Zoran: instructions for use, what helps, dosage, analogues

Lorazepam indications

Lorazepam is indicated for symptomatic convulsive states, neuroses, neurosis-like conditions, acute delirium due to the effects of alcohol, panic disorders, agitation and anxiety in schizophrenia, endogenous psychoses, psychosomatic disorders in diseases of body systems and internal organs, reactive emotional states, phobias, psychoreactive states , epilepsy (with caution), sleep disorders due to stress

Lorazepam contraindications

Lorazepam should not be prescribed for: hypersensitivity to it, acute intoxication with psychotropic drugs, acute intoxication with alcohol, myasthenia gravis, angle-closure glaucoma.

Do not take this medication during pregnancy or breastfeeding.

For children, the drug can be prescribed from the age of 12 in the form of tablets, and from the age of 18 the administration of a solution is allowed.

Caution must be exercised in case of: hypoproteinemia, severe chronic obstructive pulmonary diseases, severe depression, coma, organic brain diseases, shock, psychosis, hyperkinesis, renal disorders, porphyria, epilepsy, risk of sleep apnea, suspicion of angle closure glaucoma

Lorazepam side effects

Side effects in rare cases have been observed: amnesia, dizziness, ataxia, muscle weakness, increased fatigue, diarrhea, dysphagia, loss of appetite, liver dysfunction, nausea, dry mouth, constipation. Sometimes taking the drug causes changes in peripheral blood and allergic reactions. With intravenous administration, phlebitis and thrombosis occur extremely rarely.

Side effects

Most patients tolerate Zoran without any complications.

In case of hypersensitivity to ranitidine or excipients, the development of allergic reactions is possible.

In rare cases, the following side effects have been reported:

dyspepsia (nausea, vomiting);
general weakness;
cephalgia;
disturbances of consciousness and hallucinations (in weakened patients);
intestinal disorders (diarrhea);
muscle and joint pain;
alopecia;
acute pancreatitis;
recurrent inflammation of the parotid salivary glands.

Long-term therapy with high doses can cause painful tension in the mammary glands (gynecomastia), decreased libido, menstrual irregularities in women and decreased potency in men.

Dosage and method of administration

Directions for use and dosage: Orally (regardless of food intake). The dose and duration of treatment are selected strictly individually, depending on the indications and therapeutic effect. The initial single dose for adults is 5-10 mg; for outpatient treatment, the average daily dose is 30-50 mg; in hospital, the maximum dose is 120 mg/day. The average course duration is 2-4 weeks. The dose for children 6-12 years old has not been established

Precautions: Use with caution if there is a predisposition to arterial hypotension, especially in elderly patients (due to the possibility of cardiac dysfunction), or an increased risk of drug dependence. Should not be administered with MAO inhibitors, phenothiazine derivatives. The likelihood of overdose symptoms increases with concomitant use of CNS depressants or alcohol

During the treatment period, alcoholic beverages are excluded. Should not be used for a long time (due to the risk of developing drug dependence). If long-term treatment is necessary (several months), the course should be carried out using the method of intermittent therapy, stopping treatment for several days and then prescribing the same individually selected dose. Cancellation should be carried out gradually. With abrupt withdrawal of oxazepam, withdrawal syndrome may occur (tremor, convulsions, abdominal or muscle spasms, vomiting, perspiration), most often appearing after taking high doses or long-term treatment. With long-term treatment, monitoring of liver function and peripheral blood patterns is necessary. Should not be used by vehicle drivers and people whose profession involves increased concentration of attention. Special instructions: Recommended for the treatment of anxiety, tension, agitation, irritability in weakened patients, elderly people, as well as patients with residual effects of traumatic or infectious lesions of the central nervous system. Please note that anxiety or tension associated with everyday stress does not usually require treatment with anxiolytics

The likelihood of overdose symptoms increases with concomitant use of CNS depressants or alcohol. During the treatment period, alcoholic beverages are excluded. Should not be used for a long time (due to the risk of developing drug dependence). If long-term treatment is necessary (several months), the course should be carried out using the method of intermittent therapy, stopping treatment for several days and then prescribing the same individually selected dose. Cancellation should be carried out gradually. With abrupt withdrawal of oxazepam, withdrawal syndrome may occur (tremor, convulsions, abdominal or muscle spasms, vomiting, perspiration), most often appearing after taking high doses or long-term treatment. With long-term treatment, monitoring of liver function and peripheral blood patterns is necessary. Should not be used by vehicle drivers and people whose profession involves increased concentration of attention. Special instructions: Recommended for the treatment of anxiety, tension, agitation, irritability in weakened patients, elderly people, as well as patients with residual effects of traumatic or infectious lesions of the central nervous system. Please note that anxiety or tension associated with everyday stress does not usually require treatment with anxiolytics.

