Lorapam Injection
Lorazepam
4mg/ml
Popular Pharmaceuticals Ltd.
| Pack size | 5 amps Pack |
|---|---|
| Unite Price | 75.28 BDT |
Indications
Lorapam Injection is used for:
Anxiety, Status epilepticus, Sedation, psychosomatic, organic or psychotic illness, insomnia associated with anxiety, nervousness, restlessness, nausea and vomiting, related to chemotherapy and anticonvulsants, and as a premedicant before dental or general surgery or prior to investigative procedures where there may be discomfort.
Adult Dose
Oral
Anxiety Disorders
Adult: 1-6 mg/day in 2 or 3 divided doses, up to 10 mg/day.
Insomnia associated w/ anxiety
1-4 mg/day at bedtime.
Premed in surgery
2-3 mg the night before operation, then a smaller dose in the morning if needed.
Parenteral
Preoperative Sedation, Anxiety Relief, & Anterograde Amnesia
0.05 mg/kg IM for 1 dose; 2 hours before surgery; not to exceed 4 mg (2 mg/dose in elderly), OR
0.044 mg/kg IV for 1 dose; 15-20 minutes before surgery; not to exceed 4 mg (2 mg/dose in elderly)
Status Epilepticus
Usual 4 mg/dose slow IV at 2 mg/min
If seizure persists after 5-10 min, administer 4 mg IV again
Anxiolytic/Sedation in ICU
Intubated and mechanically ventilated patients
0.02-0.04 mg/kg loading dose IV
0.02-0.06 mg/kg intermittent IV q2-6hr PRN, OR
0.01-0.1 mg/kg/hr continuous IV; not to exceed 10 mg/hr
Elderly: Half the usual adult dose or less.
Hepatic impairment: Mild to moderate: May require reduced doses. Severe: Contraindicated.
Child Dose
Status Epilepticus
Infants and children: 0.05-0.1 mg/kg IV over 2-5 minutes; not to exceed 4 mg/dose; may repeat q10-15min PRN
Alternatively, 0.1 mg/kg at slow IV rate not to exceed rate of 2 mg/min; not to exceed dose of 4 mg
Adolescents: 4 mg slow IV; if seizure persists after 10-15 minutes, administer 4 mg IV again
Renal Dose
Renal impairment
PO: Dose adjustment not necessary
IV/IM: Use with caution in mild-to-moderate impairment; not recommended in severe impairment or renal failure
Administration
May be taken with or without food.
Reconstitution: Dilute w/ an equal volume of compatible diluent (e.g. sterile water for inj, NaCl 0.9% inj, dextrose 5% inj).
Oral concentrate soln: Dose should be added to 30 mL or more of diluent (e.g. water, juice, carbonated or soda-like beverage) or to semi-solid food (e.g. applesauce, pudding).
Contra Indications
Severe hepatic impairment; respiratory depression; acute narrow-angle glaucoma; pregnancy and lactation.
Precautions
Patient w/ compromised pulmonary function (decreased reserve), myasthenia gravis, CV or cerebrovascular disease, impaired gag reflex; at risk of falls. Patient w/ history of alcohol or drug abuse and those w/ personality disorders. Not intended for treatment of primary depressive or psychotic disorders. It should not be administered by intra-arterial inj. Avoid abrupt withdrawal. Renal and mild to moderate hepatic impairment. Elderly or debilitated patients, childn. Pregnancy and lactation. Patient Counselling May impair ability to perform activities requiring mental alertness or physical coordination (e.g. driving, operating machinery) for 24-48 hr following admin of the drug. Monitoring Parameters Monitor resp and CV status, BP, heart rate, symptoms of anxiety, CBC and LFTs.
Lactation: Excreted in human breast milk; not recommended
Pregnancy-Lactation
Pregnancy category: D
Lactation: Excreted in human breast milk; not recommended
Risk of serious adverse effects, including CNS and respiratory depression, exist
Minor tranquilizers should be avoided in first trimester of pregnancy, due to increased risk of congenital malformations
Maternal use shortly before delivery is associated with floppy infant syndrome (good and consistent evidence)
Prenatal benzodiazepine exposure slightly increased oral cleft risk (limited or inconsistent evidence)
Interactions
Drugs that affect the CNS (e.g. barbiturates, phenothiazines, antidepressants, MAOIs) may have additive CNS effects. Scopolamine may increase sedation, hallucinations and irrational behaviour. May reduce sedative and anxiolytic effect w/ caffeine, theophylline or aminophylline. May increase plasma level w/ Na valproate or probenecid.
Side Effects
Side effects of Lorazepam :
Sedation, drowsiness, ataxia, dizziness, confusion, depression, unmasking of depression, hypotension, fatigue, muscle weakness, asthenia, transient anterograde amnesia or memory impairment, changes in vital signs (e.g. resp rate, BP). Thrombocytopenia, agranulocytosis, pancytopenia, hyponatraemia, disinhibition, euphoria, suicidal ideation, nausea, constipation, change in libido, impotence, decreased orgasm. Increase in bilirubin, liver transaminases or alkaline phosphatase.
Potentially Fatal: Resp depression.
Mode of Action
Lorazepam is a short acting benzodiazepine. It increases neuronal membrane permeability to Cl ions by binding to stereospecific benzodiazepine receptors on the postsynaptic GABA neuron w/in the CNS (including the limbic system, reticular formation) and enhancing the GABA inhibitory effects resulting in hyperpolarisation and stabilisation.
Note
Lorapam 4mg/ml Injection generic name is Lorazepam. Lorapam 4mg/ml Injection is manufactured by Popular Pharmaceuticals Ltd.Lorapam is availble in all over Bangladesh.
Mes BD drug index information on Lorapam Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.