LorazepamNursing considerations
Known brand names include Ativan.
A benzodiazepine (Schedule IV controlled substance) taken by mouth for anxiety, or given IV or IM to stop status epilepticus and to sedate patients before surgery.
Known brand names include Ativan.
A benzodiazepine (Schedule IV controlled substance) taken by mouth for anxiety, or given IV or IM to stop status epilepticus and to sedate patients before surgery.
Sources: [1]
High-alert medication (IV only). IV moderate sedation agents, with lorazepam named, are on the ISMP acute care high-alert list. Oral lorazepam for adults is not listed.
Sources: [1]
The label does not describe a narrow therapeutic index or direct dosing by measured blood levels of the drug.
Use with opioids can cause profound sedation, respiratory depression, coma, and death; limit doses and durations and monitor closely. Benzodiazepines carry risks of abuse, misuse, and addiction. Continued use causes physical dependence; abrupt stop or rapid dose cuts can cause life-threatening withdrawal, so taper gradually.
Flumazenil, a benzodiazepine receptor antagonist, can reverse sedation but is an adjunct to airway support, IV fluids, and other supportive care. It can trigger withdrawal and seizures, especially with long-term benzodiazepine use or mixed overdose with tricyclic antidepressants, and is contraindicated when a benzodiazepine is controlling a life-threatening condition such as status epilepticus.
Sources: [1]
Sources: [1]
Doses come from the FDA label. Study tool, not for clinical decisions.
No adjustment for single injected doses, but use caution with frequent doses over a short period. Propylene glycol and polyethylene glycol toxicity from the injection vehicle is more likely in renal impairment. For oral use, follow the usual precautions for impaired renal function.
Binds the benzodiazepine site on the GABA-A receptor complex and increases the affinity of GABA for its receptor, which strengthens inhibitory signaling. Effects include less anxiety, sedation, amnesia, and fewer seizures. It is conjugated to an inactive glucuronide excreted in urine, with a half-life of about 12 hours.