Prescription

Chemical name

7-Хлор-5-(2-хлорфенил)-1,3- дигидро-3-гидрокси-2H-1,4 -бензодиазепин-2-он

Gross

C15-H10-Cl2-N2-O2

Characteristics

Anksiolitik, derivative Benzodiazepina.pocti white powder, it is very poorly soluble in water.

Of drugs

Drugs, the anxiolytic, sedative, sleeping, miorelaksirutee (central), protivosudorozhnoe. Interacts with specific receptors benzodiazepinovmi ГАМК-бензодиазепин-ре цепторного set increases sensitivity to Gamk-retseptorov GABA. As a result of increased frequency of the opening transmembrannah channels for ions chlorine giperpoliarizuetsa postsinaptical disc neirona, oppressed neironalnaya activity and hampered mezhneironnaya over to the central nervous system. Effects due to the influence of the various departments of central nervous system : a set of almond-shaped limbic system (anxioliticeski) retikuljarnuu properties barrel brain and nonspecific kernel cheeks, hypothalamus (sedative and hypnotic), the spinal cord (miorelaksiruty) gippocamp (protivosudorozhny). Reduces anxiety subcortical structures (limbical system Diencephalon, dystonia), responsible for the emotional reactions and inhibits the interaction of these structures overbark brain. 4-3 week Funktion.podavlet anxiety, fear, reduces agitation emotional stress. Provides antipanicescoe and amnesticescoe (mostly in Injecting application) effect. Good for sleeplessness caused alarm or short-term stress : facilitates sleep onset (shorter period sleep), reduces the number of night probujdeni increases the duration of sleep. Polisinapticalkie stops spinale reflexes and decreased skeletal muscle Myshc.lorazepam has low toxicity and great breadth of therapeutic действия.Исследовани�� reproduction in animals showed that the introduction of krolikam lorazepama in doses 40 mg / kg inwards and 4 mg / kg and above / with causing rezorbtion fruit and increased frequency loss fruit. Is abnormalities in rabbits regardless of the dose. The month study in rats carcinogenic activity not Obnaroujeno.pri ingestion well, but slowly absorbed from the digestive tract, bioavailability is 90%. C_max achieved within 2 h, depending on the dose : dose of 2 mg C_max is 20 ng / J About 85% is associated with plasma proteins. Equilibrium concentration in the blood is usually in 2-3 days. Passes through GEB and placental barrier. Rapidly metabolized in the liver by conjugation with the formation of a low-metabolita glukuronida lorazepama. T_1/2 nekongugirovannogo lorazepama about 12h, the metabolita - 1830 Report the news is mostly in the form of Glukuronida.pri / m introduction C_max achieved through 60-90 minutes. T_1/2 Injecting with the introduction of 16-hour In the application within six months there are phenomena cumulation. Pharmacokinetic parameters lorazepama unchanged in older persons.

Indications

Neuroses accompanied by anxiety, excitement, including generalizovannoe disturbing disorder, post-traumatic stress disorder, phobias, обсессивно-компульси��ное disorder psihoreaguye state jet emotional disorders, anxiety and depressive states of different genesis (as a rule, in combination with antidepressants), insomnia, psychosomatic disorders (including in the cardiovascular, gastrointestinal and other diseases), premedikation the surgical and diagnostic manipulation (in combination with analgetikami), headache voltage; nausea and vomiting caused by chemotherapy, epilepsy (in a combination therapy), deliri alcohol, and the withdrawal syndrome in chronic alcoholism (in a combination therapy).

Restrictions on the use of

Chronic respiratory distress, the syndrome patients during sleep, otkratougolnaya glaucoma, drug and alcohol dependency, depression (see "Precautions"), paranoia expressed by the human kidney.

Pregnancy and lactation

Contraindicated in pregnancy (especially in the first trimester). At the time of treatment should stop breastfeeding.

Contraindications

Hypersensitivity, incl. other benzodiazepine - male, zakratougolnaya glaucoma, the acute intoxication means distressing as CNS, respiratory depression, liver failure, pregnancy (especially I trimester), breast-feeding, age and 18 years of age.

Side-Effects

From the nervous system and sensory organs : weakness, fatigue, drowsiness, disorientation, headache, dizziness, depression, ataxy, sleeping, ajitation, impaired vision, episodes Amnesia.so part of the intestine : dry mouth, nausea, vomiting, diarrhoea, changing Appetita.so the Skin : erythema, Krapiwnica.prochie : change in the composition of the blood (lakopenia), the increase in the development Ldg.vozmozhno adjusting, Drug dependence syndrome lifting rebound-sindroma (see "Precautions").

Specific guidance

It should be borne in mind that anxiety or stress in the day-to-day stress, usually do not require treatment anxiolitikami.

Patient interaction

Alcohol and means oppressed CNS (including fenotiazina, narcotic analgesics, barbiturates), antidepressants increase neurotropic activity. Together with the use of alcohol, in addition to strengthening the oppressive influence on the central nervous system may be paradoxical reaction (agitation aggressive behaviour, the state of pathological intoxication). Oral contraceptives lower lorazepama concentration in the blood. Nicotine suppresses activity lorazepama (speeding up the metabolism). Lorazepam potenziruet the general and local anesthetics, strengthens the kurarepodobnykh drugs.

Overdosing

Symptoms : drowsiness, gipotenzia, sputannosti consciousness, oppression reflexes, Koma.lechenie : induction vomiting, stomach wash, in / with the introduction of norepinephrine to increase AD symptomatic therapy, monitoring vital functions. The specific antidote - benzodiazapine antagonist receptors flumazenila (in the hospital).

Precautions

To apply caution in patients with depression, given the propensity for suicide. In patients with drug and alcohol problems apply under the close supervision Vracha.pobochne effects typically occur at the beginning of therapy. It should be borne in mind the possibility of increasing the frequency of side effects in older and weakened Patientov.vo treatment, and within two days after the meeting to be deleted reception alcohol; Drivers of vehicles and people whose work requires quick mental and physical reactions, as well as linked to the high concentration of attention, during this period should not engage in professional Deatelnostu.pri long-term use may cause addiction, as well as drug addiction (especially to the reception of high doses). Therefore, it should not apply lorazepam longer than 4-6 weeks. Where necessary, long-term care insurance should periodically make weekly breaks admission preparation. In a dramatic treatment to the occurrence of the syndrome (tremor, convulsions, abdominal or muscle cramp, vomiting, perspiration), it may also be a symptom similar to the symptoms of the illness (anxiety ajitation, irritability, emotional stress, insomnia, convulsions). With long-term use should be periodically monitored picture peripheral blood, liver and kidneys.

Dosing and Administration

Inside. The dosage and duration of treatment shall strictly Individuhalno.v neurological practice, and 1 mg 2-3 times a day; In a psychiatric practice, 4-6 mg / day; To sleep for 1-2 mg for 30 minutes before sleep. The elderly and handicapped patients dose should not exceed 2 mg / day (divided doses). In patients with liver disease and / or kidney, as well as in patients with cerebral sclerosis, gipotenziei, heart failure, weight correction recommended doses.

Directory → Neurotropic funds → Medicines → Prescription