ATIVAN 1. Name & class of drug – generic and trade name.

GENERIC NAME: Lorazepam BRAND NAME: Ativan CLASSIFICATION: CNS agent, anxyolytic, sedative-hypnotic, benzodiazepine 2. Dose range and routes for adult & geriatric client. PREPARATIONS: PO/IV/IM – (0.5, 1, 2) mg tablets, 2mg/ml oral sol’n, (2mg, 4mg)/ml injection DOSING: Antianxiety – PO – 2 – 6 mg/d in divided doses Insomnia – PO – 2 – 4 mg at bedtime Premedication – IM – 2 – 4 mg (0.05 mg/kg) at least 2 hours before surgery IV – 0.044 mg/kg up to 2 mg 15 – 20 min before surgery Status epilepticus IV – 4 mg injected slowly at 2 mg/min, may repeat dose once if inadequate response after 10 Mins. 3. Purpose prescribed. Underline reason your client is prescribed drug. THERAPEUTIC EFFECTS: antianxiety agent that also causes mild suppression of REM sleep, while increasing total sleep time USES: management of anxiety disorders and for short-term relief of symptoms of anxiety. Also used for preanesthetic medication to produce sedation and to reduce anxiety and recall of events related to day of surgery; for management of status epilepticus 4. Major side effects & drug interactions. DRUG INTERACTIONS: alcohol, CNS depressant, anticonvulsants, potential CNS depression. Cimetidine increases toxicity. Ativan may decrease antiparkinsonian effects of levodopa. May increase phenytoin levels. Smoking decreases sedative and antianxiety effects

HERBAL INTERACTIONS: kava-kava, valerian may potentiate sedation SIDE EFFECTS: drowsiness, sedation, dizziness, weakness, unsteadiness, depression, sleep disturbances, confusion, hallucinations, N/V 5. Nursing Implications & teaching. IMPLICATIONS: • Have equipment for maintaining patent airway immediately available before starting IV administration • IM or IV injection of 2 – 4 mg is usually followed by a depth of drowsiness or sleepiness that permits patient to respond to simple instructions whether pt appears to be asleep or awake • Supervise ambulation of elderly pts for atleast 8 hr to prevent falling and injury • Assess CBC and liver function tests periodically for pts on long-term therapy • Supervise pt who exhibits depression with anxiety closely, possibility of suicide exists, particularly when there is apparent improvement in mood TEACHING: • Do not drive or engage in dangerous activities until full effects of drug is known • Do not drink large amounts of coffee, antiolytic effect can be altered • Do not consume alcohol for at least 24 – 48 hours after an injection, avoid when taking orally • Notify Dr if daytime psychomotor function is impaired • Do not stop med abruptly, stop gradually to avoid withdrawal symptoms • Do not self medicate with OTC drugs