Contraindications

Contraindications to the use of Lorazepam according to the instructions are:

Angle-closure glaucoma;
Myasthenia;
Acute alcohol intoxication;
Acute intoxication with psychotropic drugs;
Hypersensitivity to lorazepam or other components of the drug.

Lorazepam in any dosage forms should not be used during pregnancy , especially in the first trimester, and during breastfeeding. The drug in the form of tablets is prescribed from the age of 12, in the form of an injection solution - from the age of 18.

In addition, Lorazepam should be used with caution when:

Suspicion of angle-closure glaucoma and sleep apnea;
Epilepsy;
Porphyria;
Renal dysfunction;
Hyperkinesis;
Psychosis;
Shock;
Organic brain diseases;
Comatose state;
Severe depression;
Severe chronic obstructive pulmonary diseases;
Hypoproteinemia.

For what indications is it prescribed?

in conditions of a psychoreactive nature; in the treatment of extreme nervous emotional tension and anxiety; during schizophrenic conditions; symptoms of VSD; for relief of asthenia; if there are psychosomatic disorders; in case of insomnia, which appears due to stress and increased anxiety; for the treatment of epileptic conditions (in these cases, the medicine is used as part of a complex treatment); used for panic disorders; for alcoholic delirium, while the drug is used as part of a combination treatment; during depressive states in which signs of anxiety are observed (used with extreme caution!); for headaches that are accompanied by increased muscle tension; used during disorders with manic and catatonic character; to eliminate neurosis-like conditions and neuroses in which tension and anxiety are observed; in order to relieve a panic attack; to prevent nausea and vomiting that occurs during chemotherapy.

Indications for use

What does Arterial help with? The drug in question is prescribed for the following symptoms:

episodic or constant increase in blood pressure;
hereditary predisposition to hypertension;
vegetative-vascular dystonia;
migraine attacks;
intolerance to antihypertensive medications
manifestation of allergic reactions;
disorders of the nervous system - neurasthenia, hysteria, panic attacks;
with a low level of resistance to stress.

Please note: The arterial serves not only to cleanse the blood vessels. It improves blood circulation and thins the blood. It also prevents the causes of diseases: hypertension, stroke, heart attack, thrombosis, atherosclerosis. The drug is suitable for smokers, people with diabetes, and diseases of the cardiovascular system.

Storage and dispensing of medicine

Lorazepam is a potent psychotropic drug and is included in List B of the Russian Pharmacopoeia.

It can only be purchased with a special prescription and by presenting a prescription form from a doctor at the pharmacy.

However, on some Internet resources and forums you can find discussions on the topic: “lorazepam is purchased with a prescription or not,” and in them some pharmacy chains declare the possibility of its over-the-counter purchase with a virtual order.

It is important to carefully check such information for the accuracy of the information and the reputation of the pharmaceutical company. Lorazepam can be stored for 3 years, in a cool, dark place.

Opened ampoules are not reused!

Lorazepam can be stored for 3 years in a cool, dark place. Opened ampoules are not reused!

Lorivan/Lorazepam. Instructions for use

Available in tablets.

One tablet contains:

Active substance: lorazepam 1 mg

20 pcs. – blisters (2) – cardboard packs.

Indications

- in conditions of a psychoreactive nature;

- in the treatment of extreme nervous emotional tension and anxiety, in case of psychosomatic disorders, to relieve a panic attack;

- during schizophrenic conditions;

- symptoms of VSD;

- in case of insomnia, which appears due to stress and increased anxiety;

- for the treatment of epileptic conditions (in these cases, the medicine is used as part of a complex treatment);

- during depressive states in which signs of anxiety are observed (used with extreme caution!);

- for headaches that are accompanied by increased muscle tension;

- to eliminate neurosis-like conditions and neuroses in which tension and feelings of anxiety are observed;

- to prevent nausea and vomiting that occurs during chemotherapy;

Dosage

Inside. The tablets are taken three times a day. The dosage at one time should be 1 mg.

For a hypnotic effect, the drug is used half an hour before bedtime, the dosage is 1-2 mg. During a state of increased anxiety and excitability, the medicine is taken 6 mg per day.

During premedication, the medication is prescribed one hour before surgery. The dosage of the medicine should be 2.5-5 mg.

When used for seizures, withdrawal of the drug should be done slowly. The treatment period for this disorder is about a week.

