로라제팜

동물 종별 용량

투여 경로

금기

• Hypersensitivity to benzodiazepines
• Severe respiratory insufficiency (unless mechanically ventilated)
• Glaucoma
• Significant liver disease
• Significant kidney disease
• Pregnant animals
• Lactating animals

이상반응

• Increased appetite
• Aggression
• Increased activity/excitement (paradoxical reaction)
• Vocalization
• Ataxia
• Somnolence
• Lethargy
• Disinhibition (potential emergence of aggression)
• Drowsiness
• Mild transient incoordination (ataxia)
• Tremor and inappetence (associated with acute withdrawal)

약물 상호작용

• CNS Depressants (opiates, barbiturates, sedatives, anticonvulsants) · Additive CNS effects
• Probenecid · Decreased renal clearance of lorazepam
• Scopolamine · Increased CNS depression, irrational behavior
• Theophylline · Decreased sedation from lorazepam
• Valproate · Increased lorazepam serum concentration
• Itraconazole · Inhibits the metabolism of lorazepam, potentially leading to increased plasma concentrations and prolonged sedation. · moderate
• Ketoconazole · May inhibit the metabolism of lorazepam, increasing the risk of toxicity. · moderate
• Other CNS Depressants · Additive CNS depression and sedation. · major

모니터링

• Clinical efficacy (seizure control or anxiety reduction)
• Adverse effects (CNS depression, paradoxical excitation, ataxia)
• Behavioral changes (watch for paradoxical aggression or extreme sedation)
• Liver enzymes (ALT, AST, ALP, Bilirubin), especially in cats
• Appetite and water intake

과용량

Overdoses of lorazepam are generally limited to **CNS depression** (confusion, lethargy, somnolence, decreased reflexes). - **Severe Toxicity:** Very large overdoses can cause ataxia, hypotension, coma, and rarely death. - **Treatment:** Standard protocols for removing/binding the drug in the gut (if orally ingested) and supportive systemic measures. Forced diuresis with IV fluids/electrolytes and mannitol may enhance excretion in patients with normal renal function. - **Antidote:** **Flumazenil** may be considered for adjunctive treatment of serious overdoses, but it does not replace supportive therapy. *Caution: Flumazenil is not recommended in patients with seizure disorders as it may induce seizures.* - **Note:** Analeptic agents (CNS stimulants like caffeine) are generally not recommended.