Drug monograph

Lorazepam Generic name: Lorazepam Brand names: Ativan Pharmacological category: Benzodiazepines Indications/uses: Management of anxiety disorders or short-term relief of the symptoms of anxiety or anxiety associated with depressive symptoms, Status epilepticus, preanesthesia Unlabeled uses: Alcohol detoxification; insomnia; psychogenic catatonia; partial complex seizures; antiemetic adjunct Mechanism of action: Binds to stereospecific benzodiazepine receptors on the postsynaptic GABA neuron at several sites within the central nervous system, including the limbic system, reticular formation. Enhancement of the inhibitory effect of GABA on neuronal excitability results by increased neuronal membrane permeability to chloride ions. This shift in chloride ions results in hyperpolarization (a less excitable state) and stabilization. Adverse reactions:

Central nervous system: Sedation Confusion, dizziness, akathisia, unsteadiness, headache, depression, disorientation, amnesia Respiratory: Respiratory depression Nasal congestion, hyperventilation, apnea Cardiovascular: Hypotension Dermatologic: Dermatitis, rash Gastrointestinal: Weight gain or loss, nausea, changes in appetite Neuromuscular & skeletal: Weakness

Warnings/precautions: Use with caution in elderly or debilitated patients, patients with hepatic disease (including alcoholics) or renal impairment. Use with caution in patients with respiratory diseaseCauses CNS depression (dose-related) resulting in sedation, dizziness, confusion, or ataxia which may impair physical and mental capabilities. Lorazepam may cause anterograde amnesia. Pregnancy category: D Breast-feeding/lactation: Crosses into breast milk Contraindications: Hypersensitivity to this drug or any component of its formulation (cross-sensitivity with other benzodiazepines may exist); acute narrow-angle glaucoma; sleep apnea (parenteral); intra-arterial injection of parenteral formulation; severe respiratory insufficiency (except during mechanical ventilation); pregnancy Dose: Infants and Children: Oral, I.V.: Usual: 0.05 mg/kg/dose (range: 0.02-0.09 mg/kg) every 4-8 hours Adults: Oral: 1-10 mg/day in 2-3 divided doses; usual dose: 2-6 mg/day in divided doses

Reference: lexi-comp Drug Guide