Lorazepam is a tranquilizing drug used in managing anxiety, nausea and vomiting, insomnia, and seizures.
Lorazepam decreases anxiety. Doctors may order it to treat muscle spasms that may accompany severe pain. Lorazepam may also be given with other drugs to help control nausea and vomiting associated with cancer treatment. It may be given just prior to the administration of chemotherapy to decrease the chances of nausea and vomiting. Patients experiencing difficulty sleeping may receive lorazepam. It is sometimes given prior to surgery or other procedures to help the patient relax, feel drowsy, and decrease his or her memory about the procedure.
Lorazepam depresses the central nervous system when taken at the recommended dose.
Lorazepam may be given by mouth, injected into a muscle or administered through a vein. Patients should take the smallest dose possible that relieves symptoms. The dose should be adjusted, based on the patient's reaction to the drug. Between 0.5 mg and 1 mg of Lorazepam may be given every six to eight hours to aid in controlling treatment-related nausea and vomiting. When given prior to chemotherapy to decrease the risk of this side effect, 2 mg is usually administered a half-hour before treatment. An additional 2 mg may be given every four hours as needed. To control anxiety, 1 mg to 3 mg at two to three times per day is the typical dose. For sleep, patients may take from 2 mg to 4 mg at bedtime. Older or debilitated adults may be given 0.5 mg to 2 mg per day in divided doses. If a dose is missed, the patient should take it as soon as possible, but patients should not take two pills at the same time. This drug may be taken with or without food.
Lorazepam, like other drugs of this type, can create physical and mental dependence. Patients should not take more than the amount ordered and should not suddenly stop taking this medication. The amount taken should gradually be decreased, then discontinued. If the drug is abruptly stopped, the patient may experience agitation, irritability, difficulty sleeping, convulsions, and other withdrawal symptoms.
Patients allergic to this type of anti-anxiety drug should not take lorazepam. Those with narrow-angle glaucoma, pre-existing depression of the central nervous system, severe uncontrolled pain, or severe decrease in blood pressure should avoid taking it. This drug should be used cautiously in patients with kidney or liver disease, myasthenia gravis, lung disease, alcohol intoxication, or anyone with a history of drug abuse. This drug should not be given to children under 12. Children between 12 and 18 may receive the drug by mouth, but not through a vein. Pregnant women and those trying to become pregnant should not take lorazepam. This drug has been associated with fetal malformations when taken during the first three months of pregnancy. Patients taking this drug should not breast feed.
Drowsiness and sleepiness are common and expected effects of lorazepam. Patients should not drive or operate machinery or appliances while taking this drug. Patients older than 50 years of age may experience greater and longer sedation after receiving lorazepam.
Lorazepam may also make patients feel dizzy, weak, unsteady or clumsy. Less frequently, they may also feel depressed, disoriented, nauseous, or agitated while taking this drug. Other side effects include headache, difficulty sleeping, rash, yellowing eyes, vision changes, and hallucinations. Redness and pain may occur at the injection site. Patients may experience high or low blood pressure and partial blockage of the airway after an injection of lorazepam. Nausea, vomiting, dry mouth, and constipation may occur. Sex drive may decrease, but this side effect is reversible. Patients should alert their physician to any side effects of confusion, depression, excitation, depression, nightmares, impaired coordination, changes in personality, changes in urinary pattern, chest pain, heart palpitations, or any other side effects.
Alcohol and other central nervous system depressants can increase the drowsiness associated with this drug. Some over-the-counter medications depress the central nervous system. The herbal remedies kava and valerian may increase the effects of this type of drug. Patients should check with the doctor before starting any new medication. A patient's tolerance for alcohol will be diminished. Patients should refrain from drinking alcoholic beverages when taking lorazepam and for 24 to 48 hours after receiving an injection before a procedure.
When lorazepam is administered in a muscle or vein, it may interact with scopolamine, causing drowsiness, odd behavior, and hallucinations.
Debra Wood, R.N.
—Seeing or hearing things that are not present