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Pharmacologic class: Benzodiazepine
Therapeutic class:乐动体育开户 Anxiolytic
Controlled substance schedule IV
Pregnancy risk category D
Unknown. Thought to depress CNS at limbic system and disrupt neurotransmission in reticular activating system.
Injection: 2 mg/ml, 4 mg/ml
Solution (concentrated): 2 mg/ml
Tablets: 0.5 mg, 1 mg, 2 mg
Indications and dosages
Adults: 2 to 3 mg P.O. daily in two or three divided doses. Maximum dosage is 10 mg daily.
Adults: 2 to 4 mg P.O. at bedtime
➣乐动体育开户 Premedication before surgery (as antianxiety agent, sedative-hypnotic, or amnestic)
Adults:乐动体育开户 0.05 mg/kg (not to exceed 4 mg) deep I.M. injection at least 2 hours before surgery, or 0.044 mg/kg (not to exceed 2 mg) I.V. 15 to 20 minutes before surgery. For greater amnestic effect, give up to 0.05 mg/kg (not to exceed 4 mg) I.V. 15 to 20 minutes before surgery.
➣ Status epilepticus
Adults: 4 mg I.V. given slowly (no faster than 2 mg/minute). If seizures continue or recur after 10 to 15 minutes, repeat dose. If seizure control isn't established after second dose, other measures should be used. Don't exceed 8 mg in 12 hours.
• Elderly or debilitated patients
乐动体育开户• Acute alcohol withdrawal syndrome
• Hypersensitivity to drug, other benzodiazepines, polyethylene or propylene glycol, or benzyl alcohol
• Acute angle-closure glaucoma
乐动体育开户• Coma or CNS depression
• Hepatic or renal failure
乐动体育开户Use cautiously in:
• hepatic or renal impairment
• history of suicide attempt, drug abuse, depressive disorder, or psychosis
• elderly patients
乐动体育开户• pregnant or breastfeeding patients.
乐动体育开户• For I.V. use, dilute with equal volume of compatible diluent, such as normal saline solution or dextrose 5% in water. Keep resuscitation equipment and oxygen at hand.
☞ Give each 2 mg of I.V. dose slowly, over 2 to 5 minutes. Don't exceed rate of 2 mg/minute.
乐动体育开户• Don't give parenteral form to children younger than age 18.
CNS: amnesia, agitation, ataxia, depression, disorientation, dizziness, drowsiness, headache, incoordination, asthenia
CV (with too rapid I.V. administration): hypotension, bradycardia, tachycardia, apnea, cardiac arrest, cardiovascular collapse
EENT: blurred vision, diplopia, nystagmus
GI:乐动体育开户 nausea, abdominal discomfort
Other: increased or decreased appetite
Drug-drug. CNS depressants (including antidepressants, antihistamines, benzodiazepines, sedative-hypnotics):乐动体育开户 additive CNS depression
Hormonal contraceptives:乐动体育开户 increased lorazepam clearance
Drug-herbs. Chamomile, hops, kava, skullcap, valerian:乐动体育开户 increased CNS depression
Drug-behaviors. Alcohol use:乐动体育开户 increased CNS depression
Smoking: increased metabolism and decreased efficacy of lorazepam
☞ During I.V. administration, monitor ECG and cardiovascular and respiratory status.
• Monitor vital signs closely.
• Evaluate for amnesia.
乐动体育开户• Watch closely for CNS depression. Institute safety precautions as needed to prevent injury.
☞ Monitor for signs and symptoms of overdose (such as confusion, hypotension, coma, and labored breathing).
乐动体育开户• Assess liver function tests and CBC.
乐动体育开户• Tell patient and family about drug's possible CNS effects. Recommend appropriate safety precautions.
• Explain that with long-term use, drug must be discontinued slowly (typically over 8 to 12 weeks).
• Instruct patient to avoid alcohol, because it increases drowsiness and other CNS effects.
• Caution patient to avoid smoking, because it speeds drug breakdown in body.
乐动体育开户• Advise female patient to inform prescriber if she is pregnant or breastfeeding.
乐动体育开户• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, herbs, and behaviors mentioned above.