Overdose

Symptoms: drowsiness, hypotension, confusion, depressed reflexes, coma.

Treatment: induction of vomiting, gastric lavage, intravenous administration of norepinephrine to increase blood pressure, symptomatic therapy, monitoring of vital functions. Administration of a specific antidote—the benzodiazepine receptor antagonist flumazenil (in a hospital setting).

Drug interactions

Lorazepam enhances the effect of central nervous system depressants, incl. phenothiazines, narcotic analgesics, barbiturates, antidepressants, hypnotics, anticonvulsants, antihistamines with a sedative effect.

Potentiates the effect of general and local anesthetics, enhances the effect of curare-like drugs.

When used simultaneously with alcohol, in addition to enhancing the inhibitory effect on the central nervous system, paradoxical reactions are possible (psychomotor agitation, aggressive behavior, state of pathological intoxication). Nicotine inhibits the activity of lorazepam (accelerates its metabolism).

Side effects

From the nervous system and sensory organs: lethargy, fatigue, drowsiness, disorientation, headache, dizziness, depression, ataxia, sleep disturbance, agitation, visual impairment, episodes of amnesia.

From the gastrointestinal tract: dry mouth, nausea, vomiting, diarrhea, change in appetite.

From the skin: erythema, urticaria.

Other: changes in blood composition (leukopenia), increased LDH activity.

The development of addiction, drug dependence, withdrawal syndrome, rebound syndrome is possible (see “Special Instructions”).

special instructions

Use with caution in patients with depression, given suicidal tendencies. In patients with drug and alcohol dependence, use under close medical supervision. Side effects are usually observed at the beginning of therapy

The possibility of a more frequent occurrence of side effects in elderly and debilitated patients should be considered.

Side effects are usually observed at the beginning of therapy. The possibility of a more frequent occurrence of side effects in elderly and debilitated patients should be taken into account.

During treatment and for 2 days after its completion, it is necessary to avoid drinking alcoholic beverages; Drivers of vehicles and people whose work requires quick mental and physical reactions, and is also associated with increased concentration, should not engage in professional activities during this period.

If treatment is abruptly stopped, withdrawal syndrome may occur (tremor, convulsions, abdominal or muscle spasms, vomiting, perspiration), and symptoms similar to those of the disease may also occur (anxiety, agitation, irritability, emotional tension, insomnia, convulsions).

With long-term use, it is necessary to periodically monitor the picture of peripheral blood, liver and kidney function.

Please note that anxiety or tension associated with everyday stress does not usually require treatment with anxiolytics.

Drug interactions

When used simultaneously with drugs that have a depressant effect on the central nervous system, with ethanol or ethanol-containing drugs, the depressant effect on the central nervous system increases. After simultaneous use of lorazepam and ethanol, the development of psychomotor agitation, aggressiveness, and pathological intoxication is possible (the development of this condition does not depend on the amount of ethanol taken).

With simultaneous use, the effectiveness of oral contraceptives is reduced.

With simultaneous use, the effect of depolarizing muscle relaxants is enhanced.

When used simultaneously with nicotine, the metabolism of lorazepam increases and its activity decreases.

With simultaneous use, probenecid may interfere with the binding of lorazepam to glucuronic acid, which leads to an increase in its concentration in the blood plasma, and due to the enhanced therapeutic effect, excessive sedation may develop.

SSRI antidepressants and alcohol

In normal health, brain cells transmit information through the exchange of serotonin molecules. Depressive states are accompanied by an imbalance of this signaling substance, which acts as a neurotransmitter.

Antidepressants that are part of the SSRI group (selective serotonin reuptake inhibitors) work as follows - by preventing the uptake of serotonin by brain tissue, they support the prolonged activity of central serotonergic processes. As a result, the neurotransmitter, accumulating in the area of the receptors, has a longer effect on them. As a result, it is possible to mitigate or completely neutralize depressive, anxiety, and phobic disorders, and normalize mental self-regulation.

The types of SSRIs, as well as the substances they contain, are presented in the table below:

Drug names	Active substance
Prozac Fluval Deprex	Fluoxetine
Velafax Ephelon Velaxin	Venlafaxine
Sirestill Adepress Plizil	Paroxetine
Cipramil Citol Oprah	Citalopram
Lenkusin Selectra Cipralks	Escitalopram
Deprefol Asentra Stimuloton	Sertraline

The listed products belong to easily tolerated antidepressants. However, you cannot combine alcohol, including low-proof alcohol, with any of them, since ethanol also stimulates the action of serotonin to a certain point.

