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Lysanxia

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Indications:

* Symptomatic treatment of severe manifestations of anxiety and / or disabling. * Prevention and treatment of delirium tremens and other manifestations of alcohol withdrawal.

Contraindications:

Myasthenia gravis. Hypersensitivity to benzodiazepines. Severe respiratory failure. Severe renal impairment. Sleep apnea syndrome

Adverse reactions:

They are related to the dose ingested, the individual susceptibility of the patient. * Neuropsychiatric side effects (see section warnings and precautions for use): . anterograde amnesia, which can occur at therapeutic doses, the risk increasing in proportion to the dose . behavioral disorders, alterations of consciousness, irritability, aggressiveness, agitation, . physical and psychological dependence, even at therapeutic doses with withdrawal symptoms or rebound upon discontinuation of treatment, . lightheadedness, headache, ataxia, . confusion, decreased alertness or sleepiness (especially elderly patients), insomnia, nightmares, tension, . changes in libido. * Adverse skin: rash, itching or not. * Adverse general: muscular hypotonia, asthenia. * Adverse Ocular diplopia. * Due to the presence, as excipients, terpene derivatives, and in case of non-compliance with recommended doses: . risk of seizures in infants and children, . possibility of unrest and confusion among the elderly.

Interactions:

Drink: Increase by alcohol the sedative effect of benzodiazepines and related. The alteration of vigilance can make dangerous driving and operating machinery. Do not take alcoholic drinks and medicines containing alcohol. ASSOCIATIONS TAKE INTO ACCOUNT: - Other central nervous system depressants: opioid derivatives (analgesics, cough suppressants and alternative treatments other than buprenorphine), neuroleptics, barbiturates, other anxiolytics, hypnotics, antidepressants, sedatives, antihistamines, sedatives H1; central antihypertensive other: baclofen; thalidomide; pizotifen. Increase of the central depression. The alteration of vigilance can make dangerous driving and operating machinery. In addition, for morphine derivatives (analgesics, antitussives and substitution treatment), Barbiturates: increased risk of respiratory depression, which can be fatal in overdose. - Buprenorphine: Increased risk of respiratory depression, which can be fatal. Carefully evaluate the benefit / risk of this association. Inform the patient of the need to respect the prescribed dosages.

Warnings:

* Extreme caution is recommended in patients with a history of alcoholism or other addictions, drug or not (see Section Interactions). * IN THE SUBJECT WITH A major depressive episode: Benzodiazepines and related should not be prescribed alone as they leave the depression change for its own account with persistence or increase the risk of suicide. * TERMS OF STOPPING THE PROGRESSIVE TREATMENT: They must be set to the patient accurately. Besides the need to gradually decrease dose, patients should be advised of the possibility of a rebound, to minimize the anxiety that might arise from symptoms related to this interruption, even progressive. The patient should be warned of the possibly uncomfortable this phase. * CHILD: Even more than in adults, the risk / benefit ratio is carefully evaluated and the treatment duration as short as possible. The use of prazepam is not recommended for children. * ABOUT AGE OR RENAL FAIL FAIL LIVER: The risk of accumulation leads to reduce the dosage in half for example (see Warnings section). * INSUFFICIENT BREATHING: Impaired breathing should be taken into account the depressant effect of benzodiazepines and related products (especially as anxiety and agitation may be signs call for decompensation of respiratory function that justifies passage ICU). * Pregnancy: To date, no effect malformation is attributed to exposure to benzodiazepines during the first trimester of pregnancy. When taking high doses of benzodiazepines on the 2nd and / or third trimesters of pregnancy decreased fetal movements active and fetal heart rate variability have been described. Treatment in late pregnancy by benzodiazepine even at low doses, may be responsible in the newborn for signs of infiltration such qu’hypotonie axial suction disorders causing poor weight gain. These signs are reversible, but can last 1-3 weeks depending on the half life of the benzodiazepine prescribed. In large doses, respiratory depression or apnea, and hypothermia may appear reversible in the newborn. In addition, a neonatal abstinence syndrome is possible even in the absence of signs of infiltration. It is particularly characterized by hyperexcitability, restlessness and tremor of the newborn occurring remote delivery. The time of onset depends on the half-life of the drug and may be important when it is long. Given these data, the use of nordazepam is possible during pregnancy regardless of the term, in strict compliance with the indications and dosages. In late pregnancy, it is necessary to establish a treatment nordazepam, avoid prescribing high doses and account for the monitoring of the newborn, the effects described above.

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Dr. Samer Al-Jneidy

Dr. Samer Al-Jneidy Pediatrician

Dr. Hani Najjar

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Dr. Faisal Dibsi

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