Name

lorazepam (Ativan®)

Class

Benzodiazepine

Sedative/Hypnotic

Description/Mechanism

Raises seizure threshold and stops active seizures by hyperpolarizing neural membranes via enhancement of GABA (an inhibitory neurotransmitter) activated chloride channels.

Onset

1-5 minutes

Duration

6-8 hours

Indications

Initial control of status epilepticus or severe recurrent seizures.

Anxiety

Contraindications

Hypersensitivity

Shock

Adverse Reactions

Respiratory depression

Bradycardia

Hypotension

Sedation

Ataxia

Psychomotor impairment

Confusion

Drug Interactions

Lorazepam may precipitate CNS depression and psychomotor impairment when the patient is taking CNS depressant medications.

Supplied

2 and 4 mg/ml concentration in 1 ml vials

Dose/Administration

Prior to IV administration, lorazepam must be diluted with an equal volume of sterile water or sterile saline. When given IM, lorazepam is not to be diluted.

Adult

IV/IM: 1-4 mg slow (over 2-10 min), may be repeated in 15-20 minutes. Max dose 8 mg.

Pediatric

IV/IO/IM 0.05 to 0.15 mg/kg slow (over 2 minutes). May repeat in 15-20 minutes to a max of 0.2mg/kg

Rectal dose: 0.1 - 0.2 mg/kg

Special Consideration

Pregnancy Safety: Category D

Monitor respiratory rate and blood pressure during administration.

Have suction and intubation equipment available.

Inadvertent intra-arterial injection may produce arteriospasm, resulting in gangrene that may require amputation.

Lorazepam expires in four weeks when not refrigerated.