Indications

Medicines should be taken strictly as prescribed. Indications include:

the need to normalize sleep during anxiety attacks and stressful situations;
use in combination with other groups of drugs for the treatment of epilepsy;
depressed states and various phobias;
increased arousal and emotionality;
migraine attacks;
states of anxiety, agitation, manic disorders in schizophrenia;
acute delirium due to alcohol poisoning;
panic attacks;
convulsive symptoms;
all kinds of neuroses.

Lorazepam should not be prescribed to children under 12 years of age. The instructions for use also describe other contraindications. Among them:

myasthenia gravis;
closed-type glaucoma;
alcohol intoxication;
hypersensitivity to the components of the drug;
bearing a fetus;
breast-feeding;

Also, with great caution, you need to prescribe medicine for:

porphyria;
epilepsy;
attacks of sleep apnea;
closed glaucoma;
shock states;
lung diseases;
severe depressive states;
coma

The drug Clonazepam has the same contraindications for the treatment of depression. The instructions are mandatory to study before starting treatment.

Zoran's analogues

Analogs in terms of active substance and medicinal properties are:

Ranitidine;
Ranisan;
Zantac;
Acylok;
Gastak;
Ranighast.

Plisov Vladimir, doctor, medical observer

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Characteristics of the drug

Anxiolytic based on benzodiazepine.

In its pure form it is a powder substance that is difficult to dissolve in water and other liquids.

Lorazepam actively affects different parts of the brain (limbic and reticular zones, thalamus, spinal cord, subcortical formations), changing the biochemical processes in it, inhibiting the neuronal activity of nerve cells and reducing the transmission of impulses through them.

Therefore, the drug can:

suppress fears, anxieties, panic;
significantly shortens the period of falling asleep and relieves nightmares;
relaxes skeletal muscles.

Lorazepam, instructions for use (Method and dosage)

Take 1 mg three times a day. For a hypnotic effect, the drug is taken half an hour before bedtime at a dose of 1-2 mg. For anxiety and increased excitability, take up to 6 mg per day.

For the purpose of premedication, Lorazepam is prescribed 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 mc/kg.

To prevent the risk of developing a convulsive syndrome, discontinuation of the drug should be carried out gradually. The duration of therapy is no more than 7 days.

For patients with pathologies of the renal or hepatic system, the dosage is reduced.

Maximum daily tablets - no more than 10 mg, solution no more than 4 mg.

Selective serotonin reuptake inhibitors (SSRIs)

Serotonin is a signaling substance (scientifically called a neurotransmitter). Brain cells exchange serotonin molecules to transmit information. In depression, there is an imbalance of serotonin.

Imagine that brain cells are throwing molecules around like balls. The point of contact between cell processes is called a synapse. When a cell receives a serotonin molecule, the signal is received, the cell no longer needs serotonin, and it gets rid of it. The removal of serotonin from the synapse is called reuptake. If this process is interfered with (inhibited), then there will be more serotonin in the synapse. This will strengthen or extend the signal. In some way that is not fully understood, this will alleviate depression by stabilizing your mood. This is exactly what this group of antidepressants do.

SSRIs are drugs containing the following active substances (the most popular trade names of drugs containing this active substance are indicated in brackets):

fluoxetine (deprex, portal, prozac, profluzac, fluval)
sertraline (Aleval, Asentra, Deprefolt, Zoloft, Serenata, Sirlift, Stimuloton, Thorin)
paroxetine (adepress, actaparoxetine, paxil, plisil, rexetine, sirestill)
citalopram (Oprah, Pram, Siozam, Tsipramil, Citol)
escitalopram (lenuxin, miracitol, selectra, cipralex, esipi)
fluvoxamine (fevarin)
venlafaxine (Velaxin, Velafax, Newelong, Efevelon)
duloxetine (Cymbalta)

Alcohol cannot be combined with selective serotonin reuptake inhibitors because alcohol itself prolongs (extends) the action of intracerebral serotonin to a certain point, and is also an inducer of dopamine synthesis (like MAO inhibitors (monoamine oxidase inhibitors), also antidepressants and also incompatible with alcohol) . Therefore, on the one hand, when alcohol is taken simultaneously with antidepressants, competition for the substrate may occur, and this will increase not so much the direct, but rather the side (undesirable) effects of antidepressants.

These side effects, indicated in the instructions for use, can also develop with standard administration and dosage of antidepressants: due to the polymorphism of serotonin receptors, effects opposite to those expected can develop (depending on which receptors the antidepressant acts on - those it targets, or the opposite Both are serotonin). With the simultaneous effect of alcohol, the probability and degree of stimulation of different types of serotonin receptors turns out to be almost unpredictable.

