单词 | modafinil |
释义 | modafinilmo·daf·i·nilM5390750 (mə-dăf′ə-nĭl′)modafinil(məʊˈdæfɪnɪl)modafinilmodafinil[mo-daf´ĭ-nil″]modafinilPharmacologic class: Nonamphetamine CNS stimulant Therapeutic class: Analeptic Controlled substance schedule IV Pregnancy risk category C ActionUnknown. Thought to stimulate CNS by decreasing the release of gamma-aminobutyric acid (a CNS depressant), thereby increasing mental alertness. AvailabilityTablets: 100 mg, 200 mg Indications and dosages➣ Narcolepsy Adults: 200 mg/day P.O. as a single dose in morning Dosage adjustment• Severe hepatic impairment Contraindications• Hypersensitivity to drug PrecautionsUse cautiously in: • recent myocardial infarction, unstable angina, severe hepatic impairment, hyperthyroidism, hypertension, glaucoma, anxiety • history of left ventricular hypertrophy, ischemic ECG changes, chest pain, arrhythmias, or mitral valve prolapse with previous CNS stimulant use • history of psychosis • drug abuse • pregnant or breastfeeding patients • children (safety and efficacy not established). Administration• Give without food (food delays drug absorption). Adverse reactionsCNS: headache, dizziness, nervousness, insomnia, depression, anxiety, amnesia, tremor, emotional lability CV: hypertension, chest pain, vasodilation, hypotension, syncope, arrhythmias EENT: abnormal vision, amblyopia, epistaxis, rhinitis, pharyngitis GI: nausea, vomiting, diarrhea, dry mouth, anorexia GU: abnormal urine, urinary retention, albuminuria, abnormal ejaculation Hematologic: eosinophilia Metabolic: hyperglycemia Musculoskeletal: joint disorders, neck pain and rigidity Respiratory: lung disorder, dyspnea, asthma Skin: dry skin Other: fever, chills, herpes simplex infection InteractionsDrug-drug. Carbamazepine, phenobarbital, rifampin, other CYP3A4 inducers: decreased modafinil blood level Cyclosporine, theophylline: decreased blood levels of these drugs Diazepam, phenytoin, propranolol, tricyclic antidepressants, warfarin: increased blood levels of these drugs Hormonal contraceptives: decreased contraceptive efficacy Itraconazole, ketoconazole, other CYP3A4 inhibitors: increased modafinil blood level Methylphenidate: delayed modafinil absorption Drug-diagnostic tests. Aspartate aminotransferase, eosinophils, gamma-glutamyl transferase, glucose: increased levels Hepatic enzymes: abnormal levels Patient monitoring• Monitor respiratory and cardiovascular status, including vital signs and ECG. • Monitor neurologic status, including mood, motor function, cognition, and emotional lability. • Monitor blood glucose level in diabetic patient. • Monitor patient carefully if he is also receiving MAO inhibitors. (However, interaction studies with MAO inhibitors haven't been done.) Patient teaching• Tell patient he may take with or without food, but that food may delay drug absorption up to 1 hour. See Advise patient to immediately report chest pain, irregular heart beats, light-headedness, or fainting. • Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration, vision, motor function, and alertness. • Instruct female patient to use reliable nonhormonal contraception during and for 1 month after therapy. • Tell diabetic patient to monitor blood glucose level closely and stay alert for hyperglycemia. • As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above. modafinil(mə-dăf′ə-nĭl)modafinilProvigil® Neurology A nonamphetamine antinarcoleptic used as a 1st-line treatment of excess daytime sleepiness in narcolepsy. See Narcolepsy.modafinilA non-amphetamine (amfetamine) nervous system stimulant used to treat NARCOLEPSY and sleep apnoea. Modafinil is an ampakine that boosts the activity of the neurotransmitter glutamate. It is being widely used by people with reasons to wish to remain awake and alert. A brand name is Provigil. |
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