NCTI- Pharmacology- Drug List J- Lorazepam

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RunNickMarini
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18311
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NCTI- Pharmacology- Drug List J- Lorazepam
Updated:
2010-05-08 12:23:15
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NCTI Pharmacology Drug List Lorazepam
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NCTI- Pharmacology- Drug List J- Lorazepam
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  1. Lorazepam
    trade name
    Ativan
  2. Lorazepam
    class
    • Benzodiazepine
    • Sedative
    • Anti-anxiety (anxiolytic)
  3. Lorazepam
    mechanism of action
    Most potent of all Benzodiazepines; its effects (anxiolytic, sedative, hypnotic, and skeletal muscle relaxant) are all mediated by increasing the levels of the inhibitory neurotransmitter GABA. GABA works mostly at the hypothalamus, limbic system and thalamus in the brain.
  4. Lorazepam
    indications
    • 1. status epilepticus
    • 2. sedation prior to cardioversion/pacing
    • 3. anxiety
  5. Lorazepam
    contraindications
    • 1. pregnancy or nursing mothers
    • 2. Use with caution in shock, coma, acute alcohol intoxication, suicidal patients and those with depressed respirations.
  6. Lorazepam
    side effects
    CNS: Anterograde amnesia, drowsiness, sedation, dizziness/disorientation, confusion, Hallucinations (found frequently in elderly patients), restlessness

    Cardiovascular: hypertension or hypotension

    GI: nausea/vomiting, abdominal discomfort

    Other: depressed hearing
  7. Lorazepam
    precautions
    Use further care when administering Ativan to patients with renal or hepatic impairment; the elderly or debilitated; and those with psychosis
  8. Lorazepam
    interactions
    Alcohol, CNS depressants, and anticonvulsants may potentiate CNS depression; may also increase Dilantin levels; and smoking decreases sedative and anti-anxiety effects.
  9. Lorazepam
    routes
    IV, IO, IM, PR
  10. Lorazepam
    onset and duration
    Onset is 1-5 min IV, 15-30 min IM; peak effects in 15-20 mins IV, 2 hrs IM; duration 6-8 hours.
  11. Lorazepam
    dosages
    • Sedation for Cardioversion:
    • Adult: 2-4 mg IM, or 0.5-2 mg IV
    • Pediatric: 0.03 mg-0.05 mg/kg IV/IM/PR max dose of 4mg

    • Seizure Management:
    • Adult: 2 mg slow IV (1mg/min) – repeat half dose if needed in 2-5 mins
    • Pediatric: 0.1 mg/kg slow IV (over 2-5 mins); repeat half dose if needed in 2-5 minutes (Can be given PR to children if no IV obtained)

    Riverside County Protocol: Not in Riverside County Protocol
  12. Lorazepam
    notes
    Keep benzodiazepine antagonist (i.e. Romazicon) nearby; patient over 50 years of age have frequent incidents of psychosis with Ativan administration do exceed 2 mg initial dose

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