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Nazee (Clonazepam)
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Nazee

Nazee is used to prevent and control seizures. This medication is known as an anticonvulsant or antiepileptic drug. It is also used to treat panic attacks. Nazee works by calming your brain and nerves. It belongs to a class of drugs called benzodiazepines.

Other names for this medication:
Azpax, Calmnir, Cleps, Cloam, Clodep, Clonapik, Clonark, Clonasig, Clonatrac, Clonax, Clonix, Clonopam, Clopam, Closis, Clotweet, Cloze, Convaclon, Dipwell, Ection, Epicloz, Epitril, Escitacalm, Escitapax, Esitor, Estalonix, Ezinite, Jbcloz, Lonipax, Meloprax, Nazee, Nexclo, Nozim, Nupam, Onapil, Ozepam, Petril, Prasilex, Revozip, Rivotril, Sezolep, Somnolex, Somnotril, Xenotril, Zepam, Zepamax, Zeptril, Zicam, Zozep

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Also known as: Clonazepam

Description

Nazee, like other benzodiazepines, while being a first-line treatment for acute seizures, is not suitable for the long-term treatment of seizures due to the development of tolerance to the anticonvulsant effects.

Nazee has been found effective in treating epilepsy in children, and the inhibition of seizure activity seemed to be achieved at low plasma levels of Nazee. As a result, Nazee is sometimes used for certain rare childhood epilepsies; however, it has been found to be ineffective in the control of infantile spasms. Nazee is mainly prescribed for the acute management of epilepsies. Nazee has been found to be effective in the acute control of non-convulsive status epilepticus; however, the benefits tended to be transient in many of the people, and the addition of phenytoin for lasting control was required in these patients.

It is also approved for treatment of typical and atypical absences, infantile myoclonic, myoclonic and akinetic seizures. A subgroup of people with treatment resistant epilepsy may benefit from long-term use of Nazee; the benzodiazepine clorazepate may be an alternative due to its slow onset of tolerance.

Dosage

Nazee is indicated for the treatment of panic disorder, with or without agoraphobia, as defined in DSM-V. Panic disorder is characterized by the occurrence of unexpected panic attacks and associated concern about having additional attacks, worry about the implications or consequences of the attacks, and/or a significant change in behavior related to the attacks.

The efficacy of Nazee was established in two 6-to 9-week trials in panic disorder patients whose diagnoses corresponded to the DSM-IIIR category of panic disorder.

Panic disorder (DSM-V) is characterized by recurrent unexpected panic attacks, ie, a discrete period of intense fear or discomfort in which four (or more) of the following symptoms develop abruptly and reach a peak within 10 minutes: palpitations, pounding heart or accelerated heart rate; sweating; trembling or shaking; sensations of shortness of breath or smothering; feeling of choking; chest pain or discomfort; nausea or abdominal distress; feeling dizzy, unsteady, lightheaded or faint; derealization (feelings of unreality) or depersonalization (being detached from oneself); fear of losing control; fear of dying; paresthesias (numbness or tingling sensations); chills or hot flushes.

The effectiveness of Nazee in long-term use, that is, for more than 9 weeks, has not been systematically studied in controlled clinical trials. The physician who elects to use Nazee for extended periods should periodically reevaluate the long-term usefulness of the drug for the individual patient.

Overdose

Symptoms of clonazepam overdosage, like those produced by other CNS depressants, include somnolence, confusion, coma and diminished reflexes.

Treatment includes monitoring of respiration, pulse and blood pressure, general supportive measures and immediate gastric lavage. Intravenous fluids should be administered and an adequate airway maintained. Hypotension may be combated by the use of levarterenol or metaraminol. Dialysis is of no known value.

Flumazenil, a specific benzodiazepine-receptor antagonist, is indicated for the complete or partial reversal of the sedative effects of benzodiazepines and may be used in situations when an overdose with a benzodiazepine is known or suspected. Prior to the administration of flumazenil, necessary measures should be instituted to secure airway, ventilation and intravenous access. Flumazenil is intended as an adjunct to, not as a substitute for, proper management of benzodiazepine overdose. Patients treated with flumazenil should be monitored for resedation, respiratory depression and other residual benzodiazepine effects for an appropriate period after treatment. The prescriber should be aware of a risk of seizure in association with flumazenil treatment, particularly in long-term benzodiazepine users and in cyclic antidepressant overdose. The complete flumazenil package insert, including CONTRAINDICATIONS, WARNINGS AND PRECAUTIONS, should be consulted prior to use.

Flumazenil is not indicated in patients with epilepsy who have been treated with benzodiazepines. Antagonism of the benzodiazepine effect in such patients may provoke seizures.

Serious sequelae are rare unless other drugs or alcohol have been taken concomitantly.

Storage

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach.

Side effects

The most common side effects associated with Nazee are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

The elderly metabolize benzodiazepines more slowly than younger individuals and are also more sensitive to the effects of benzodiazepines, even at similar blood plasma levels. Doses for the elderly are recommended to be about half of that given to younger adults and are to be administered for no longer than two weeks. Long-acting benzodiazepines such as Nazee are not generally recommended for the elderly due the risk of drug accumulation.

The elderly are especially susceptible to increased risk of harm from motor impairments and drug accumulation side effects. Benzodiazepines also require special precaution if used by individuals that may be pregnant, alcohol- or drug-dependent, or may have comorbid psychiatric disorders. Nazee is generally not recommended for use in elderly people for insomnia due to its high potency relative to other benzodiazepines.

Nazee is not recommended for use in those under 18. Use in very young children may be especially hazardous. Of anticonvulsant drugs, behavioural disturbances occur most frequently with Nazee and phenobarbital.

Doses higher than 0.5–1 mg per day are associated with significant sedation. Nazee may aggravate hepatic porphyria. Nazee is not recommended for patients with chronic schizophrenia. A 1982 double-blinded, placebo-controlled study found Nazee increases violent behavior in individuals with chronic schizophrenia.

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Maxillo-ethmoidal chloroma in acute myeloid leukaemia: case report. Health risk assessment (HRA) questionnaires have become a popular tool to help quantify health issues within populations. Integrating the molecular, cellular and tissue level of description, this model links a broad spectrum of experimental observations encompassing spatially confined cell proliferation, directed cell migration, multiple cell lineage decisions and clonal competition.Using computational simulations we demonstrate that the model is capable of quantitatively describing and predicting the dynamic behaviour of the intestinal tissue during steady state as well as after cell damage and following selective gain or loss of gene function manipulations affecting Wnt- and Notch-signalling. This new epidemiologic research adds to the evidence of an association between panic attacks and suicide attempts during the middle years of adolescence. luminescens is unusual in that it fails to reduce nitrate and ferments only glucose and mannose. This cell transformation phenotype required constitutive activation of AKT, ERK1/2, mTOR, and p70S6K1.

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