But potentially much more dangerous is the possibility of severe autonomic disorders: pressure surges, blood clotting disorders, secretory disorders, arrhythmia.

English scientist Andrew Herxheimer and New Zealand scientist David B. Menkes published an article in the Pharmaceutical Journal noting that many patients do not take seriously the warning that alcohol should not be combined with selective serotonin reuptake inhibitors.

Manufacturers of antidepressants explicitly do not recommend doing this on the instructions that are included in the boxes with medicines, but they rely on the results of studies on healthy volunteers in whose bodies their medicine does not interact with alcohol in any way.

It turns out that these warnings had not previously been confirmed by scientific research, and therefore did not convince either doctors or patients. Herxheimer and Menses described specific manifestations of pathological intoxication syndrome, which often causes serious consequences in patients taking SSRIs or similar antidepressants.

Lorazepam instructions

Lorazepam is an anti-anxiety drug. It is used for panic attacks, neurosis-like conditions, and disorders due to stress.

The drug has antiemetic, anticonvulsant, sedative, anxiolytic, hypnotic, and central muscle relaxant effects.

Lorazepam is a medium-acting drug used to reduce anxiety and eliminate panic attacks.

There are no positive results in affective, hallucinatory, and delusional disorders. It is not recommended to use the drug as the main one in the treatment of psychotic disorders (depression, anxiety caused by depression, etc.).

It is not advisable to use Lorazepam for a long time. This may cause addiction and reduced effectiveness.

The drug is dispensed in the form of tablets or solution, which must be administered intravenously or intramuscularly.

special instructions

Use with extreme caution in cases of suspected angle-closure glaucoma, severe chronic obstructive pulmonary diseases, coma, shock, epilepsy, renal dysfunction, hyperkinesis, hypoproteinemia, severe depression, organic brain diseases, porphyria, psychosis, and suspected sleep apnea. In case of liver dysfunction, a minimal increase in T1/2 of lorazepam is observed.

The development of adverse reactions is more likely at the beginning of treatment and in cases where recommended doses are exceeded.

With long-term use of lorazepam, addiction and drug dependence may develop.

In the case of using lorazepam for premedication, it may be necessary to reduce the dose of fentanyl derivatives used for induction of anesthesia, while it is possible to reduce the time to blackout using induction doses.

Impact on the ability to drive vehicles and operate machinery

Patients taking lorazepam should refrain from engaging in potentially hazardous activities that require increased attention and speed of psychomotor reactions.

Antidepressants and alcohol - consequences of combination

The most likely consequences of a prohibited combination include increased heart rate (up to 120 beats per minute), liver damage, the appearance of hallucinations, the development of depressive psychosis and sexual disorders. Alcohol after antidepressants, or shortly before taking medications, increases the risk of severe autonomic disorders in the form of:

sudden changes in pressure;
heart rhythm disturbances;
insufficient or increased blood clotting.

If you use antidepressants and alcohol, the consequences are very diverse. The outcome of the situation is largely determined by related factors, including the type and amount of drink, the environment, the availability and quality of snacks. The nature of the reaction also largely depends on the state of the human body.

Sources

https://medi.ru/instrukciya/lerivon_12336/
https://instrukciya-primeneniyu.com/lerivon/
https://PsihBolezni.ru/lechenie/lorazepam-instruktsiya-po-primeneniyu-tsena-otzyvy-analogi-pobochnoe-dejstvie-sostav/
https://www.neboleem.net/lerivon.php
https://www.rlsnet.ru/mnn_index_id_864.htm
https://drugfinder.ru/drug/lerivon/
https://dolgojit.net/lerivon.php
https://doctor-86.ru/stati/alkogol-i-antidepressanti.html
https://www.rlsnet.ru/tn_index_id_1911.htm
https://medside.ru/lerivon
https://depressio.ru/lekarstva/antidepressanty/325-lerivon.html
https://NeuroDoc.ru/lekarstva/lorazepam.html
https://pohmelje.ru/antidepressanty-i-alkogol/
https://Elixir.farm/lekarstva/lerivon/
https://medside.ru/lorazepam

Interaction

When premedicating with Lorazepam, in some cases it is necessary to reduce the dosage of fentanyl derivatives.

The drug reduces the effectiveness of levodopa in treating patients with parkinsonism. The drug enhances the toxic effect of zidovudine.

Barbiturates, narcotic analgesics, phenothiazines, antidepressants, MAO inhibitors enhance the inhibitory effect on the nervous system and increase neurotropic activity.

