Nurse Teaching on Precautions to be observed while taking Temazepam

Nurse educated the patient/caregiver on precautions to be observed while taking Temazepam as below:

  1. Take Temazepam as ordered by your physician. This medication can induce some nausea and vomiting, when taken on empty stomach. Taking Temazepam with some food or snack can help avoid these unpleasant gastrointestinal symptoms.
  2. Follow closely on the expiration date of the Temazepam medication. If using a pillbox, check the expiration date on the medication container every time you fill the pillbox. If you are taking this medication for longer periods of time, set reminders on your phone, one 10 days ahead, the next a week ahead, and then every day, before you run out of the medication. This helps with securing the refill in time and making arrangements for pick-up at the pharmacy. Also, you can avoid the unpleasant withdrawal response from sudden discontinuation of medication due to running out on the medication.
  3. Maintain strict compliance with intake of the medication as ordered, with regards to dosage and frequency, to derive the benefit of the medication.
  4. Do not change the dose on this medication without consulting your doctor.
  5. Therapeutic effects of temazepam taken for relief of insomnia can last for about 8 hours. Temazepam carries the risk of inducing temporary short-term memory loss at the end of these 8 hours. If you have a shorter sleep time in bed for the night, less than the 8 hour duration for which temazepam acts, you could probably experience the symptoms of short-term memory loss and confusion, when you wake up, thus compromising safety and leading to falls and accidents. So, plan to have atleast 8 hours of restful sleep in the night, if you are taking dose of temazepam.
  6. If your schedule does not permit an eight hour sleep time for the night, you can avoid taking the dose of temazepam. This helps to avoid the risk for confusion and short-term memory loss, during your waking hours the next morning, thus helping to avoid any falls and accidents. Individuals are at risk to perform dangerous activities, such as, driving, without any knowledge or memory of the performance. Report any such behaviors to your physician, for any changes to be considered in plan of care.
  7. Continue taking temazepam as ordered, for the prescribed length of time, even if your symptoms of insomnia are under control. Discontinuing the medication abruptly, without physician recommendation, can lead to recurrence of the insomnia symptoms.
  8. Avoid drinking alcohol with temazepam. Both alcohol and temazepam depress the nervous system and significantly increase the risk for confusion, drowsiness, and difficulty concentrating, when taken together. Their effects on the brain and nervous system can get added up and lead to severe depression of the nervous system, thus compromising safety and resulting in accidents and falls. Also, even if you are consuming any alcoholic beverages, limit the use of alcohol to one drink and space it out from temazepam intake by atleast 3 – 4 hours, to avoid any possible interactions.
  9. Your physician could change the dose of temazepam, based on the relief obtained from insomnia or side-effects developed. So, maintain compliance with follow-up physician appointments, to have your doctor updated. Be accommodative to the plan of frequent dose changes, until you show an optimum response.
  10. Try changing the positions very slowly, as sudden change of positions can make the episodes of confusion and dizziness even worse and precipitate accidents and falls. One should stay away from activities, such as, driving, operating heavy machinery, swimming, and other activities needing mental alertness, until they are used to the side effects caused by the temazepam.
  11. Individuals using temazepam develop resistance to the dose in due course of time, thus blunting the therapeutic effect. The dose of temazepam should probably be enhanced at this point, to derive the same therapeutic benefit, thus increasing the risk for addiction. The risk for addiction is even more in individuals with history of substance/drug abuse, as the craving for the desired effect in these individuals will be high. As temazepam intake can be habit forming and carries a potential for addiction, it is usually prescribed for short span of time only, for a maximum of 2 weeks. If symptoms of insomnia are not relieved or further worsen within this time period, notify your doctor on the same, to have your sleep disturbance further investigated into.
  12. Individuals with history of drug abuse are more likely to abuse this medication. So, if you have any family members with drug abuse history, make sure your medication is not being stolen. Keep a count on your tablets to prevent chance for abuse. Also, do not share your medication with any family members or friends.
  13. Individuals on temazepam for long period of time can present with severe withdrawal symptoms, if temazepam were discontinued abruptly. Individuals can present with shakiness and nervousness, anxiety, aggression, mood disturbances, restlessness, and rebound insomnia, as part of the withdrawal syndrome. Reduce the dose of temazepam gradually over a period of time to avoid the withdrawal symptoms.
  14. Temazepam, as part of depression of the CNS for inducing sleep, can also cause depression of the respiratory center in the brain. This induces slowing down of respirations, reduce gas exchange, and the breathing pattern can become irregular. Individuals with history of asthma and COPD should be extra careful in this regard. Keep a close watch on respiratory patterns and any increase in difficulty breathing should be appropriately reported.
  15. A lot of other nonprescription products and prescription medications can also influence the activity of temazepam in the body. So, be sure to mention your physician and pharmacist regarding your history with temazepam and check with them regarding safety, in the event you are being started on any new medications.
  16. Patients are at risk to experience hallucinations and mood disturbances, such as, exacerbation of anxiety and depressive symptoms, with temazepam use. Any changes in the mood and behavior following temazepam intake must be reported to the physician, for any change in plan of care to be considered.
  17. Observe a regular sleep time every evening, as sleep is a habit that can be trained. Take the dose of temazepam about an hour before the sleep time, as it needs about 30 – 45 minutes to show the desired effect of sleep induction. Maintaining compliance with the sleep time and medication intake an hour before the sleep time can help avoid forgetting the medication intake.
  18. Temazepam use in expectant mothers could harm the unborn baby and result in pregnancy complications, such as, low birth weight baby, small head circumference, and preterm delivery. So, temazepam use should be avoided during pregnancy and in women planning to get pregnant. Women in the child-bearing age group, taking temazepam on a regular basis, must employ effective contraceptive measures in order to avoid getting pregnant.
  19. Consider life-style changes such as, avoiding daytime naps, avoiding caffeinated drinks closer to sleep time, and having some regular physical exercise can complement temazepam intake and promote sleep.
  20. Your physician could change the dose of temazepam, based on the relief obtained from symptoms of insomnia and anxiety, or side-effects developed. So, maintain compliance with follow-up physician appointments, as scheduled. Be accommodative to the plan of dose changes, until you show an optimum response.
  21. If a dose is missed, it can be skipped and take the scheduled dose on time. Compensating for the missed dose by taking an extra dose can pose serious risk for toxicity and side-effects. Notify your doctor and other health care personnel regarding your dose noncompliance.
  22. Caregivers should be aware and keep a close watch on the symptoms of overdose with temazepam. Individuals can present with severe confusion, dizziness, very low blood pressure numbers, severe difficulty breathing, loss of consciousness, and coma. In the event of an overdose, seek emergency medical service to prevent fatal outcome.

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