Lorazepam (Ativan)

Question 1

Classification

Answer 1

Benzodiazepine, anxiolytic, sedative

Question 2

Mechanism of Action

Answer 2

• Interacts with GABA-benzodiazepine, receptor complexes, (benzodiazepine agonist)
• Antianxiety effects
• Sedation
• Reducton of seizure activity

Question 3

Indications

Answer 3

• Status epilepticus
• Relief of severe anxiety
• Sedation prior to cardioversion or pacing

Question 4

Contraindications

Answer 4

• Hypersensitivity
• Altered LOC of unknown etiology
• Acute narrow angle glaucoma
• Patients with sleep apnea syndrome

Question 5

Adverse Effects

Answer 5

• Hypotension, bradycardia
• Dizziness, ataxia, fatigue, drowsiness, amnesia
• Respiratory depression, apnea

Question 6

Administration

Answer 6

• Seizures: 4 mg slow IV (2 mg/min) for patients 18+
• Sedation: 2 mg total (or 0.04 mg/kg) whichever is smaller.
• Anxiety: 2 mg total (or 0.04 mg/kg) whichever is smaller.

Question 7

Special Considerations

Answer 7

• Immedietely prior to IV use ativan must be diluted with equal volume of compatible solution. Contents should be mixed thoroughly by gently inverting the container repeatedly until a homogenous solution results. Do not shake vigorously as this will result in air entrapment. When properly diluted the drug may be injected directly into vein or into tubing of an existing IV infusion. The rate of injection should not exceed 2 mg/min.