Narcotic analgesics enhance the effect of euphoria, causing an increase in psychological dependence.

Clozapine may cause respiratory depression when taken concomitantly with lorazepam.

Lorivan/Lorazepam. Instructions for use

Available in tablets.

One tablet contains:

Active substance: lorazepam 1 mg

20 pcs. – blisters (2) – cardboard packs.

Contraindications

- hypersensitivity to the constituent components of the drug;

- angle-closure glaucoma;

- depressive neuroses;

- myasthenia;

- acute intoxication;

- pregnancy and lactation;

- age up to 13 years (efficacy and safety have not been established);

The medicine is used with caution in the following conditions: during liver damage; heart failure; during hypotensia; with multiple sclerosis; with reduced body weight

Overdose

Symptoms: drowsiness, hypotension, confusion, depressed reflexes, coma.

Drug interactions

Potentiates the effect of general and local anesthetics, enhances the effect of curare-like drugs.

Side effects

From the gastrointestinal tract: dry mouth, nausea, vomiting, diarrhea, change in appetite.

From the skin: erythema, urticaria.

Other: changes in blood composition (leukopenia), increased LDH activity.

The development of addiction, drug dependence, withdrawal syndrome, rebound syndrome is possible (see “Special Instructions”).

Side effects

The product in question can cause the following effects:

dyspeptic disorders, increased bilirubin, AST, ALT, dry mouth;
rapid heartbeat, drop in blood pressure;
stupor, disinhibition, headaches, anterograde amnesia, accommodation paresis, depression, dizziness, dysarthria, loss of strength, loss of orientation, ataxia, aggressiveness, confusion;
in people with COPD, when taking high doses of the drug, alveolar hypoventilation is observed;
With airway obstruction and brain damage, depression of the respiratory center is observed.

Pharmacokinetics

Suction

When Lerivon is taken orally, mianserin is well absorbed from the gastrointestinal tract. Cmax is reached after 3 hours. Bioavailability is about 20%.

Distribution

With a constant course of taking the drug, the time to establish Css is 6 days.

Metabolism

Subject to the "first pass" effect.

Metabolized in the liver by monohydroxylation and, to a small extent, N-oxidation. When used in average therapeutic doses, it does not cause the phenomenon of induction of liver enzymes.

Removal

T1/2 is on average 32 hours, which allows you to achieve therapeutic concentrations when taking the drug once a day.

It is excreted mainly in urine and partially in bile.

How to use Lorazepam

Adults are usually prescribed Lorazepam in a daily dose of 2 mg, divided into 3 doses. It is recommended to take half the daily dose in the morning and afternoon, and the second half immediately before bed.

Depending on the symptoms, the dosage of Lorazepam may vary:

In neurological practice – 1 mg up to 3 times a day;
To relieve agitation, 2 mg of Lorazepam is used as an intravenous injection.

The maximum daily dose for oral administration is 10 mg; for intramuscular and intravenous administration, a single dose should not exceed 4 mg of Lorazepam.

With abrupt withdrawal of Lorazepam, withdrawal syndrome may develop, which manifests itself as:

Insomnia;
Increased anxiety;
Shiver;
Irritability and increased reaction to auditory, tactile or light stimuli;
Gastrointestinal disorders;
Excitation;
Headache and muscle pain;
Convulsions and psychotic states.

Caution should be exercised when using Lorazepam simultaneously with drugs that have a depressant effect on the central nervous system and with ethanol-containing drugs, since such a combination of drugs can lead to the development of aggressiveness, psychomotor agitation and pathological intoxication. It should also be taken into account that nicotine reduces the activity of Lorazepam

Doses and regimen

Tablets should not be chewed or crushed.

The optimal dosage is determined by a gastroenterologist taking into account the nosological form, the severity of clinical symptoms and the dynamics of the process.

The daily dose for the treatment of gastrointestinal diseases is usually 300-450 mg (divided into 2-3 doses). According to indications, it can be increased to 900 mg.

For preventive purposes, it is recommended to drink 1 tablet. (150 mg) in the evening before bed .

The duration of the course depends on the nature and course of the disease.

Parenterally, 50-100 mg is prescribed every 6-8 hours.

The solution is administered intravenously (25 mg/hour over 2 hours) or slowly over 5 minutes.

note

For slow intravenous administration, 50 mg of the drug is diluted to a volume of 20 ml with a solution of dextrose (5%) or sodium chloride (0.9%).

Intramuscular injections (50 mg) are repeated 3-4 times a day.

