Lorazepam (Injectable)

Lorazepam is used in the treatment of a myriad of conditions associated with anxiety, sedation, and withdrawal.

Overview

Lorazepam works by accentuating the effect of GABA; a neurotransmitter naturally synthesized by the body. Gamma-aminobutyric acid is a chemical utilized by the nerves in the brain to communicate with one another, effectively reducing the activity of nerves in the central nervous system.

It is postulated that anxiety and other psychological disorders are characterized by excessive activity in the brain. Lorazepam and other benzodiazepines function by intensifying the effect of GABA in the brain, reducing activity, and ultimately producing a calming effect on the patient.

Comparatively, lorazepam is metabolized faster than other drugs in the benzodiazepine group. Ergo is relatively unlikely for its concentrations to reach toxic levels in the blood.

Conditions Treated

  • Anxiety
  • Insomnia
  • Nausea and vomiting in patients undergoing chemotherapy
  • Convulsive disorders such as status epilepticus
  • Pre-sedation before surgery
  • Alcohol withdrawal treatment

Type Of Medicine

Central nervous system depressants of the Benzodiazepine family.

Side Effects

Most drugs if not all are accompanied by unwanted effects. These side effects are heavily documented to aid warn the patient if they occur. Not all reported side effects are experienced by every patient. Some patients report no adverse reactions to a drug. Notwithstanding it is crucial to promptly inform your healthcare provider if you register any of the symptoms listed below.

Among the more common side effects of lorazepam are:

  • Unusual drowsiness and sleepiness
  • Blurred vision
  • Loss of coordination
  • Faintness, dizziness or lightheadedness when rising from a lying or sitting position abruptly
  • Shortness of breath
  • Laboured breathing
  • Blue lips, skin, or fingernails
  • Irregular breathing
  • Excessive sweating
  • Sedation
  • Unsteadiness

It is vital to remember that a doctor has made a prescription based on weighing the consequences of the drug against the expected merits.The least common side effects of lorazepam are as listed below.

  • Cessation of breathing
  • Chronic sleepiness
  • Dwindling responsiveness and awareness
  • Nausea

Sporadically, the undesirable effects of a drug may be severe and in need of immediate medical attention. The severe side effects of a drug are infrequent and only happen in isolated incidences. It is critical to inform your health care professional if you experience the following side effects:

  • Lumbago, ( lower back pain)
  • Fever or chills
  • Incessant urge to urinate
  • Convulsions
  • Blood stained or cloudy urine
  • Dementia
  • Delusions
  • Headaches
  • Loss of consciousness
  • Sleep apnea
  • Fast paced breathing accompanied by dizziness
  • Changes in consciousness
  • Extremely shallow breathing

Some side effects are isolated at the injection site where the drug was intravenously administered. If you experience any of the side effects listed below, immediately contact your doctor for further remediation of the problem.

  • Bleeding
  • Burning
  • Skin discoloration
  • Infalamttion
  • Itching
  • Infection such as a persistent cough or a sore throat
  • Coldness
  • Pain
  • Rash
  • Scarring
  • Soreness
  • Stinging
  • Swelling
  • Tingling
  • Ulceration
  • Warmth around the injection site
  • Feeling of pressure
  • Hives
  • Tenderness

Some side effects that ensue after the administration of lorazepam do not require the attention of a medical practitioner. These side effects usually subside during treatment as the body steadily acclimatizes to the use of the drug. One such side effect is;
General lethargy

A severe allergic reaction to lorazepam is hugely uncommon but possible. Signs of severe allergic reaction to the medicine are;

  • Skin Iritation And Itching
  • Inflammation Of The Face, Tongue An Throat
  • Faintness
  • Laboured breathing

It is prudent to mention the occurrence of any symptom apart from those that are desired. Your medical provider may be able to advise ways to prevent, alleviate and reduce some the side effects you may encounter. Immediately check with your doctor the minute any side effects develop or if you have any questions regarding the possible side effects of lorazepam.

Dosage

Lorazepam can only be taken with the prescription of a healthcare professional. A doctor is tasked with the duty to weigh the intended and desired effects of lorazepam against its known adverse results before making a prescription and subsequently deciding on an appropriate dosage.

The dosage of lorazepam is dependent on the health condition of the patient at the time of administration, the condition for which it is to be treated, and the age of the patient. Expertly, the dosage of lorazepam is tailored to the patient's needs.

As with all prescription drugs it is core to strictly adhere to the instructions of both the manufacturer of the medicine and the attending healthcare professional.

Lorazepam should only be taken under a doctor's prescription. This translates to mean that patients should not take more than is required either in frequency or amount. Lorazepam has the potential to be addictive, and thus one should not take more than is needed. Lorazepam overdose is often lethal.

