Lorazepam (Ativan) #

Question 1

Class / Action

Answer 1

Anticonvulsant, Sedative, Anxiolytic / Binds to benzodiazepine receptors. Enhances GABA to produce sedation, relaxation of skeletal muscle, anti convulsion, and induced coma. Has amnesia effect.

Question 2

Onset / Duration of Action

Answer 2

ONSET: 1-5min IV; 15-30min IM
DURATION: 6-8hrs

Question 3

Indications

Answer 3

1. Procedural sedation
2. Anxiolysis
3. Status epilepticus

Question 4

Contraindications

Answer 4

1. Known sensitivity to benzodiazepines, polyethylene glycol, propylene glycol, or benzyl alcohol.
2. COPD
3. Hx of obstructive sleep apnea
4. Shock of any origin
5. Acute closed-angle glaucoma

Question 5

Precautions

Answer 5

1. Administer IV & IO Doses SLOWLY
2. Dilute with NS or D5W Prior to Administration
3. Repeat doses may be needed for management of status epileptics

Question 6

Dosage / Administration

Answer 6

1. Sedation/Anxiolysis:
   Adult & Peds: 0.05mg/kg IV/IO, MAX Single Dose 2mg
2. Seizures:
   Adult: 4mg IV/IO over 2-5min, Repeat in 10-15min; Can also be given IM or PR
   Peds: 0.1mg/kg SIVP over 1min, MAX Single Dose 4mg, May repeat x1

Question 7

Adverse Reactions

Answer 7

1. Headache
2. Amnesia
3. Dysarthria
4. Syncope
5. Tremors
6. Respiratory Depression
7. Paradoxical CNS Stimulation
8. HypOtension