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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