Description
Clobazam, marketed under the brand names Frisium and Urbanol, is a benzodiazepine derivative. It binds to specific GABA receptors in the central nervous system (CNS), including the limbic system and reticular formation. This results in increased permeability of neuronal membranes to chloride ions, leading to the inhibitory effect of GABA, which causes hyperpolarization and stabilization.
Clobazam is well absorbed from the gastrointestinal tract when taken orally, with peak plasma concentrations achieved after 1-4 hours. It rapidly crosses the blood-brain barrier and has a protein-binding capacity of 85%. The drug undergoes hepatic metabolism through demethylation and hydroxylation. It is primarily excreted through the urine, both as unchanged drug and metabolites, with an elimination half-life of 18-42 hours.
The indications for clobazam are not available in the provided information. However, it is commonly used for short-term management of anxiety and as an adjunct in epilepsy.
Clobazam may cause adverse reactions such as constipation, anorexia, nausea, dizziness, fine tremors, worsening of respiratory symptoms in predisposed individuals, ataxia, drowsiness, headache, confusion, loss of libido, motor dysfunction, dependence, visual disturbances, and weight gain. Respiratory depression can be a potentially fatal side effect.
Precautions should be taken to avoid overdosage, which can result in drowsiness, mental confusion, lethargy, ataxia, hypotonia, hypotension, respiratory depression, coma, and very rarely, death. Treatment includes emptying the stomach through induced vomiting or gastric lavage within one hour of ingestion. Activated charcoal may be administered to reduce absorption. Respiratory and cardiovascular functions should be monitored, and flumazenil may be given if necessary. Forced diuresis or hemodialysis are unlikely to be effective.
Special precautions should be taken in individuals who may experience impaired ability to perform skilled tasks and hazardous activities, including the elderly, those with renal or hepatic impairment, alcoholics, and obese individuals. Withdrawal from clobazam should be done gradually.
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