Talk:Flurazepam

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Flurazepam actually is a pregnancy category X, which means that it will cause major birth defects and must not be used in women who are not on birth control. So, in placement of your "?", make sure and place an "X" under the title "Therapeutic Considerations."-A. Ryan, ANS3

I'm adding an arguably better image (right below), but the article is so short, that two pictures are hardly warrented. Fuzzform 01:05, 19 April 2007 (UTC)[reply]

Off-topic content

Does anyone else think that the latter half of the article is unneccessary? There's nothing about the study cited specific to flurazepam; that section could be copied and pasted into any benzodiazepine article. While it is pertinent to benzodiazepines, the article is about flurazepam and should be kept to flurazepam-specific information. I am relatively new and don't know how to handle the kind of change of integrating that content into the article on benzodiazepines or (not liking this idea) creating its own page, which I guess would be titled "conference on benzodiazepines, 1998" or something. I must say, though, that the entire section seems pretty biased, and sort of pointless.. it'd be like if someone held a conference investigating acetaminophen and concluded that because more people die from APAP overdoses than any other pharmaceutical, nobody should.. well, you get the point. That's my own personal qualm, but I still think the passage could be edited a bit for NPOV. I'd appreciate other thoughts on dealing with this content that doesn't belong here; if a few months pass and I don't hear any feedback I'll take care of it. Mr0t1633 (talk) 14:00, 14 July 2008 (UTC)[reply]

I just found the same exact passage in the article for clorazepate. The tolerance and dependence really does not need to be emphasized so much - more words than the rest of the article - because these properties are already well-known and long-established. There's no need for a page detailing it on every benzodiazepine article. If there is a page on benzodiazepine addiction, then that's where it belongs. If not, I'm going to axe most of the content eventually, if nobody weighs in to the contrary. Mr0t1633 (talk) 14:10, 14 July 2008 (UTC)[reply]

I removed it from this article.--Literaturegeek | T@1k? 14:17, 14 July 2008 (UTC)[reply]

Wow, thanks. I'll do the same for clorazepate. Mr0t1633 (talk) 14:21, 14 July 2008 (UTC)[reply]

Beat me to it! You got some quick fingers there. Thanks again, I didn't expect anyone to even notice the talk page here. I'm glad to see the article no longer espouses incorrect (or at least unproven) statements that benzodiazepines lack any analgesic or antidepressive activity, for example. Mr0t1633 (talk) 14:24, 14 July 2008 (UTC)[reply]

You are welcome. I just shortened the clorazepate part because if we delete the whole thing there really is no information on dependence and withdrawal. Hope that is ok.--Literaturegeek | T@1k? 14:27, 14 July 2008 (UTC)[reply]

Elderly

Deleted "Elderly" because it is tangential to Flurazepam. It is really unspecific and applies to sedatives in general. The deletion has already been discussed and agreed on the Temazepam page, and I carried it over to here. I don't think we need a new discussion for every benzodiazepine, where this info has been replicated. Will you please not REVERT edits without discussion, I may remind you. 70.137.181.232 (talk) 22:26, 14 July 2008 (UTC) It was deleted because 1. copyvio 2. it doesn't belong there anyway.[reply]

Nobody protested, neither did I. I agree the copyvio could have easily been fixed, but it is not the important point. The impotant point is similar to the benzodiazepines committee. As it stands it applies to practically all sedatives, is unspecific to flurazepam, doesn't address the specific problem of its long halflife and possible consequences.

I agree that for flurazepam it could be more important than for temazepam, because of long halflife and consequently possible accumulation. But flurazepam is also more lipid soluble than temazepam, so redistribution into a larger volume plays more of a role. I don't know how the steady state looks. I agree it is a concern. But the reference is much too general there.

But I don't think it justifies a whole chapter, more a short warning about possible accumulation and resulting daytime impairment, as well as general mention that it is not intended for long-term use.

