lorazepam (Ativan)

Class: Anticonvulsant and sedative

Description: Lorazepam is a benzodiazepine that's used as an anticonvulsant, sedative, and hypnotic.

Lorazepam has a shorter half-life than that of diazepam and its onset of action is about the same. Lorazepam is used to manage anxiety and stress.  It is also a good premedication for minor operative procedures and cardioversion because it induces amnesia, which eliminates the patient's recall of procedures.  Lorazepam is also used as an anticonvulsanct in pediatric patients because of its shorter half-life.

Onset: 1-5 minutes (IV), 15-30 minutes (IM)

Peak Effects: 15-20 minutes (IV), 2 hours (IM)

Duration: 6-8 hours

Half-Life: 10-20 hours

Indications: Lorazepam is used in major motor seizures, in status epilepticus, a premedication before cardioversion, and for acute anxiety states.

Contraindications: Hypersensitivity

Precautions: Lorazepam should be diluted with normal saline or D5W prior to administration.

May need additional doses because lorazepam is a short acting drug and seizure activity may recur.

Flumazenil (Romazicon)-benzodiazepine antagonist-should be available as an antidote.

Side Effects: hypotension, drowsiness, headache, amnesia, respiratory depression, blurred vision, nausea, and vomiting

Interactions: Effects of lorazepam can be addictive when used in conjunction with other CNS depressants and alcohol.

Dosage:  0.5-2.0mg IV

                  1.0-4.0mg IM

                  Lorazepam can be given rectally when an IV cannot be placed. Draw the medication up into a syringe and attach a small, red, rubber pediatric feeding tube and insert the feeding tube 2 to 4 cm into the rectum and administer the drug.

                  pediatric dosage: 0.05-0.10mg/kg (maximum of 4 doses)