Mastering Lorazepam Dosages: Your Ultimate Guide! #lorazepamdosages #anxiety #benzodiazepine
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.
Administration
Lorazepam can be administered orally (0.5 mg tablet, 1 mg tablet, 2 mg tablet, oral concentrate solution 2 mg/mL, 1 mg extended-release capsule, 2 mg extended-release capsule, and 3 mg extended-release capsule). In addition, it can be administered via intravenous(IV) or intramuscular(IM) injection (2 mg/mL solution and 4 mg/mL solution). The onset of its action is 1 to 3 minutes if administered IV and 15 to 30 minutes if administered IM.
Anxiety Disorder
The initial starting dose is 2 to 3 mg orally; repeat the dose 2 to 3 times per day; the maximum recommended dosage is 10 mg daily.
Insomnia Due to Anxiety or Stress
In patients under 65 years of age, the dose is 0.5 to 2 mg orally at bedtime, and in patients over 65 years of age, the dose is reduced to 0.5 to 1 mg at bedtime.
Premedication for Anesthesia
If given IM, the dose is 0.05 mg/kg administered 2 hours before surgery (maximum dose 4 mg). If administered IV, the dose is 0.044 mg/kg, administered 15 to 20 minutes before surgery (maximum dose 4 mg). In patients older than 50 years of age, the maximum dosage is 2 mg.
Status Epilepticus
Administered IV, the dose is 0.1 mg/kg (maximum dose 4 mg), at a maximum rate of 2 mg per minute; may repeat in 5 to 10 minutes. Note: Must dilute dose with 1:1 saline. According to American Epilepsy Society guidelines, parenteral lorazepam is one of the first-line treatments for convulsive status epilepticus.
Agitation in the Intensive Care Unit (ICU) Patient (off-label use)
An IV Loading dose is 0.02 to 0.04 mg/kg (maximum single dose 2 mg); the Maintenance dose is 0.02 to 0.06 mg/kg every 2 to 6 hours as needed or 0.01 to 0.1 mg/kg per hour with a maximum dosing of less than 10 mg per hour.
Alcohol Withdrawal Delirium (off-label use)
IV dose is 1 to 4 mg every 5 to 15 minutes until the patient is calm; can repeat every hour as needed. IM dose is 1 to 4 mg every 30 to 60 minutes until the patient is calm; can repeat every hour as needed.
Alcohol Withdrawal Syndrome (off-label use)
According to ASAM (American Society of Addiction Medicine) clinical practice guidelines, lorazepam is one of the most frequently used drugs for managing alcohol withdrawal. The symptom-triggered regimen can be administered orally, intramuscularly, or intravenously at 2 mg to 4 mg per hour as needed; the severity assessment scale must determine the dose.
The fixed-dose regimen can be administered orally, intramuscularly, or intravenously at 2 mg every 6 hours for four doses, followed by 1 mg every 6 hours for eight additional doses. Note: Symptom-triggered regimen is preferable to the fixed-dose regimens; lower doses and shorter treatment duration are in order. Lorazepam is preferred in patients with cirrhosis.
Chemotherapy-associated Nausea and Vomiting (off-label use)
Lorazepam is used for breakthrough nausea/vomiting or adjunct to standard antiemetics. It can be given orally, intravenously, or sublingually at 0.5 to 2 mg every 6 hours as needed.
Psychogenic Catatonia (off-label use)
IM dose is 1 mg to 2 mg; clinicians can repeat the dose in 3 hours and then again in another 3 hours if the initial and subsequent doses are ineffective. It can be administered orally, intramuscularly, or intravenously; initially, 1 mg and may be repeated in 5 minutes if necessary. If the initial challenge is unsuccessful, one may increase the dose to 4 to 8 mg daily and continue treatment for up to 5 days.
Vertigo (off-label use)
According to the American Academy of Otolaryngology-Head and Neck Surgery((AAO-HNS), lorazepam (1-2 mg every 8 hours) is preferred when a rapid onset of action is required to relieve vertigo in Meniere's disease. However (AAO-HNS) doesn't endorse the use of benzodiazepines for the relief of vertigo in benign paroxysmal positional vertigo (BPPV).
Use in Specific Population
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