For stress ulcers, to prevent the development of bleeding, first administer 50 mg IV slowly, and then carry out a continuous infusion at the rate of 0.125-0.25 mg/kg/h until the patient is able to resume enteral nutrition. Maintenance dose – 150 mg (in tablets) 2 times a day.

To prevent aspiration of gastric juice, 150 mg (or 50 mg IV) is prescribed the evening before surgery and 2 hours before anesthesia (IV - 45 minutes).

Important

Rapid intravenous administration may cause a slow heart rate (bradycardia).

From the beginning of labor, women in labor are given 150 mg of Zoran orally at intervals of 6 hours.

pharmachologic effect

Pharmacology:

Pharmacological action - anxiolytic, sedative, hypnotic, muscle relaxant (central), anticonvulsant. Interacts with specific benzodiazepine receptors of the GABA-benzodiazepine receptor complex, increases the sensitivity of GABA receptors to GABA. As a result, the frequency of opening of transmembrane channels for chlorine ions increases, the postsynaptic membrane of the neuron is hyperpolarized, neuronal activity is inhibited and interneuron transmission to the central nervous system is inhibited. The effects are due to the influence on various parts of the central nervous system: the amygdala complex of the limbic system (anxiolytic), the reticular formation of the brain stem and the nonspecific nuclei of the thalamus, hypothalamus (sedative and hypnotic), spinal cord (muscle relaxant), hippocampus (anticonvulsant). Reduces the excitability of subcortical formations (limbic system, thalamus, hypothalamus), responsible for emotional reactions, and inhibits the interaction of these structures with the cerebral cortex. Stabilizes vegetative functions. Suppresses anxiety, fear, reduces psychomotor agitation, emotional stress. It has an antipanic and amnestic (mainly when used parenterally) effect. Effective for insomnia caused by anxiety or short-term stressful situations: it facilitates the onset of sleep (shortens the period of falling asleep), reduces the number of night awakenings, and increases the duration of sleep. Inhibits polysynaptic spinal reflexes and reduces skeletal muscle tone. Lorazepam has low toxicity and a wide range of therapeutic effects. An animal reproduction study showed that administration of lorazepam to rabbits in doses of 40 mg/kg orally and 4 mg/kg or higher intravenously led to fetal resorption and an increased incidence of fetal death. Causes developmental abnormalities in rabbits regardless of dose. In an 18-month study in rats, no carcinogenic activity was detected. When taken orally, it is well but slowly absorbed from the gastrointestinal tract, bioavailability is 90%. C_max is achieved within 2 hours and depends on the dose: at a dose of 2 mg, C_max is 20 ng/ml. About 85% binds to plasma proteins. Equilibrium concentration in the blood is usually achieved after 2-3 days. Passes through the BBB and the placental barrier. Rapidly metabolized in the liver by conjugation to form the main inactive metabolite - lorazepam glucuronide. T_1/2 of unconjugated lorazepam is about 12 hours, the main metabolite is 18 hours. It is excreted mainly by the kidneys, mainly in the form of glucuronide. With intramuscular administration, C_max is achieved in 60-90 minutes. T_1/2 with parenteral administration is 16 hours. When used for 6 months, no accumulation phenomena are observed. The pharmacokinetic parameters of lorazepam do not change in the elderly.

Cepril

Description:

disinfectant

Production:

Russia
Instructions for use of the disinfectant "Cepril"
Purpose:

the product is intended for use

in medical institutions, obstetric hospitals, clinical, microbiological and other laboratories, infectious foci for:
disinfection of indoor surfaces, hard furniture, surfaces of apparatus, instruments, incubators (incubators) and accessories for them, sanitary equipment, waste bins, cleaning equipment, rubber mats, patient care items, personal hygiene products, shoes made of rubber, plastic and other polymer materials, toys, linen, tableware and laboratory utensils, medical waste of groups B and C from textiles (cotton swabs, used dressings, disposable underwear and bed linen, staff clothing, masks, etc.) and other materials (dishes, etc.) including laboratory, single-use medical devices) for bacterial infections (including tuberculosis), viral etiology, candidiasis and dermatophytosis;
disinfection on sanitary transport;
general cleaning in medical and preventive care and children's institutions;
disinfection of medical devices (including surgical and dental instruments, rigid and flexible endoscopes and instruments for them), components of anesthesia and respiratory equipment, suction systems of dental units, saliva ejectors and spittoons for bacterial infections (including tuberculosis), viral etiology, candidiasis and dermatophytosis;
disinfection, combined with pre-sterilization cleaning, of medical products (including surgical and dental, except for dental forceps and mirrors with amalgam, rigid and flexible endoscopes, instruments for them) for bacterial infections (including tuberculosis), viral etiology, candidiasis and dermatophytosis;
pre-sterilization cleaning, not combined with disinfection, of medical products (including surgical and dental, except for dental forceps and mirrors with amalgam, rigid and flexible endoscopes, instruments for them);

