Article Contents ::
Details About Generic Salt :: Lorazepam
Main Medicine Class:: Nervous System Sub Medicine Class :: Anxiolytics
| 1C. ANTI-EPILEPTICS in 1. NERVOUS SYSTEM |
| LORAZEPAM |
| BENZODIAZEPINE | ANXIOLYTIC, ANTI-EPILEPTIC |
| also comes under 1B. Anxiolytics in 1. Nervous System, |
| PK: A: Prompt D: Neonates:0.76 L/kg, Adults:1.3 L/kg (Vd) M: Hepatic E: Urine & feces |
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Indications & Dose: ANTIEMETIC Adjuvant therapy PO/IV Adult 0.5-2mg q4-6h Child 0.05mg/kg (up to 2mg/dose)Prior to chemotherapy | ANXIETY Acute PO/IV/IM Child 0.05mg/kg/dose (range: 0.02-0.09 mg/kg) q4-8h | ANXIETY DISORDERS PO Adult 1-6mg/day in 2-3 divided doses with the largest dose at night, max 10mg/day Elderly 0.5-4mg/day; initial dose < 2mg | IV/IM Adult 25-30 µg/kg q6h | INSOMNIA ASSOCIATED WITH ANXIETY Acute Short-term therapy PO Adult 1–2mg HS | PANIC DISORDER Acute IV/IM Adult 25–30µg/kg (usual range 1.5–2.5mg), repeated q6h if necessary | PREMEDICATION PO Adult 2-3mg given night before the operation (may follow next morning by smaller dose if needed); Alternatively, 2-4mg 1-2h before an operation Child 1 month-12 yr: 50-100µg/kg 1h before an operation max 4mg (same dose may also be given the night before, in addition to, or to replace the dose before, the operation) | IV/IM Adult 50µg/kg 30-45min before the operation if given IV or 60-90min if given IM | SEDATION PO Adult 1-10mg/day in 2-3 divided doses; usual dose: 2-6mg/day in divided doses Elderly 0.5-4mg/day; initial dose < 2mg | PO/IV/IM Child 0.05mg/kg/dose (range: 0.02-0.09mg/kg) q4-8h | STATUS EPILEPTICUS IV Adult 4mg repeated once after 10mins if necessary Child <12 yr: 100µg/kg, max 4mg repeated once after 10mins if necessary |
| Contra: Hypersensitivity, myasthenia gravis, respiratory depression, glaucoma
Precautions: Respiratory disease, history of drug/alcohol abuse, elderly, renal/hepatic impairment, avoid prolonged use & abrupt withdrawal, acute porphyria ADR: Serious: Respiratory depression, hypotension, jaundice, Others: Drowsiness, fatigue, muscle weakness, ataxia, confusion, vertigo, constipation, blurred vision, insomnia, irritability, libido, urinary retention, phlebitis DDI: Serious Zidovudine causes headache, Loxapine causes significantly respiratory depression, Hormonal Contraceptives decreases drug effects, Alcohol effects is enhanced by drug, Probenecid/Fluvoxamine increases drug level, Rifampicin very marked increase in the metabolism and/or clearance of drug Others Valproic acid increases drug level Diet: With/without food Monitor: Anxiety, BP, respiratory & CV status |