A completely general discussion of the caveats of sedative use in the elderly is IMO overdone and then tangential to the article. Even more so the discussion what could be done, used, developed instead and what other drugs share the same problems. This is not a teaching book of geriatric sleep medicine. The reference could however be used in the short discussion to be inserted in side effects. Just my lay opinion. 70.137.181.232 (talk) 08:17, 15 July 2008 (UTC)

A more detailed chapter on pharmacokinetics of flurazepam, including redistribution effects and eventually active metabolites could also be included. I have no such reference, but I am sure if we find a good one it will also include a discussion of the elimination and accumulation in the elderly and resulting problems. If you find such more specific reference it would be much better. 70.137.181.232 (talk) 08:32, 15 July 2008 (UTC)

Maybe this is a good start http://www.rxlist.com/cgi/generic/fluraz_cp.htm Of course all the general considerations, no long term use recommended, careful with daytime aftereffects etc. apply. But this one is a bit more specific. Looks like the long lived part is the N1-desalkyl metabolite. (active). The other metabolite N1-hydroxyethyl-derivative is also active I think, and is a hypnotic, I guess. This and the flurazepam itself seem to have surprisingly short apparent halflives. The N1-desalkyl metabolite is I think more lipid soluble and has a larger distribution volume, I guess in my lay brain. It also has more the pharmacological properties of a day tranquilizer, namely long halflife and little hypnotic effect, I guess, so that it does make less sleepy than flurazepam itself, but prevents daytime rebound anxiety and withdrawal symptoms, I guess. 70.137.181.232 (talk) 11:57, 15 July 2008 (UTC)

So I can only guess that the goal of this drug design was to have a "two-in-one" combination of a short lived hypnotic and a long lived anxiolytic day tranquilizer. And with that profile it differs markedly from some other hypnotics. However, temazepam seems to embody a similar trick, namely the metabolite of N1-demethylation is desmethyl-temazepam=oxazepam. The O-conjugate of desmethyl-temazepam is excreted as a minor metabolite. (7%) How far this contributes to day time aftereffects I do not know. 70.137.181.232 (talk) 12:10, 15 July 2008 (UTC) Retrieved from "http://en.wikipedia.org/wiki/User_talk:Literaturegeek"

Can I delete it now? 70.137.181.232 (talk) 14:16, 16 July 2008 (UTC)[reply]

Flurazepam is such a small article. Deleting the elderly bit is deleting a third of the article. Then you could argue that we should delete most or all of the pharmacology section because it takes up half the page and then delete most or all of the dependence section after that because it takes up most of the page and then we are left with an article which is only a paragraph long which will require to be flagged to be expanded. I want it to stay. Elderly people are the largest consumers of hypnotics so it is very relevant I feel. Review papers are also considered a strong evidence base on wikipedia. Also RXlist is not peer reviewed. Was that not the argument you used for the BBC news refs? Now you are wanting non-peer reviewed sources to be used.--Literaturegeek | T@1k? 14:39, 16 July 2008 (UTC)[reply]

Ok. I start feel sorry for the poor little article. The rxlist thing is only a start to dig for a ref. But you agree that the Elderly chapter could be more specific? I generally don't like that a whole lot of general things have been replicated all over the benzo articles. 70.137.181.232 (talk) 19:52, 16 July 2008 (UTC)[reply]

The rxlist stuff is probably copied from the fda monograph. We can certainly not compare the fda monograph with the shit some wild running and sensationalist reporters are sucking out of their thumb. 70.137.181.232 (talk) 19:52, 16 July 2008 (UTC) 70.137.181.232 (talk) 19:52, 16 July 2008 (UTC)[reply]

Can someone create a new source and add a footnote in the Pharmacology section after the sentence that contains, "...may provide next-day anxiety relief." I would do it, but I lack the Wikipedia knowledge to accomplish that. Here's where I got the information to make that edit about anxiety relief: Lisa M. Mican, Pharm. D BCPP Clinical Pharmacologist, Austin State Hospital (2007) [DSHS Formulary Review] "Flurazepam" dshs.state.tx.us/mhprograms/efc/flurazepam.doc Ssrtm (talk) 12:37, 23 August 2017 (UTC)[reply]

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