to that of opioids, cannabinoids, and GHB. Common street names of benzodiazepines include “Benzos” and “Downers”. The five most encountered benzodiazepines on the illicit market are alprazolam (Xanax), lorazepam (Ativan), clonazepam (Klonopin), diazepam (Valium), and temazepam (Restori). The method of abuse is typically oral or snorted in crushed form. The DEA notes a particularly high rate of abuse among heroin and cocaine abusers. Designer benzodiazepines are currently offered in online shops selling “research chemicals”, providing drug abusers an alternative to prescription-only benzodiazepines. Data defining pharmacokinetic parameters, drug metabolisms, and detectability in biological fluids is limited. This lack of information presents a challenge to forensic laboratories. Changes in national narcotics laws in many countries led to the control of (phenazepam and etizolam), which were marketed by pharmaceutical companies in some countries. With the control of phenazepam and etizolam, clandestine laboratories have begun researching and manufacturing alternative benzodiazepines as legal substitutes. Delorazepam, diclazepam, pyrazolam, and flubromazepam have emerged as compounds in this class of drugs. References Drug Enforcement Administration, Office of Diversion Control. “Benzodiazepines.” http://www.deadiversion.usdoj.gov/drugs_concern/benzo_1. -
UNDERSTANDING PHARMACOLOGY of ANTIEPILEPTIC DRUGS: Content
UNDERSTANDING PHARMACOLOGY OF ANTIEPILEPTIC DRUGS: PK/PD, SIDE EFFECTS, DRUG INTERACTION THANARAT SUANSANAE, BPharm, BCPP, BCGP Assistance Professor of Clinical Pharmacy Faculty of Pharmacy, Mahidol University Content Mechanism of action Pharmacokinetic Adverse effects Drug interaction 1 Epileptogenesis Neuronal Network Synaptic Transmission Stafstrom CE. Pediatr Rev 1998;19:342‐51. 2 Two opposing signaling pathways for modulating GABAA receptor positioning and thus the excitatory/inhibitory balance within the brain Bannai H, et al. Cell Rep 2015. doi: 10.1016/j.celrep.2015.12.002 Introduction of AEDs in the World (US FDA Registration) Mechanism of action Pharmacokinetic properties Adverse effects Potential to develop drug interaction Formulation and administration Rudzinski LA, et al. J Investig Med 2016;64:1087‐101. 3 Importance of PK/PD of AEDs in Clinical Practice Spectrum of actions Match with seizure type Combination regimen Dosage regimen Absorption Distribution Metabolism Elimination Drug interactions ADR (contraindications, cautions) Mechanisms of Neuronal Excitability Voltage sensitive Na+ channels Voltage sensitive Ca2+ channels Voltage sensitive K+ channel Receptor‐ion channel complex Excitatory amino acid receptor‐cation channel complexes • Glutamate • Aspartate GABA‐Cl‐ channel complex 4 Mechanism of action of clinically approved anti‐seizure drugs Loscher W, et al. CNS Drugs 2016;30:1055‐77. Summarize Mechanisms of Action of AEDs AED Inhibition of Increase in Affinity to Blockade of Blockade of Activation of Other glutamate GABA level GABAA sodium calcium potassium excitation receptor channels channels channels Benzodiazepines + Brivaracetam + + Carbamazepine + + (L) Eslicarbazepine + Ethosuximide + (T) Felbamate +(NMDA) + + + + (L) + Gabapentin + (N, P/Q) Ganaxolone + Lacosamide + Lamotrigine + + + + (N, P/Q, R, T) + inh. GSK3 Levetiracetam + + (N) SV2A, inh. -
Control Substance List
