Sensitivity to triazolam in the elderly

Article Abstract:

For many drugs, it is important that the amount in a patient's blood be kept within the "therapeutic window". This means that enough drug is present to accomplish the desired effect, but not so much that side effects occur. The amount of drug in the blood depends not only on the dose taken, but also on the rate at which the body metabolizes or excretes the drug. Therefore, if the drug metabolism of a patient is impaired, that patient may suffer the effects of abnormally high blood levels. Triazolam is the most widely prescribed hypnotic drug in the United States, and is used in the treatment of insomnia. Triazolam is a member of a class of drugs called benzodiazepines; there is evidence that elderly patients have a decreased ability to metabolize these drugs. Therefore, elderly patients may be expected to have higher blood levels than younger persons taking the same dose, and furthermore, if repeated doses of the drug are taken elderly patients may have a higher risk of the accumulation of the drug. A study was undertaken to evaluate the response of elderly patients to two different doses of triazolam. The responses of 21 healthy elderly subjects, average age 69, were compared with the responses of 26 healthy young subjects, average age 30. The results confirmed that the elderly patients had a decreased rate of clearance of triazolam from the body. This decreased clearance of triazolam resulted in the elderly patients having higher amounts in their blood and, as a result, significantly greater levels of sedation than the younger patients. Elderly patients also suffered more impairment than younger patients on tests of learning and motor skills; side effects involving these skills are commonly observed with triazolam. The results of this study suggest that when triazolam is used to treat elderly patients, the appropriate dose should be approximately half that used in the treatment of younger patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Aged, Elderly, Complications and side effects, Dosage and administration, Hypnotics and sedatives, Hypnotics, Triazolam, Central nervous system depressants

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Use of benzodiazepines in anxiety disorders

Article Abstract:

Generalized anxiety disorder occurs in 5% to 15% of the population. It is characterized by excessive anxiety, restlessness and fatigue and can also cause heart palpitations, shortness of breath and dizziness. Benzodiazepines are the standard treatment. Despite fears that these drugs are abused, most patients use them responsibly. These drugs are the most commonly prescribed tranquilizers in the US. Alprazolam (Xanax) has replaced diazepam (Valium) as the most commonly prescribed tranquilizer in the US. Common side effects of benzodiazepines are sedation, drowsiness, uncoordinated movements and difficulty with balance. Many users become adapted to these side effects. Many symptoms of anxiety will return when the drugs are discontinued, since they do not cure the illness.

Health aspects, Anxiety, Panic disorders, Panic disorder, Benzodiazepines

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Differential impairment of triazolam and zolpidem clearance by ritonavir

Article Abstract:

The protease inhibitor ritonavir may prolong the action of some sleeping pills because it inhibits their metabolism. In a study on human liver cells, the drug prolonged the action of triazolam but not the action of zolpidem.

Analysis, Physiological aspects, Ritonavir, Drug interactions, Drug metabolism

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