In patients older than 50 years of age, the maximum dosage is 2 mg.
If administered IV, the dose is 0.044 mg/kg, administered 15 to 20 minutes before surgery (maximum dose 4 mg). If given IM, the dose is 0.05 mg/kg administered 2 hours before surgery (maximum dose 4 mg). In patients under 65 years of age, the dose is 0.5 to 2 mg orally at bedtime, and in patients over 65 years of age, the dose is reduced to 0.5 to 1 mg at bedtime. The initial starting dose is 2 to 3 mg orally repeat the dose 2 to 3 times per day the maximum recommended dosage is 10 mg daily. The onset of its action is 1 to 3 minutes if administered IV and 15 to 30 minutes if administered IM. In addition, it can be administered via intravenous(IV) or intramuscular(IM) injection (2 mg/mL solution and 4 mg/mL solution).
Lorazepam can be administered orally (0.5 mg tablet, 1 mg tablet, 2 mg tablet, oral concentrate solution 2 mg/mL, 1 mg extended-release capsule, 2 mg extended-release capsule, and 3 mg extended-release capsule). Lorazepam is excreted primarily in the urine. Įxcretion: The elimination half-life is 14±5 hours, and clearance is 1.1☐.4 mL/min/kg. Lorazepam glucuronide is an inactive metabolite. Lorazepam undergoes direct glucuronidation without prior cytochrome p450 metabolism consequently, lorazepam can be used in patients with hepatic dysfunction with insignificant effects on the pharmacokinetics. Metabolism: Lorazepam is metabolized by conjugation in the liver and undergoes enterohepatic recirculation. Lorazepam crosses the blood/brain barrier freely by passive diffusion. Lorazepam has approximately 90% plasma protein binding. Lorazepam crosses the blood/brain barrier freely by passive diffusion.ĭistribution: The volume of distribution is 1.3 L/kg. The bioavailability of lorazepam is approximately 90%. Peak concentrations are attained two hours following oral administration. Its inhibitory action in the amygdala is beneficial in anxiety disorders, while its inhibitory activity in the cerebral cortex is beneficial in seizure disorders.Ībsorption: lorazepam is well absorbed after oral administration. This shift in chloride ions results in hyperpolarization and stabilization of the cellular plasma membrane. It enhances the inhibitory effects of GABA, which increases the conductance of chloride ions in the cell. Lorazepam binds to benzodiazepine receptors on the postsynaptic GABA-A ligand-gated chloride channel neuron at several sites within the central nervous system (CNS).
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