Medication 7-110 - Ativan (Lorazapam)

CMH EMS & MIH Protocols

Scope of Practice:

• Registered Nurse
• Paramedic
• Community Paramedic

Route(s):

• IM/SQ, IV, PO, PR, SL,

Pharmacodynamics (class and mechanism of action):

• Sedative (Benzodiazepine: Binds to benzodiazepine receptor and enhances effects of GABA).
• Anticonvulsant (Skeletal muscle relaxant).

Pharmacokinetics:

• Half-life: 9-16 hours.
• Onset time:
• IM: 15-30 minutes.
• IV: 5 minutes.
• PO: 1 hour.
• Peak action time:
• IM/IV: 60-90 minutes.
• PO: 2 hours.
• Duration of action:
• IM/IV: 6-8 hours.
• PO: 12-24 hours.

• Peak	90	180	270	360	450	540	630	720	810	900	990	minutes
  Duration	90	180	270	360	450	540	630	720	810	900	990	minutes

Dosing:

• Refer to specific protocol(s) below for dose(s).

Indications:

• Protocol 2-198 - Cardiac Arrest.

Contraindications:

• Pregnancy and nursing.
• Sensitivity to benzodiazepines, polyethylene glycol, benzyl alcohol.
• COPD.
• Shock.
• Coma.
• Closed angle glaucoma.

Pregnancy Risk Factor:

• Category D
• Positive evidence of risk: There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Potential Incompatibilities:

• NA.

Precautions and Adverse Effects:

• Use caution with Suicidal Tendencies, Depressive Disorders, Psychosis, acute alcohol intoxication, renal or hepatic impairment, organic brain syndrome, myasthenia gravis, GI disorders, elderly or debilitated, limited pulmonary reserve.
• May cause apnea, Nausea, Vomiting, drowsiness, restlessness, delirium, anterior grade amnesia, weakness, unsteadiness, depression, sleep disturbances, confusion, hallucinations, Hypertension, hypotension, blurred vision, Abdominal Discomfort.

Antidote:

• Flumazenil.

Controlled Substance Information:

• Schedule IV
• Moderate potential for abuse. Abusing the drug may lead to moderate mental or physical addiction.
• DEA number: 2885.
• Narcotic: No.
• Street names: Control, Silence.

CMH Pre-Hospital Services Mission: "Provide safe, exceptional, and compassionate care to our communities with an emphasis on highly trained and empowered staff."

CMH Mobile Integrated Healthcare Mission: "Provide exceptional, compassionate, and patient-centered care by a mobile collaborative team to improve patient experience, improve quality outcomes, and reduce healthcare costs."

Polk, Hickory, Cedar, & St Clair County EMS Protocols is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.