Additionally, patients should not share lorazepam prescriptions with others. The sharing of lorazepam is illegal.

The following are the standard approved dosage of lorazepam, Intravenous administration for adults based on the different medical conditions for which lorazepam is used. Lorazepam is not recommended for the use of children below 18 years of age.

Anxiety:
Lorazepam is used for the control of anxiety disorders, the alleviation of short-term anxiety or the anxiety associated with depressive symptoms.

2mg total, or dosage of 0.044mg/kg per day. This dosage is administered into the body intravenously through the use of injection.

Light Anesthesia:
Lorazepam is used as a pre-anesthetic medication for adult patients. It causes sleepiness |(sedation), alleviate anxiety, and generates a decreased ability to recollect the affairs and activities associated with the day of a surgical procedure. This medicine is given by a nurse or medical professional.

Lorazepam is administered parenterally. The two routes of administration both require the use of injection.

Intramuscular injection: delivers medicine deep into the muscles. The standard dose of lorazepam as a preanesthetic medication is 0.05mh/kg with a strict maximum of 4mg. For optimum effects, lorazepam should be administered two hours before the surgical procedure
.
Intravenous injection: delivers medicine through, a vein, straight into the bloodstream the standard dosage is a total of 2mg or 0.044mg/kg. For optimal effects, lorazepam should be administered 15 to 20 minutes before the operative procedure.

Status Epilepticus

Lorazepam is used in the treatment and management of convulsive disorders such as status epilepticus in adults. Lorazepam is customarily administered intravenously through injection, however, in the event an IV port is unavailable, the intramuscular route is used. During administration, vital signs should be monitored, and the airways should remain clear and unobstructed.

0.1mg/kg up to 4mg dose is given intravenously. The treatment may be repeated if need be in 5 to 10 minutes. A maximum of 8mg daily should not be surpassed.

Interactions

Some medicine should not be used together lest their interaction have counterproductive effects. Conversely, some drug interactions are synergetic and may amplify the impact of another. In case of the former, doctors may require modifying your dosage with significance to the amount and frequency of administration.

All benzodiazepines intensify the effects of drugs that reduce the processes and activities of the brain (central nervous system depressants). These agents range from commercially available alcohol, barbiturates, narcotics, to tranquilizers, opioids, other analgesics, and benzodiazepines.

Furthermore inform your doctor whether you are taking drugs such as antihistamines such as cetrizine, cough syrups such as hydrocodone, sleeping pills such as diazepam, marijuana, muscle spasm relievers. These may cause extreme lethargy.

The coupling of lorazepam and the drugs as mentioned earlier lead to excessive sedation.

  • Barbiturates
  • Amobarbital
  • Butabarbital
  • Butalbital
  • Mephobarbital
  • Pentobarbital
  • Phenobarbital
  • Secobarbital

Tranquilizer

  • Loxapine

Opiod/ synthetic analgesics

  • Alfentanil
  • Anileridine
  • Buprenorphine
  • Butorphanol

Other benzodiazepines

  • Bromazepam
  • Buprenorphine

Some drugs used in combination increases the likelihood of the occurrence of side effects. Your doctor should be able to tweak your dosage to minimize side effects in case the following drugs are too prescribed to one patient:

  • Valproic acid
  • St John's Wort
  • Posaconazole
  • Probenecid
  • Theophylline
  • Pyrimethamine

Lorazepam has no known interactions with food. However, taken in combination with a depressant such as alcohol can cause extreme lethargy.

Warnings

Before the use of lorazepam divulge your medical history information, to inform him especially if you have or have been treated for the following conditions

Before taking lorazepam inform your healthcare professionals if you have any allergies to benzodiazepines such as diazepam or alprazolam. This medication may constitute docile ingredients which can cause allergic reactions nonetheless.

Lorazepam causes drowsiness, dizziness and occasional blurred vision in some patients. Driving or operation of heavy machinery should be limited until you are confident of how you react to lorazepam. Furthermore, avoid alcohol and tobacco. Inform your doctor when you begin experiencing hallucinations.

The elderly are more prone to the adverse effects of this medicine, and in some cases, lorazepam may have the opposite effect in the elderly. It may aggravate anxiety instead of alleviating. It may cause mood changes, loss of coordination, hallucinations, sleep disturbances, increased sexual interest and increased the risk of injury through falls.

Lorazepam is reported to cause disruptions in fetal development such as congenital conditions, and thus this medication is not recommended for pregnant women. Inform your doctor if you are pregnant or planning on getting pregnant. Inform your doctor if you notice symptoms in your newborn such as incessant crying, problems feeding and slow breathing.

Lorazepam transfers into breast milk and is therefore not recommended for lactating mothers. Consult your medical professional if you are breastfeeding.