Ativan (Lorazepam) Drug Information: Overdosage and Contraindications

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May 25, 2012

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Anxiety »

Generalized anxiety disorder facts

Generalized anxiety disorder (GAD) is a mood disorder that is characterized by multiple and/or nonspecific worries that interfere with the person's life in some way.
The most common anxiety disorders are specific phobias. Other anxiety disorders include social anxiety disorder, panic disorder, generalized anxiety disorder, obsessive compulsive disorder, and posttraumatic stress disorder.
GAD is quite common, affecting millions of people.
While there is no single cause of GAD, there are many factors that increase the risk of developing this disorder.
Signs and symptoms of anxiety can include those that are emotional or behavioral and ways of thinking that are responses to feeling as if one is in danger.
The similarities and differences in symptoms of anxiety in adults compared to children and adolescents depend on the diagnosis.
There seem to be gender d...

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OVERDOSE

In postmarketing experience, overdose with lorazepam has occurred predominantly in combination with alcohol and/or other drugs. Therefore, in the management of overdosage , it should be borne in mind that multiple agents may have been taken.

Symptoms

Overdosage of benzodiazepines is usually manifested by varying degrees of central nervous system depression ranging from drowsiness to coma. In mild cases, symptoms include drowsiness, mental confusion, paradoxical reactions, dysarthria and lethargy. In more serious cases, and especially when other drugs or alcohol were ingested, symptoms may include ataxia, hypotonia, hypotension, cardiovascular depression, respiratory depression, hypnotic state, coma, and death. MANAGEMENT

General supportive and symptomatic measures are recommended; vital signs must be monitored and the patient closely observed. When there is a risk of aspiration, induction of emesis is not recommended. Gastric lavage may be indicated if performed soon after ingestion or in symptomatic patients. Administration of activated charcoal may also limit drug absorption. Hypotension, though unlikely, usually may be controlled with norepinephrine bitartrate injection. Lorazepam is poorly dialyzable. Lorazepam glucuronide, the inactive metabolite, may be highly dialyzable.

The benzodiazepine antagonist flumazenil may be used in hospitalized patients as an adjunct to, not as a substitute for, proper management of benzodiazepine overdose. The prescriber should be aware of a risk of seizure in association with flumazenil treatment, particularly in long-term benzodiazepine users and in cyclic antidepressant overdose. The complete flumazenil package insert including CONTRAINDICATIONS, WARNINGS, and PRECAUTIONS should be consulted prior to use.