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Clonazepam / Klonopin

- benzodiazepine for Convulsions (petit mal akinetic & myoclonic seizures) and anxiety;
- peak levels in 1-2hrs, and t 1/2 in 18-40hrs, excreted in the urine;
- Adult: initially try, 1.5mg/day divided in 3 doses;
- Dosage may be increased .5-1mg/3days to max dose of 20mg/day;
- 2 step metabolizism + active metabolites;
- Contraindicated in Acute narrow angle glaucoma, significant liver dz,
- Note interaction w/ ETOH;
- Note dependence: withdrawl symptoms include: convulsions, tremor, abdominal and muscle cramps, vomiting and sweating;
- Note that Klonopin may precipitate seizures in those at risk;
- Peds: < 10yrs or < 30 kg:  0.01-0.03 mg/kg/day in 2-3 divided doses initially; increase 0.25-0.5 mg/day every 3 days prn upto 0.1-0.2 mg/kg/day divided tid