Drugs DrugID SubstanceName DEANumbScheNarco OtherNames 1 1-(1-Phenylcyclohexyl)pyrrolidine 7458 I N PCPy, PHP, rolicyclidine 2 1-(2-Phenylethyl)-4-phenyl-4-acetoxypiperidine 9663 I Y PEPAP, synthetic heroin 3 1-[1-(2-Thienyl)cyclohexyl]piperidine 7470 I N TCP, tenocyclidine 4 1-[1-(2-Thienyl)cyclohexyl]pyrrolidine 7473 I N TCPy 5 13Beta-ethyl-17beta-hydroxygon-4-en-3-one 4000 III N 6 17Alpha-methyl-3alpha,17beta-dihydroxy-5alpha-androstane 4000 III N 7 17Alpha-methyl-3beta,17beta-dihydroxy-5alpha-androstane 4000 III N 8 17Alpha-methyl-3beta,17beta-dihydroxyandrost-4-ene 4000 III N 9 17Alpha-methyl-4-hydroxynandrolone (17alpha-methyl-4-hyd 4000 III N 10 17Alpha-methyl-delta1-dihydrotestosterone (17beta-hydroxy- 4000 III N 17-Alpha-methyl-1-testosterone 11 19-Nor-4-androstenediol (3beta,17beta-dihydroxyestr-4-ene; 4000 III N 12 19-Nor-4-androstenedione (estr-4-en-3,17-dione) 4000 III N 13 19-Nor-5-androstenediol (3beta,17beta-dihydroxyestr-5-ene; 4000 III N 14 19-Nor-5-androstenedione (estr-5-en-3,17-dione) 4000 III N 15 1-Androstenediol (3beta,17beta-dihydroxy-5alpha-androst-1- 4000 III N 16 1-Androstenedione (5alpha-androst-1-en-3,17-dione) 4000 III N 17 1-Methyl-4-phenyl-4-propionoxypiperidine 9661 I Y MPPP, synthetic heroin 18 1-Phenylcyclohexylamine 7460 II N PCP precursor 19 1-Piperidinocyclohexanecarbonitrile 8603 II N PCC, PCP precursor 20 2,5-Dimethoxy-4-(n)-propylthiophenethylamine 7348 I N 2C-T-7 21 2,5-Dimethoxy-4-ethylamphetamine 7399 I N DOET 22 2,5-Dimethoxyamphetamine 7396 I N DMA, 2,5-DMA 23 3,4,5-Trimethoxyamphetamine -
124.210 Schedule IV — Substances Included. 1
1 CONTROLLED SUBSTANCES, §124.210 124.210 Schedule IV — substances included. 1. Schedule IV shall consist of the drugs and other substances, by whatever official name, common or usual name, chemical name, or brand name designated, listed in this section. 2. Narcotic drugs. Unless specifically excepted or unless listed in another schedule, any material, compound, mixture, or preparation containing any of the following narcotic drugs, or their salts calculated as the free anhydrous base or alkaloid, in limited quantities as set forth below: a. Not more than one milligram of difenoxin and not less than twenty-five micrograms of atropine sulfate per dosage unit. b. Dextropropoxyphene (alpha-(+)-4-dimethylamino-1,2-diphenyl-3-methyl-2- propionoxybutane). c. 2-[(dimethylamino)methyl]-1-(3-methoxyphenyl)cyclohexanol, its salts, optical and geometric isomers and salts of these isomers (including tramadol). 3. Depressants. Unless specifically excepted or unless listed in another schedule, any material, compound, mixture, or preparation which contains any quantity of the following substances, including its salts, isomers, and salts of isomers whenever the existence of such salts, isomers, and salts of isomers is possible within the specific chemical designation: a. Alprazolam. b. Barbital. c. Bromazepam. d. Camazepam. e. Carisoprodol. f. Chloral betaine. g. Chloral hydrate. h. Chlordiazepoxide. i. Clobazam. j. Clonazepam. k. Clorazepate. l. Clotiazepam. m. Cloxazolam. n. Delorazepam. o. Diazepam. p. Dichloralphenazone. q. Estazolam. r. Ethchlorvynol. s. Ethinamate. t. Ethyl Loflazepate. u. Fludiazepam. v. Flunitrazepam. w. Flurazepam. x. Halazepam. y. Haloxazolam. z. Ketazolam. aa. Loprazolam. ab. Lorazepam. ac. Lormetazepam. ad. Mebutamate. ae. Medazepam. af. Meprobamate. ag. Methohexital. ah. Methylphenobarbital (mephobarbital). -
Calculating Equivalent Doses of Oral Benzodiazepines
Calculating equivalent doses of oral benzodiazepines Background Benzodiazepines are the most commonly used anxiolytics and hypnotics (1). There are major differences in potency between different benzodiazepines and this difference in potency is important when switching from one benzodiazepine to another (2). Benzodiazepines also differ markedly in the speed in which they are metabolised and eliminated. With repeated daily dosing accumulation occurs and high concentrations can build up in the body (mainly in fatty tissues) (2). The degree of sedation that they induce also varies, making it difficult to determine exact equivalents (3). Answer Advice on benzodiazepine conversion NB: Before using Table 1, read the notes below and the Limitations statement at the end of this document. Switching benzodiazepines may be advantageous for a variety of reasons, e.g. to a drug with a different half-life pre-discontinuation (4) or in the event of non-availability