MEDMONDAY: Lorazepam

Today I picked Lorazepam!

šŸ’ŠClass, Category, and ScheduleĀ 

Chemical Class: Benzodiazepine

Class: Amnestic, antianxiety, anticonvulsant, sedative

Pregnancy Class: D

šŸ’ŠMain Purpose

Treatment of anxiety and possible seizures

šŸ’ŠMechanism of Action

  • Lorazepam potentiates the effects of GABA & other inhibitory neurotransmitters by binding to the specific benzodiazepine receptors in the cortical and limbic areas of the CNS
  • GABA inhibits excitatory stimulation, which helps control emotional behavior
  • The limbic system contains a highly dense area ofĀ benzodiazepine receptors –> thus explaining the antianxiety affects of lorazepam
  • Lorazepam also hyperpolarizes neuronal cells and thus interfering with their ability to generate seizures

šŸ’ŠIncompatibilities

Ā Don’t mix I.V lorazepam with buprenorphine

šŸ’ŠContraindicationsĀ 

-Acute angular glaucoma

-Psychosis

-Hypersensitivity to lorazepam, it’s components or benzodiazepines

šŸ’ŠNursing ConsiderationsĀ 

  • Before starting lorazepam therapy in a patient with depression, make sure the patient already takes an antidepressant
  • Use caution when administering lorazepam to elderly patients with compromised respiratory function as it may cause hypo-ventilation, respiratory depression, sedation, and unsteadiness
  • Not recommended for pregnant women in their third trimester as the drug may affect brain development in the fetus
  • Use cautiously when administering to patients with a history of alcohol abuse –> can cause an increased risk of physical and psychological dependence
  • Stopping the drug abruptly increases the risk of withdrawal symptoms, thus the dosage should be tapered gradually, especially in epileptic patients

 

šŸ’ŠDosages ofĀ Oral Concentrate TabletsĀ 

1.Treatment: Insomnia caused by anxiety

Adults: 1 to 3 mg twice daily or three times daily. Maximum 10 mg daily –> To treat insomnia caused by anxiety

Dosage adjustment: For elderly or debilitated patients, initial dosage may be reduced to 0.5 to 2 mg daily in divided doses

2. Treatment: Provide preoperative sedationĀ 

Dosage for Adults: 2 to 4 mg at bedtime

Dosage adjustment: For elderly or debilitated patients, dosage may be reduced

šŸ’ŠDosages for I.V InjectionĀ 

1. Treatment: Provide preoperative sedationĀ 

Adults: Initial : 0.044 mg/kg or 2 mg, whichever is less, given 2 hours before procedure. Maximum: 0.05 mg/kg or total 4 mg

2. Treatment: To treatĀ status epilepticus

Adult Initial: 4 mg at a rate of 2 mg/min. Repeated in 10 to 15 min if seizures don’t subside. Maximum: 8 mg/ 24 hour

One thought on “MEDMONDAY: Lorazepam

  1. Rishi says:

    Another consideration – an infusion of lorazepam (Ativan) can cause acidosis because of the preservative (propylene glycol). One of the many reasons why I hate benzo drips. šŸ˜‰

    Like

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