MED Lorazepam - ATI medications sheet PDF

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ATI medications sheet...

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ACTIVE LEARNING TEMPLATE:

Medication

Fullerton STUDENT NAME Kira _____________________________________ MEDICATION Lorazepam __________________________________________________________________________

REVIEW MODULE CHAPTER ___________

analgesic adjuncts antianxiety agents CATEGORY CLASS benzodiazepines/ ______________________________________________________________________ PURPOSE OF MEDICATION

Expected Pharmacological Action Depresses the CNS, probably by potentiating GABA, an inhibitory neurotransmitter. PO Anxiety disorder. IM IV. Status epilepticus, Preanesthetic to produce sedation, decrease preoperative anxiety and induce amnesia.

Therapeutic Use Sedation. Decreased anxiety. Decreased seizures.

Complications CNS: dizziness, drowsiness, lethargy, hangover, headache, ataxia, slurred speech, forgetfulness, confusion, menta depression, rhythmic myoclonic jerking in pre-term infants, paradoxical excitation CV: rapid IV use only: APNEA, CARDIAC ARREST, bradycardia, hypotension Derm: rash EENT: blurred vision GI: constipation, diarrhea, nausea, vomiting, weight gain (unusual) Resp: respiratory depression Misc: physical dependence, psychological dependence, tolerance

Medication Administration IM (Adults): 0.05 mg/kg (not to exceed 4 mg) 2 hr before surgery. IV (Adults): 0.044 mg/kg (not to exceed 2 mg) 15– 20 min before surgery. PO (Adults): Anxiety– 1– 3 mg 2– 3 times daily (up to 10 mg/day). Insomnia– 2– 4 mg at bedtime. PO (Geriatric Patients or Debilitated Patients): Anxiety– 0.5– 2 mg/day in divided doses initially. Insomnia– 0.25– 1 mg initially as needed.

Contraindications/Precautions Hypersensitivity; Cross-sensitivity with other benzodiazepines may exist; Comatose patients or those with pre-existing CNS depression; Uncontrolled severe pain; Angle-closure glaucoma; Severe hypotension;

Interactions Use with opioids or other CNS depressants, including other benzodiazepines, non-benzodiazepine sedative/hypnotics, anxiolytics, general anesthetics, muscle relaxants, antipsychotics, and alcohol may cause profound sedation, respiratory depression, coma, and death; reserve concurrent use for when alternative treatment options are inadequate. May the efficacy of levodopa. Smoking may metabolism and effectiveness.

Evaluation of Medication Effectiveness Increase in sense of well-being. Decrease in subjective feelings of anxiety without excessive sedation. Reduction of preoperative anxiety. Postoperative amnesia. Improvement in sleep patterns.

ACTIVE LEARNING TEMPLATES

Nursing Interventions Lab Test Considerations: Patients on high-dose therapy should receive routine evaluation of renal, hepatic, and hematologic function. Toxicity Overdose: If overdose occurs, flumazenil (Romazicon) is the antidote. Do not use with patients with seizure disorder. May induce seizures.

Client Education Instruct patient to take medication exactly as directed and not to skip or double up on missed doses. If medication is less effective after a few wk, check with health care professional; do not increase dose. Advise patient that lorazepam is usually prescribed for short-term use and does not cure underlying problem. Advise patient to decrease lorazepam dose gradually to minimize withdrawal symptoms; abrupt withdrawal may cause tremors, nausea, vomiting, and abdominal and muscle cramps. Teach other methods to decrease anxiety, such as increased exercise, support groups, relaxation techniques. Emphasize that psychotherapy is beneficial in addressing source of anxiety and improving coping skills.

THERAPEUTIC PROCEDURE

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