Lorazepam (Ativan)

Question 1

Lorazepam Classification

Answer 1

Anticonvulsant/Sedative/Hypnotic/Benzodiazepine

Question 2

Lorazepam Mechanism

Answer 2

Positive allosteric modulator for GABA receptors -> Binds to benzodiazepine receptor site Cl- channels and potentiates binding and effects of GABA -> increased Cl- concentration = hyperpolarization of the cell

Question 3

Lorazepam Pharmacokinetics

Answer 3

Onset: 1-5min IV, 15-30min IM
Peak Effects: 15-20min IV, 2h IM
Duration: 6-8h
Half Life 10-20h

Question 4

Lorazepam Indications

Answer 4

• Major Motor Seizures
• Acute Anxiety
• Premed for cardioversion or TCP
• EtOH withdrawal or delirium tremens
• Post intubation sedation

Question 5

Lorazepam Contraindications

Answer 5

Hypersensitivity

Question 6

Lorazepam Side Effects/Adverse Reactions

Answer 6

Hypotension, drowsiness, amnesia, respiratory depression, AMS, blurred vision, N/V

Question 7

Lorazepam Dose

Answer 7

Adult:
Seizure: 4mg IV IO
Premed/anxiety/withdrawal: 0.5-2mg slow IV IO: 1-4mg IM
Post intubation sedation: 2-4mg slow IV IO q5-10min

Pedi:
0.05mg/kg slow IV IO

Question 8

Lorazepam Precautions

Answer 8

• May cause CNS depression and respiratory depression

- Caution with EtOH intoxication

Question 9

Lorazepam Drug Interactions

Answer 9

Additive effects with CNS deppressants and EtOH