Description overdue on 22.01.2012

Tranquillizer . anxiolytic . It has a hypnotic, sedative, muscle relaxant, anksiliticheskim, anticonvulsant effects. The mechanism of action of the drug is based on the strengthening of the inhibitory effects of GABA neurotransmitter in the transmission of impulses along the nerve roots. The drug stimulates the benzodiazepine receptor allosteric center, reduces the excitability of the subcortical structures of the brain (hypothalamus, limbic system , Thalamus), inhibits spinal, polysynaptic reflexes. Anxiolytic effects   caused by exposure to   amygdala   in the limbic system, the reduction of emotional stress, weakening the feelings of anxiety, worry and fear. Sedation   due to the influence on the non-specific thalamic nuclei,   reticular pharmacy   the brain stem, that the leads to a decrease expressiveness of neurologic symptomatology (fear, anxiety). Hypnotic effect   It is achieved through inhibition of reticular cells pharmacy in the brain stem. Providing enhanced presynaptic inhibition achieved anticonvulsant effect. The drug does not relieve the excitement in the hearth, but inhibits the spread epileptogenic activity . Miorelaksiruyuschee action central genesis arises as a result inhibitions of spinal, polysynaptic, of afferent retarding tract. Allowed direct inhibition of motor nerve functions of the muscular system. The drug does not affect the psychotic symptoms ( hallucinations   and affective disorder ), In rare cases recorded a decrease of severity of delusional disorders, affective tension. Lorazepam is available in the form of pills.

Indications:

Lorazepam is prescribed for neuroses   and anxiety states, if somatic disorders , Deterioration of of sleep, increased irritability. In the combined therapy drug used for anxiety caused by depression. The drug is effective in psychosomatic disorders, katotonicheskih, manic states, endogenous psychosis, withdrawal symptoms, drug addiction, alcohol delirium. In practice anesthetics used for premedication . The drug is prescribed in essential, senile tremor, while rigidity of muscles, muscle cramps, contractures (trauma, arthritis, Moise), tetanus, athetosis .

Contraindications:

Lorazepam is not prescribed for angle-closure glaucoma, myasthenia   severe intolerance to benzodiazepines, acute drug intoxication, drug addiction, alcohol. The drug is contraindicated in severe COPD, pregnancy, acute respiratory failure, breastfeeding, sleep apnea syndrome . When cerebral ataxia, renal insufficiency, hepatic systems spinal ataxia , Severe depression, with organic brain diseases, hyperkinesis, psychosis, sleep apnea, gipoproteinemii   administered with caution. Paediatric use after reaching 12 years of age.

Side effect:

Nervous system : Ataxia, emotional dullness, lethargy, poor concentration, fatigue, hypersomnia. Rarely observed extrapyramidal disorder . catalepsy , Sputannots consciousness   ecmnesia , Depressed mood, myasthenia gravis, paradoxical reactions (severe agitation, hallucinations, confusion, muscle spasm, suicidal tendencies, outbursts of aggression, fear). Senses : Violations of of visual perception, diplopia . Organs of hematopoiesis Neutropenia, anemia. Digestive system : Jaundice, increased liver transaminases, dry mouth, diarrhea, decreased appetite. Genito-urinary system : dysmenorrhea , Decreased libido, a pathology of the renal system, the delay urination, urinary incontinence . Lorazepam has teratogenic effects on the fetus, the use of breastfeeding causes suppression of sucking reflex in a child, disturbed breathing. It noted the development of drug dependence, drop in blood pressure, depression of the respiratory center. Withdrawal is accompanied by feelings of fear, dysphoria , Myalgia, sweating, tremor.

Overdose:

Confusion, reduced reflexes, paradoxical agitation, confusion, excessive sleepiness, nystagmus , Ataxia, ataxophemia , Deep sleep, tremor, coma , Depression of cardiac and respiratory systems, collapse , Drop in blood pressure, shortness of breath, bradycardia . It is recommended to conduct an emergency forced diuresis , Used as an antidote flumazenil. Hemodialysis is not effective.

Mode of application:

Lorazepam take three times a day for 1 mg. For the hypnotic effect of the drug taking half an hour before going to sleep at a dose of 1-2 mg. When anxiety and increased excitability take up to 6 mg per day. In order lorazepam premedication administered one hour before surgery at a dose of 2, 5-5 mg for children the dosage is calculated according to the following scheme: 0, 05 mg / kg. For the prevention of of risk of development convulsive syndrome cancellation of of a medicament should be carried out gradually. Duration of treatment - no more than 7 days. Patients with abnormal renal, hepatic dosing system is reduced.

Special instructions:

Patients with from cerebral sclerosis , Arterial hypotension, with reduced body weight, with chronic heart failure requires correction dosing regimen. In the period of treatment is strictly forbidden welcome alcoholic beverages. Taking large dosages for a long time causes formation drug dependence . It is unacceptable abrupt discontinuation of the drug lorazepam. The drug adversely affects the management of complex machinery, driving a vehicle, perform the complex work associated with concentration of attention.

Drug Interactions:

During the pre-medication Lorazepam may also have to decrease the dosage of fentanyl derivatives. The medicament reduces efficiency levodopa   at treatment patients with Parkinson . The drug increases the toxic effect zidovudine . Barbiturates, opioids, phenothiazines, antidepressants, MAO inhibitors   dampening effect on the nervous system, increase the neurotrophic activity. Narcotic analgesics increase the effect euphoria Causing increase in psychological dependence. Clozapine   It can cause respiratory depression when taken with the drug lorazepam.