Lorazepam

When ATH:
N05BA06

Characteristic.

Anxiolytic, benzodiazepine derivative.

Almost white powder, very poorly soluble in water.

Pharmacological action.
Anxiolytic, sedation, snotvornoe, miorelaksiruyuschee, central, anticonvulsant.

Application.

Neuroses, accompanied by anxiety, emotion, incl. generalized anxiety disorder, post traumatic stress disorder, Phobias, obsessive compulsive disorder, psihoreaktivnye state, emotional reactivity disorders, anxiety in depressive states of different genesis (usually, in combination with antidepressants), insomnia, psychosomatic disorders (incl. cardiovascular, gastrointestinal and other diseases), premedication before surgical and diagnostic procedures (in combination with analgesics), tension headache; nausea and vomiting, caused by chemotherapy, epilepsy (in a combination therapy), delirium tremens, and withdrawal syndrome in chronic alcoholism (in a combination therapy).

Contraindications.

Hypersensitivity, incl. other benzodiazepines, myasthenia, zakrыtougolynaya glaucoma, acute intoxication means, depressing the central nervous system, respiratory depression, hepatic failure, pregnancy (especially I trimester), lactation, Age to 18 years.

Restrictions apply.

Chronic respiratory failure, syndrome, sleep apnea, otkrыtougolynaya glaucoma, drug and alcohol addiction, depression (cm. Precautions), psychosis, expressed by the human kidney.

Pregnancy and breast-feeding.

Contraindicated in pregnancy (especially in the I trimester). At the time of treatment should stop breastfeeding.

Side effects.

From the nervous system and sensory organs: slackness, fatiguability, drowsiness, disorientation, headache, dizziness, depression, ataxia, sleep disturbance, ažitaciâ, blurred vision, episodes of amnesia.

From the digestive tract: dry mouth, nausea, vomiting, diarrhea, change in appetite.

For the skin: эritema, hives.

Other: changes in the composition of blood (leukopenia), LDH increase.

Perhaps the development of addiction, Drug Dependence, withdrawal, rebound-синдрома (cm. Precautions).

Cooperation.

Alcohol and means, CNS depressants (incl. fenotiazinы, narcotic analgesics, barbiturates), Antidepressants increase the neurotrophic activity. In an application with alcohol in addition to increased inhibitory effect on the central nervous system may be paradoxical reactions (psychomotor agitation, violent behavior, the state of pathological intoxication). Oral contraceptives reduce the concentration in the blood lorazepam. Nicotine inhibits the activity of lorazepam (accelerates its metabolism).

Lorazepam potentiates the effect of general and local anesthetics, enhances the effect of drugs curariform.

Overdose.

Symptoms: drowsiness, gipotenziya, confusion, oppression reflexes, coma.

Treatment: induction of vomiting, gastric lavage, / in the introduction of norepinephrine to increase blood pressure, simptomaticheskaya therapy, monitoring vital functions. The introduction of a specific antidote - benzodiazepine receptor antagonist flumazenil (in hospital).

Dosing and Administration.

Inside. The dosage regimen and duration of treatment strictly individually set.

In neurological practice - for 1 mg 2-3 times a day; in psychiatric practice - 4-6 mg / day; insomnia - 1-2 mg for 30 minutes before sleep. In elderly and debilitated patients, the dose should not exceed 2 mg / day (in divided doses). In patients with diseases of the liver and / or kidney, and in patients with cerebral sclerosis, gipotenzieй, Heart Failure, underweight dose adjustment is recommended.

Precautions.

To apply caution in patients with depression, taking into account the risk of suicide. Patients with drug and alcohol used under close medical supervision.

Side effects are usually observed at the start of therapy. Consideration should be given to more frequent occurrence of side effects in the elderly and debilitated patients.

During treatment and for 2 days after the end should be deleted reception alcohol; drivers of vehicles and people, whose work requires quick mental and physical reactions, and is associated with high concentration of attention, during this period should not engage in professional activities.

Prolonged use may cause addiction, as well as drug dependence (especially when high doses). In this connection should not be used longer than lorazepam 4-6 weeks. If necessary, long-term treatment should be done periodically week breaks in the employment drug. In a dramatic treatment, you may experience withdrawal symptoms (tremor, convulsions, abdominal or muscle spasms, vomiting, evaporated), it is also possible occurrence of symptoms, similar to the symptoms of the disease (alarm, ažitaciâ, irritability, emotional stress, insomnia, convulsions).

Prolonged use should be periodically monitored picture peripheral blood, liver and kidney function.

Cautions.

It should be taken into account, that anxiety or stress, associated with daily stress, usually does not require treatment with anxiolytics.