Ativan


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Ativan

 [at´ĭ-van]
trademark for preparations of lorazepam, an antianxiety agent, sedative, and anticonvulsant.

lorazepam

Apo-Lorazepam (CA), Ativan, Dom-Lorazepam (CA), Novo-Lorazem (CA), Nu-Loraz (CA), PHL-Lorazepam (CA), PMS-Lorazepam (CA), Pro-Lorazepam (CA)

Pharmacologic class: Benzodiazepine

Therapeutic class: Anxiolytic

Controlled substance schedule IV

Pregnancy risk category D

Action

Unknown. Thought to depress CNS at limbic system and disrupt neurotransmission in reticular activating system.

Availability

Injection: 2 mg/ml, 4 mg/ml

Solution (concentrated): 2 mg/ml

Tablets: 0.5 mg, 1 mg, 2 mg

Indications and dosages

Anxiety

Adults: 2 to 3 mg P.O. daily in two or three divided doses. Maximum dosage is 10 mg daily.

Insomnia

Adults: 2 to 4 mg P.O. at bedtime

Premedication before surgery (as antianxiety agent, sedative-hypnotic, or amnestic)

Adults: 0.05 mg/kg (not to exceed 4 mg) deep I.M. injection at least 2 hours before surgery, or 0.044 mg/kg (not to exceed 2 mg) I.V. 15 to 20 minutes before surgery. For greater amnestic effect, give up to 0.05 mg/kg (not to exceed 4 mg) I.V. 15 to 20 minutes before surgery.

Status epilepticus

Adults: 4 mg I.V. given slowly (no faster than 2 mg/minute). If seizures continue or recur after 10 to 15 minutes, repeat dose. If seizure control isn't established after second dose, other measures should be used. Don't exceed 8 mg in 12 hours.

Dosage adjustment

• Elderly or debilitated patients

Off-label uses

• Acute alcohol withdrawal syndrome

Contraindications

• Hypersensitivity to drug, other benzodiazepines, polyethylene or propylene glycol, or benzyl alcohol

• Acute angle-closure glaucoma

• Coma or CNS depression

• Hepatic or renal failure

Precautions

Use cautiously in:

• hepatic or renal impairment

• history of suicide attempt, drug abuse, depressive disorder, or psychosis

• elderly patients

• pregnant or breastfeeding patients.

Administration

• For I.V. use, dilute with equal volume of compatible diluent, such as normal saline solution or dextrose 5% in water. Keep resuscitation equipment and oxygen at hand.

Give each 2 mg of I.V. dose slowly, over 2 to 5 minutes. Don't exceed rate of 2 mg/minute.

• Don't give parenteral form to children younger than age 18.

Adverse reactions

CNS: amnesia, agitation, ataxia, depression, disorientation, dizziness, drowsiness, headache, incoordination, asthenia

CV (with too rapid I.V. administration): hypotension, bradycardia, tachycardia, apnea, cardiac arrest, cardiovascular collapse

EENT: blurred vision, diplopia, nystagmus

GI: nausea, abdominal discomfort

Other: increased or decreased appetite

Interactions

Drug-drug. CNS depressants (including antidepressants, antihistamines, benzodiazepines, sedative-hypnotics): additive CNS depression

Hormonal contraceptives: increased lorazepam clearance

Drug-herbs. Chamomile, hops, kava, skullcap, valerian: increased CNS depression

Drug-behaviors. Alcohol use: increased CNS depression

Smoking: increased metabolism and decreased efficacy of lorazepam

Patient monitoring

During I.V. administration, monitor ECG and cardiovascular and respiratory status.

• Monitor vital signs closely.

• Evaluate for amnesia.

• Watch closely for CNS depression. Institute safety precautions as needed to prevent injury.

Monitor for signs and symptoms of overdose (such as confusion, hypotension, coma, and labored breathing).

• Assess liver function tests and CBC.

Patient teaching

• Tell patient and family about drug's possible CNS effects. Recommend appropriate safety precautions.

• Explain that with long-term use, drug must be discontinued slowly (typically over 8 to 12 weeks).

• Instruct patient to avoid alcohol, because it increases drowsiness and other CNS effects.

• Caution patient to avoid smoking, because it speeds drug breakdown in body.

• Advise female patient to inform prescriber if she is pregnant or breastfeeding.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, herbs, and behaviors mentioned above.

Ativan

(ăt′ə-văn′)
A trademark for the drug lorazepam.

Ativan®

Lorazepam, see there.

Ativan

A brand name for LORAZEPAM.
References in periodicals archive ?
They also discovered that, in the lead up to his wife's death, Philip had researched the effects of the sedative and had made internet searches including, 'Would 100mg of Ativan be fatal?' And the word 'autopsy' searched along with 'toxicology.' Experts concluded that Philip had spiked Karissa's banana smoothie with the drug - not enough to make her overdose, but enough to make her drowsy and confused.
from the only a second ativan can begin to smudge the incriminating
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He too was started on both methadone and Ativan at the same dosages as his son and has experienced similar symptomatic relief of RLS without any side effects for the last 2 years.
The FBI said drugs shipped into the US included methylphenidate (sold as Ritalin); various anabolic steroids; alprazolam (sold as Xanax); diazepam (sold as Valium); lorazepam (sold as Ativan); clonazepam (sold as Klonapin); and others.
Jon Hamilton's story on Morning Edition featured a man who has had numerous medications to treat his major depression, which he rattled off: "Klonopin, Ativan, Valium, Xanax, Re-meron, Gabapentin, Buspar, and De-pakote." I heard this story in the car and thought to myself that only one of those eight drugs is considered to be an anti-depressant.
Ativan and Abilify were taken to suppress anxiety and depression.
Jackson was also given diazepam (Valium), lorazepam (Ativan) and midazolam (Versed) over 10 hours during the night and morning before his death.
As well as taking the liquid drug, which is not meant to be a sleep aid, the star was given diazepam (Valium), lorazepam (Ativan) and midazolam (Versed) during a 10-hour period throughout the night and morning leading to his death.
They said he told them that he had given two doses of lorazepam, also known as Ativan, trying to get him to sleep.
The hospice nurses tried giving my mother a chip of an Ativan tablet at bedtime.
He was given medications, including Norcuron, Versed, and Ativan, which rendered him motionless.