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