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