Lorazepam

Question 1

Lorazepam Trade Name?

Answer 1

Lorazepam (Ativan)

Question 2

Lorazepam Classification?

Answer 2

Benzodiazepine

Question 3

Lorazepam Mechanism?

Answer 3

Capital/Medscape/Statpearls:
Binds to specific sites on GABA-A receptors to potentiate the effects of GABA by increasing the frequency at which the chloride channel opens, leading to hyperpolarization of the neuronal membrane and reduced neuronal excitability. Its inhibitory action in the amygdala is beneficial in anxiety disorders, while its inhibitory activity in the cerebral cortex is beneficial in seizure disorders.

Question 4

Lorazepam Indications?

Answer 4

CT Protocols:
Seizure, Sedation, Anxiolytic, Alcohol withdrawal, Post-intubation sedation

Question 5

Lorazepam Contraindications?

Answer 5

Capital: Hypersensitivity, Respiratory insufficiency, Hypotension

Question 6

Lorazepam Side Effects/Precautions?

Answer 6

Capital: Dizziness, Drowsiness, Confusion, Hypotension, Nausea/vomiting, Respiratory depression

Question 7

Lorazepam Adult Dose?

Answer 7

CT Protocols:
Alcohol Withdrawal
1-2mg IV/IO(preferred) or IM/IN; may repeat once in 5 minutes
Bradycardia – Transcutaneous Pacing, Hyperthermia, Nerve Agent, Tachycardia - Cardioversion
1mg IV/IO, may repeat once in 5 mins OR 2 mg IM, may repeat once in 10 mins
CPAP / Bilevel PAP
0.5-1mg IV/IO may repeat once in 5 min OR 1-2mg IM may repeat once in 10 min
Poisoning/Substance Abuse/OD
1mg IV/IO, may repeat once in 5 mins OR 2 mg IM, may repeat once in 20 mins
Post Intubation Sedation
1-2 mg IV/IO every 15 minutes as needed (maximum 10mg)
Restraints
1 mg IV/IO, may repeat once in 5 mins or 2mg IM, may repeat once in 5 mins
Seizure
>39 kg: 4 mg IV/IO/IM every 5 mins to a total of 8 mg
≤39 kg: 2 mg IV/IO/IM every 5 minutes to a total of 8 mg
Traumatic Brain Injury
1mg IV/IO, may repeat once in 5 min OR 2 mg IM, may repeat once in 5 mins

Question 8

Lorazepam Pediatric Dose?

Answer 8

0.05-0.20 mg/kg IV/IO/IM repeated in 5-10 minutes; max 0.2 mg/kg

Question 9

Lorazepam Onset of Action?

Answer 9

StatPearls: 1-3 minutes IV; 15-60 minutes IM

Question 10

Lorazepam Duration of Action?

Answer 10

Statpearls: 8-12 hours

Question 11

Lorazepam Max Dose Adult/Pediatric?

Answer 11

10mg

Question 12

Lorazepam Routes of Administration?

Answer 12

IV/IO/IM

Question 13

Lorazepam How Supplied?

Answer 13

2mg/ml and 4mg/ml vials and ampules
Most potent of benzodiazepines
May be mixed with Haldol in same syringe for sedation of violent patients
Expires 6 weeks out of refrigeration