Lorazepam: Difference between revisions

Line 3:

'''Lorazepam''' (trade name '''Ativan''') is ~~an intermediate-duration~~ [[psychoactive]] substance of the [[chemical class::benzodiazepine]] class ~~which produces [[anxiolytic]], [[sedative]], [[hypnotic]], [[muscle relaxant]], [[anticonvulsant]], [[Nausea suppression|anti-nausea]], [[psychoactive class::depressant]] and [[amnestic]] effects~~. ~~This compound~~ is used for the short-term treatment of [[Anxiety|anxiety]], [[insomnia]], [[seizure|acute seizures]], and the sedation of hospitalized patients.<ref>Benzodiazepines and their effects | http://www.benzo.org.uk/hindmarch.htm</ref><ref>An Economic Evaluation of Propofol and Lorazepam for Critically Ill Patients Undergoing Mechanical Ventilation (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2763279/</ref><ref>Status epilepticus: an evidence based guide (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1226249/</ref><ref>Pharmacological Management of Acute Agitation | http://link.springer.com/article/10.2165%2F00003495-200565090-00003</ref>

'''Lorazepam''' (trade name '''Ativan''') is a [[psychoactive class::depressant]] substance of the [[chemical class::benzodiazepine]] class. Lorzepam is used for the short-term treatment of [[Anxiety|anxiety]], [[insomnia]], [[seizure|acute seizures]], and the sedation of hospitalized patients.<ref>Benzodiazepines and their effects | http://www.benzo.org.uk/hindmarch.htm</ref><ref>An Economic Evaluation of Propofol and Lorazepam for Critically Ill Patients Undergoing Mechanical Ventilation (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2763279/</ref><ref>Status epilepticus: an evidence based guide (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1226249/</ref><ref>Pharmacological Management of Acute Agitation | http://link.springer.com/article/10.2165%2F00003495-200565090-00003</ref>

Users should note that that as with [[benzodiazepines]], [[Thienodiazepine#Discontinuation|the sudden discontinuation of thienodiazepines]] can be dangerous or even life-threatening for long-term or heavy users. As a result, individuals who are physically dependent on this substance are advised to [[taper]] their dose by gradually lowering the amount taken each day over a prolonged period of time instead of stopping use abruptly.<ref>Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain - Appendix B-6: Benzodiazepine Tapering | http://nationalpaincentre.mcmaster.ca/opioid/cgop_b_app_b06.html</ref>

It's worth noting that [[Benzodiazepine#Discontinuation|the sudden discontinuation of benzodiazepines]] can be potentially dangerous or life-threatening for individuals using regularly for extended periods of time, sometimes resulting in seizures or death.<ref>A fatal case of benzodiazepine withdrawal. (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/19465812</ref> It is highly recommended to [[taper]] one's dose by gradually lowering the amount taken each day for a prolonged period of time instead of stopping abruptly.<ref>Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain - Appendix B-6: Benzodiazepine Tapering | http://nationalpaincentre.mcmaster.ca/opioid/cgop_b_app_b06.html</ref>

==Chemistry==

Lorazepam is a drug of the [[benzodiazepine]] class. Benzodiazepine drugs contain a benzene ring fused to a diazepine ring, which is a seven membered ring with the two nitrogen constituents located at R1 and R4. Further, the benzodiazepine ring is bonded at R5 to a 2-chlorinated phenyl ring. R7 of the benzyl ring is also substituted with a chlorine group. Additionally, Lorazepam contains a hydroxy (OH-) group substituted at R3. It also contains an oxygen group double bonded to R2 of its diazepine ring to form a ketone. This oxygen substitution at R2 is shared with other benzodiazepine drugs with the suffix -azepam.

@@ Line 3: / Line 3: @@
 {{SubstanceBox/Lorazepam}}
-'''Lorazepam''' (trade name '''Ativan''') is an intermediate-duration [[psychoactive]] substance of the [[chemical class::benzodiazepine]] class which produces [[anxiolytic]], [[sedative]], [[hypnotic]], [[muscle relaxant]], [[anticonvulsant]], [[Nausea suppression|anti-nausea]], [[psychoactive class::depressant]] and [[amnestic]] effects. This compound is used for the short-term treatment of [[Anxiety|anxiety]], [[insomnia]], [[seizure|acute seizures]], and the sedation of hospitalized patients.<ref>Benzodiazepines and their effects | http://www.benzo.org.uk/hindmarch.htm</ref><ref>An Economic Evaluation of Propofol and Lorazepam for Critically Ill Patients Undergoing Mechanical Ventilation (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2763279/</ref><ref>Status epilepticus: an evidence based guide (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1226249/</ref><ref>Pharmacological Management of Acute Agitation | http://link.springer.com/article/10.2165%2F00003495-200565090-00003</ref>
+'''Lorazepam''' (trade name '''Ativan''') is a [[psychoactive class::depressant]] substance of the [[chemical class::benzodiazepine]] class. Lorzepam is used for the short-term treatment of [[Anxiety|anxiety]], [[insomnia]], [[seizure|acute seizures]], and the sedation of hospitalized patients.<ref>Benzodiazepines and their effects | http://www.benzo.org.uk/hindmarch.htm</ref><ref>An Economic Evaluation of Propofol and Lorazepam for Critically Ill Patients Undergoing Mechanical Ventilation (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2763279/</ref><ref>Status epilepticus: an evidence based guide (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1226249/</ref><ref>Pharmacological Management of Acute Agitation | http://link.springer.com/article/10.2165%2F00003495-200565090-00003</ref>
+Users should note that that as with [[benzodiazepines]], [[Thienodiazepine#Discontinuation|the sudden discontinuation of thienodiazepines]] can be dangerous or even life-threatening for long-term or heavy users. As a result, individuals who are physically dependent on this substance are advised to [[taper]] their dose by gradually lowering the amount taken each day over a prolonged period of time instead of stopping use abruptly.<ref>Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain - Appendix B-6: Benzodiazepine Tapering | http://nationalpaincentre.mcmaster.ca/opioid/cgop_b_app_b06.html</ref>
-It's worth noting that [[Benzodiazepine#Discontinuation|the sudden discontinuation of benzodiazepines]] can be potentially dangerous or life-threatening for individuals using regularly for extended periods of time, sometimes resulting in seizures or death.<ref>A fatal case of benzodiazepine withdrawal. (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/19465812</ref> It is highly recommended to [[taper]] one's dose by gradually lowering the amount taken each day for a prolonged period of time instead of stopping abruptly.<ref>Canadian Guideline for Safe and Effective Use of Opioids for Chronic Non-Cancer Pain - Appendix B-6: Benzodiazepine Tapering | http://nationalpaincentre.mcmaster.ca/opioid/cgop_b_app_b06.html</ref>
 ==Chemistry==
 Lorazepam is a drug of the [[benzodiazepine]] class. Benzodiazepine drugs contain a benzene ring fused to a diazepine ring, which is a seven membered ring with the two nitrogen constituents located at R<sub>1</sub> and R<sub>4</sub>.  Further, the benzodiazepine ring is bonded at R<sub>5</sub> to a 2-chlorinated phenyl ring. R<sub>7</sub> of the benzyl ring is also substituted with a chlorine group. Additionally, Lorazepam contains a hydroxy (OH-) group substituted at R<sub>3</sub>. It also contains an oxygen group double bonded to R<sub>2</sub> of its diazepine ring to form a ketone. This oxygen substitution at R<sub>2</sub> is shared with other benzodiazepine drugs with the suffix -azepam.