Major
Established
الوصف
Alprazolam combined with morphine carries an FDA boxed warning for serious risk of respiratory depression, sedation, coma, and death.
الآلية
Alprazolam potentiates GABA-A inhibitory tone; morphine reduces brainstem respiratory drive via mu-opioid receptors — both pathways converge on CNS and respiratory depression.
الأهمية السريرية
Large database studies confirm excess mortality with concomitant benzodiazepine and opioid prescriptions.
التدبير
Prescribe concurrent opioids and benzodiazepines only when alternatives are inadequate; coprescribe naloxone.