Lorazepam (Ativan)

Question 1

Lorazepam (Ativan)

Class

Answer 1

• Benzodiazepine
• Sedative
• Anticonvulsant

Question 2

Lorazepam (Ativan)

Mechanism of action

Answer 2

• Anticonvulsant
• Suppresses propagation of sz activity
• Anxiolytic

Question 3

Lorazepam (Ativan)

Indications

Answer 3

• Initial control of status epilepticus or severe recurrent sz
• Severe anxiety
• Sedation
• OK for head injury

Question 4

Lorazepam (Ativan)

Contraindications

Answer 4

• Acute narrow angle glaucoma
• Coma
• Shock
• Suspected drug abuse

Question 5

Lorazepam (Ativan)

Adverse reactions

Answer 5

• Resp depression & apnea
• Drowsiness, sedation, confusion
• Hypotension, bradycardia
• Delerium, restlessness
• Psychomotor impairment
• Ataxia

Question 6

Lorazepam (Ativan)

Drug interactions

Answer 6

• May precipitate CNS depression if pt is already taking CNS depressants

Question 7

Lorazepam (Ativan)

Dosage & administration

Answer 7

When given IV or IO, must dilute with equal volume of NS.

• Adult:
  
  • 2-4 mg slow IV @ 2mg/min or IM
    
    • May repeat in 15-20 min to max dose of 8 mg
  • For sedation: 0.05 mg/kg IM up to 4 mg IM
• Ped:
  
  • 0.05 - 0.20 mg/kg slow IV, IO slowly over 2 min or IM
    
    • May repeat in 15-20 min to max dose of 0.2 mg/kg

Question 8

Lorazepam (Ativan)

Duration

Answer 8

• Onset: 1-5 min
• Peak: Varies
• Duration: 6-8 hours

Question 9

Lorazepam (Ativan)

Special considerations

Answer 9

• Pregnancy: Cat D
• Arterial injection may cause vasospasm and gangrene
• Monitor BP and resp
• Have advanced airway ready to go
• Expires in 6 weeks when not refrigerated