at public service enterprises (hotels, hostels, hairdressers, public toilets), in cultural, recreational, sports institutions (sports and cultural complexes, cinemas, offices, etc.), social security institutions, children's institutions, penitentiary institutions, enterprises catering and trade for preventive disinfection of indoor surfaces, hard furniture, sanitary equipment, cleaning equipment, care items, personal hygiene products, shoes (made of rubber, plastic and other polymeric materials), tools (hairdressing and cosmetic), waste ( disposable products: napkins, cotton balls, caps, sheets, capes, tools, etc.), waste disposal systems (garbage containers, garbage trucks and waste collection equipment), transport for food products.

Compound:

contains as active ingredients: a mixture of quaternary ammonium compounds (QAC) – 8.0% (alkyldimethylbenzylammonium chloride – 3.0%, alkyldimethylethylbenzylammonium chloride – 3.0%, didecyldimethylammonium chloride – 2.0%) and polyhexamethylene guanidine hydrochloride ( PGMG) - 2.2%; in addition, the product contains a stabilizer and other additives; The pH of the product is 10.0+1.0

Consistency, properties:

The product is a transparent yellow liquid with a characteristic odor that mixes well with water.

Consumption rate:

Indoor surfaces (floors, walls, doors, etc.), hard furniture, surfaces of appliances, apparatus, waste bins are wiped with a rag soaked in a solution of the product at a consumption rate of the working solution of 100 ml/m2 or irrigated with a solution of the product at a consumption rate of 150 ml /m2 (Quasar type sprayer) or 300 ml/m2 (hydraulic remote control). Sanitary equipment (bathtubs, sinks, toilets, etc.) are wiped with a solution of the product using a brush or ruff, or irrigated with a solution of the product. The consumption rate of the product solution when wiping is 150 ml/m2, when irrigation is 150 (Quasar type sprayer) or 300 ml/m2 (hydraulic control panel). In case of infections of bacterial (except tuberculosis), viral and fungal etiology, the surfaces of the incubator and its accessories are thoroughly wiped with a rag soaked in a 5% solution of the product with a disinfection holding time of 60 minutes; in case of tuberculosis, they are wiped with a rag soaked in a 7% or 8.0% solution with a disinfection holding time of 60 and 30 minutes, respectively. Upon completion of disinfection, the surfaces of the incubator are wiped twice with sterile cloth napkins (diapers) abundantly moistened in sterile drinking water, and after each wash they are wiped dry with a sterile diaper. After finishing the treatment, the incubators should be ventilated for 15 minutes.

Packing:

The product is produced in polymer containers with a capacity of 0.5 to 10 dm3.

Microbiology:

the product has antimicrobial activity against gram-negative and gram-positive bacteria (including tuberculosis pathogens), viruses, fungi of the genera Candida and Trichophyton, as well as detergent properties.

Toxicity:

according to the parameters of acute toxicity, according to GOST 12.1.007-76 it belongs to the 3rd class of moderately hazardous substances when introduced into the stomach and to the 4th class of slightly hazardous substances when applied to the skin; according to K.K. Sidorov’s classification for parenteral administration (into the abdominal cavity) - low toxic substances to class 4; when exposed to inhalation in saturating concentrations (vapors), they are of little danger according to the classification of inhalation hazards of agents by degree of volatility (hazard class 4); has a local irritant effect on the skin and a pronounced effect on the mucous membranes of the eyes, does not have a sensitizing effect. Working solutions with single exposures to the skin do not cause local irritation and skin-resorptive effects; when used as an irrigation method, they cause irritation to the respiratory system and mucous membranes of the eyes. OBUV in the air of the working area: for the CHAS mixture – 1 mg/m3 (aerosol), for polyhexamethylene guanidine hydrochloride – 2 mg/m3 (aerosol).

Application:

disinfection of objects is carried out by wiping, irrigation, immersion and soaking

Shelf life:

3 years, working solutions 14 days, provided they are stored in closed containers.

Storage conditions:

The product should be stored in a cool place in closed containers, at a temperature from plus 5 to plus 30 0C away from heat sources, avoiding storage in direct sunlight, separately from medications, food products, and in places inaccessible to children.