lorazepam
Apo-Lorazepam (CAN), Ativan,
Lorazepam Intensol, Novo-Lorazem
(CAN), Nu-Loraz (CAN)
Nursing Considerations
• Before starting lorazepam therapy in a
patient with depression, make sure he
already takes an antidepressant because of
increased risk of suicide in patients with
untreated depression.
• Use extreme caution when giving lorazepam
to elderly patients, especially those
with compromised respiratory function,
because drug can cause hypoventilation,
sedation, unsteadiness, and respiratory
depression.
• Use drug cautiously in patients with a history
of alcohol or drug abuse or a personality
disorder because of an increased risk
of physical and psychological dependence.
Also use cautiously in patients with severe
hepatic insufficiency or encephalopathy
because drug may worsen hepatic
encephalopathy.
• For I.M. use, inject lorazepam deep into
large muscle mass, such as gluteus maximus.
• For I.V. use, dilute lorazepam with equal
amount of sterile water for injection, sodium
chloride for injection, or D5W. Give
diluted lorazepam slowly, at no more than
2 mg/min.
• During I.V. use, monitor patient’s respirations
every 5 to 15 minutes and keep
emergency resuscitation equipment readily
available.
WARNING Monitor patient’s respiratory status
closely because drug may cause lifethreatening
respiratory depression.
• Because stopping drug abruptly increases
risk of withdrawal symptoms, expect to
taper dosage gradually, especially in
epileptic patients.
PATIENT TEACHING
• Instruct patient to take lorazepam exactly
as prescribed and not to stop without consulting
prescriber because of risk of withdrawal
symptoms.
• Advise patient to avoid hazardous activities
until drug’s CNS effects are known.
• Urge patient to avoid alcohol while taking
lorazepam because it increases drug’s CNS
depressant effects.
• Instruct patient to report excessive drowsiness
and nausea.
• Inform pregnant patient that lorazepam
therapy will need to be discontinued early
in third trimester to avoid possible withdrawal
symptoms in newborn.
