Where is lorazepam metabolized

L — Lorazepam O — Oxazepam T — Temazepam These do not have active metabolites, and the half-life remains relatively the same even in the setting of liver disease. Chapter Hypnotics and Sedatives. New York: McGraw-Hill; Accessed November 7, Bryan D. Latest posts by Bryan D. Related Posts. Go to Top. Metabolism: Metabolized in the liver to inactive metabolites. Excretion: Metabolites are excreted in urine as glucuronide conjugates.

Contraindications and precautions Contraindicated in patients hypersensitive to drug, other benzodiazepines, or its vehicle used in parenteral dosage form and in patients with acute angle-closure glaucoma. Use cautiously in patients with pulmonary, renal, or hepatic impairment and in elderly, acutely ill, or debilitated patients. Interactions Drug-drug. Antidepressants, antihistamines, barbiturates, general anesthetics, MAO inhibitors, narcotics, phenothiazines: Potentiates CNS depressant effects of these drugs.

Use together cautiously. Cimetidine, possibly disulfiram: Diminishes hepatic metabolism of lorazepam, which increases its plasma level. Avoid use together. Scopolamine: Combined use of parenteral lorazepam and scopalamine may cause an increased risk of hallucinations, irrational behavior, and increased sedation. Discourage use together. Alcohol use: Potentiates CNS depressant effects of alcohol.

Discourage alcohol use. Heavy smoking: Accelerates lorazepam metabolism, thus lowering clinical effectiveness. Discourage smoking. Adverse reactions CNS: drowsiness, amnesia, insomnia, agitation, sedation, dizziness, weakness, unsteadiness, disorientation, depression, headache. EENT: visual disturbances. GI: abdominal discomfort, nausea, change in appetite. Other: acute withdrawal syndrome after sudden discontinuation in physically dependent patients. Overdose and treatment Signs and symptoms of overdose include somnolence, confusion, coma, hypoactive reflexes, dyspnea, labored breathing, hypotension, bradycardia, slurred speech, and unsteady gait or impaired coordination.

Treatment requires support of blood pressure and respiration until drug effects subside; monitor vital signs. Mechanical ventilatory assistance via endotracheal tube may be required to maintain a patent airway and support adequate oxygenation. Flumazenil, a specific benzodiazepine antagonist, may be useful.

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