lorazepam


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lorazepam

 [lor-az´ĕ-pam]
a benzodiazepine derivative used as an antianxiety agent, sedative-hypnotic, preanesthetic medication, and anticonvulsant, and as an antiemetic in cancer chemotherapy; administered orally, intravenously, or intramuscularly.

lorazepam

Apo-Lorazepam (CA), Ativan, Dom-Lorazepam (CA), Novo-Lorazem (CA), Nu-Loraz (CA), PHL-Lorazepam (CA), PMS-Lorazepam (CA), Pro-Lorazepam (CA)

Pharmacologic class: Benzodiazepine

Therapeutic class: Anxiolytic

Controlled substance schedule IV

Pregnancy risk category D

Action

乐动体育开户Unknown. Thought to depress CNS at limbic system and disrupt neurotransmission in reticular activating system.

Availability

Injection:乐动体育开户 2 mg/ml, 4 mg/ml

Solution (concentrated): 2 mg/ml

Tablets:乐动体育开户 0.5 mg, 1 mg, 2 mg

Indications and dosages

Anxiety

Adults:乐动体育开户 2 to 3 mg P.O. daily in two or three divided doses. Maximum dosage is 10 mg daily.

Insomnia

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.

乐动体育开户 Status epilepticus

Adults:乐动体育开户 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.

Dosage adjustment

乐动体育开户• Elderly or debilitated patients

Off-label uses

乐动体育开户• Acute alcohol withdrawal syndrome

Contraindications

• Hypersensitivity to drug, other benzodiazepines, polyethylene or propylene glycol, or benzyl alcohol

乐动体育开户• Acute angle-closure glaucoma

乐动体育开户• Coma or CNS depression

• Hepatic or renal failure

Precautions

乐动体育开户Use cautiously in:

• hepatic or renal impairment

乐动体育开户• history of suicide attempt, drug abuse, depressive disorder, or psychosis

• elderly patients

• pregnant or breastfeeding patients.

Administration

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.

乐动体育开户 Give each 2 mg of I.V. dose slowly, over 2 to 5 minutes. Don't exceed rate of 2 mg/minute.

• Don't give parenteral form to children younger than age 18.

Adverse reactions

CNS:乐动体育开户 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:乐动体育开户 blurred vision, diplopia, nystagmus

GI: nausea, abdominal discomfort

Other: increased or decreased appetite

Interactions

Drug-drug. CNS depressants (including antidepressants, antihistamines, benzodiazepines, sedative-hypnotics):乐动体育开户 additive CNS depression

Hormonal contraceptives: increased lorazepam clearance

Drug-herbs. Chamomile, hops, kava, skullcap, valerian: increased CNS depression

Drug-behaviors. Alcohol use: increased CNS depression

Smoking:乐动体育开户 increased metabolism and decreased efficacy of lorazepam

Patient monitoring

乐动体育开户 During I.V. administration, monitor ECG and cardiovascular and respiratory status.

• Monitor vital signs closely.

• Evaluate for amnesia.

• 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.

Patient teaching

• 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.

• Advise female patient to inform prescriber if she is pregnant or breastfeeding.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, herbs, and behaviors mentioned above.

lorazepam

(lôr-ăz′ə-păm′)
n.
A benzodiazepine drug, C15H10Cl2N2O2, that acts as a sedative and antianxiety agent and is used therapeutically to control seizures.

lorazepam

Neuropharmacology A benzodiazepine anxiolytic, antidepressant, sedative, hypnotic

lorazepam

A benzodiazepine tranquillizer drug similar to diazepam). A brand name is Ativan.
References in periodicals archive ?
A total of 20 patients treated with silexan suffered from 26 adverse events compared to 18 patients (19 adverse events) treated with lorazepam. In the silexan group, a causal relationship to the study medication could not be ruled out for 11 adverse events (10 patients), and 7 adverse events (7 patients) in the lorazepam group were judged to be potentially related to the study medication.
El Lorazepam se usa para reducir a corto plazo los sintomas de ansiedad asi como para el tratamiento de los desordenes de comportamiento relacionados con la ansiedad.
Both lorazepam and clonidine can be tapered and discontinued once the withdrawal is complete.
Increased lorazepam doses IV along with haloperidol were given as needed.
Among the 10 patients who received lorazepam, a bolus dose of up to 1 mg by intravenous push, symptoms resolved and temperatures normalized in 8 of the women within 90 minutes.
Revenues from sales of lorazepam reportedly rose from $9 million in 1997 to $133 million in 1998.
As part of the protocol, a physician may decide to have the nurse administer an initial dose of 1 mg of lorazepam if there is a strong history of alcohol consumption and a high CAGE score (Fig 1).
Lorazepam in its undiluted form also appears as a small white tablet that comes in various shapes or as white powder.
Diazepam, lorazepam, and clonazepam are central nervous system inhibitors and not only decrease muscle tone but may also cause sleepiness and drooling, and interfere with swallowing.
W receives a benzodiazepine challenge with lorazepam, 2 mg IM.
There, he was treated intermittently with doses of intravenous (IV) lorazepam 1mg (we are unsure of the total dose) and quetiapine 25mg/day.
It later transpired that Nichols had administered lorazepam, a non-prescribed medication that is commonly used to treat anxiety disorders.