of a specific benzodiazepine. With relatively short-acting benzodiazepines such as alprazolam and lorazepam, it is not possible to achieve a smooth decline in blood and tissue concentrations during benzodiazepine withdrawal. These drugs are eliminated fairly rapidly with the result that concentrations fluctuate with peaks and troughs between each dose. It is necessary to take the tablets several times a day and many people experience a "mini-withdrawal", sometimes a craving, between each dose. For people withdrawing from these potent, short-acting drugs it has been advised that they switch to an equivalent dose of a benzodiazepine with a long half life such as diazepam (5). Diazepam is available as 2mg tablets which can be halved to give 1mg doses. -
WO 2007/109289 Al
(12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (43) International Publication Date PCT (10) International Publication Number 27 September 2007 (27.09.2007) WO 2007/109289 Al (51) International Patent Classification: (74) Agents: INSOGNA, Anthony, M. et al; Jones Day, 222 C07D 265/14 (2006.01) A61P 25/00 (2006.01) East 41st Street, New York, NY 10017-6702 (US). A61K 31/535 (2006.01) (81) Designated States (unless otherwise indicated, for every (21) International Application Number: kind of national protection available): AE, AG, AL, AM, PCT/US2007/006959 AT,AU, AZ, BA, BB, BG, BH, BR, BW, BY,BZ, CA, CH, CN, CO, CR, CU, CZ, DE, DK, DM, DZ, EC, EE, EG, ES, (22) International Filing Date: 20 March 2007 (20.03.2007) FI, GB, GD, GE, GH, GM, GT, HN, HR, HU, ID, IL, IN, IS, JP, KE, KG, KM, KN, KP, KR, KZ, LA, LC, LK, LR, (25) Filing Language: English LS, LT, LU, LY,MA, MD, MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, OM, PG, PH, PL, PT, RO, RS, (26) Publication Language: English RU, SC, SD, SE, SG, SK, SL, SM, SV, SY, TJ, TM, TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW (30) Priority Data: 60/784,513 20 March 2006 (20.03.2006) US (84) Designated States (unless otherwise indicated, for every (71) Applicant (for all designated States except US): XYTIS kind of regional protection available): ARIPO (BW, GH, INC. [US/US]; 101 Theory Suite 100, Irvine, CA 92617 GM, KE, LS, MW, MZ, NA, SD, SL, SZ, TZ, UG, ZM, (US). -
Introduced B.,Byhansen, 16
LB301 LB301 2021 2021 LEGISLATURE OF NEBRASKA ONE HUNDRED SEVENTH LEGISLATURE FIRST SESSION LEGISLATIVE BILL 301 Introduced by Hansen, B., 16. Read first time January 12, 2021 Committee: Judiciary 1 A BILL FOR AN ACT relating to the Uniform Controlled Substances Act; to 2 amend sections 28-401, 28-405, and 28-416, Revised Statutes 3 Cumulative Supplement, 2020; to redefine terms; to change drug 4 schedules and adopt federal drug provisions; to change a penalty 5 provision; and to repeal the original sections. 6 Be it enacted by the people of the State of Nebraska, -1- LB301 LB301 2021 2021 1 Section 1. Section 28-401, Revised Statutes Cumulative Supplement, 2 2020, is amended to read: 3 28-401 As used in the Uniform Controlled Substances Act, unless the 4 context otherwise requires: 5 (1) Administer means to directly apply a controlled substance by 6 injection, inhalation, ingestion, or any other means to the body of a 7 patient or research subject; 8 (2) Agent means an authorized person who acts on behalf of or at the 9 direction of another person but does not include a common or contract 10 carrier, public warehouse keeper, or employee of a carrier or warehouse 11 keeper; 12 (3) Administration means the Drug Enforcement Administration of the 13 United States Department of Justice; 14 (4) Controlled substance means a drug, biological, substance, or 15 immediate precursor in Schedules I through V of section 28-405. 16 Controlled substance does not include distilled spirits, wine, malt 17 beverages, tobacco, hemp, or any nonnarcotic substance if such substance 18 may, under the Federal Food, Drug, and Cosmetic Act, 21 U.S.C.