Explore the Indications & Contraindications of Lorazepam #lorazepam #ativanlorazepam #youtuber #yt
In this video it is described that
Lorazepam is a Benzodiazepine medication developed by DJ Richards.
It went on the market in the United States in 1977.
Lorazepam has common use as the sedative and anxiolytic of choice in the inpatient setting owing to its fast (1 to 3 minutes) onset of action when administered intravenously.
Lorazepam is also one of the few sedative-hypnotics with a relatively clean side effect profile.
FDA-approved Indications of Lorazepam
• Short-term (4 months) relief of anxiety symptoms related to anxiety disorders
• Anxiety-associated insomnia
• Anesthesia premedication in adults to relieve anxiety or to produce sedation/amnesia
• Treatment of status epilepticus
Off-label (non-FDA-approved) Indications
• Rapid tranquilization of the agitated patient
• Alcohol withdrawal delirium
• Alcohol withdrawal syndrome
• Insomnia
• Panic disorder
• Delirium
• Chemotherapy-associated anticipatory nausea and vomiting (adjunct or breakthrough)
• Psychogenic catatonia
• Vertigo
Mechanism of Action
Lorazepam binds to benzodiazepine receptors on the postsynaptic GABA-A ligand-gated chloride channel neuron at several sites within the central nervous system (CNS).
It enhances the inhibitory effects of GABA, which increases the conductance of chloride ions in the cell.
This shift in chloride ions results in hyperpolarization and stabilization of the cellular plasma membrane.
Its inhibitory action in the amygdala is beneficial in anxiety disorders, while its inhibitory activity in the cerebral cortex is beneficial in seizure disorders.
Contraindications
Lorazepam is contraindicated in patients with an anaphylactic reaction to lorazepam, any component of the formulation, or other benzodiazepines (cross-sensitivity with other benzodiazepines may exist).
Lorazepam and other benzodiazepines should not be first-line agents for anxiety and other psychiatric disorder symptoms in the first and third trimesters of pregnancy.
Lorazepam and other benzodiazepines have an increased risk of abuse, misuse, and dependence; these medications are contraindicated in patients actively using illicit substances and drugs. Except for use in Alcohol withdrawal disorder symptoms and detoxification, lorazepam and other benzodiazepine are contraindicated in patients with a history of alcohol dependence and abuse and not in remission. Increased risk of fatality with the combined use of alcohol and lorazepam in overdose, including death.
Injection formulation contains polyethylene glycol, propylene glycol, or benzyl alcohol, so contraindications include hypersensitivity to these excipients. Extended-release capsules contain tartrazine; therefore, patients with a history of allergic reactions should avoid capsules.
Box Warning: Concomitant use of benzodiazepines with opioids can lead to sedation, severe respiratory depression, coma, and death. Avoid this combination.
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