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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by rjlockhart on March 15, 2007, at 23:23:52
I have been on Ativan, i realize that many hospitals use it as a sedative besides the major benzo's like versed, that put you to sleep.
I never heard of Xanax being used in hospitals.
I think i have heard of clonazepam in mental hostpuitals.
?
Posted by Racer on March 16, 2007, at 0:46:54
In reply to Why is Ativan preferred more at hospitals?, posted by rjlockhart on March 15, 2007, at 23:23:52
Posted by djmmm on March 16, 2007, at 6:04:51
In reply to Why is Ativan preferred more at hospitals?, posted by rjlockhart on March 15, 2007, at 23:23:52
> I have been on Ativan, i realize that many hospitals use it as a sedative besides the major benzo's like versed, that put you to sleep.
>
> I never heard of Xanax being used in hospitals.
>
> I think i have heard of clonazepam in mental hostpuitals.
>
> ?Ativan (lorazapam) is used medically because it is very fact acting, and is not metabolized by the liver, thus it is safer in patients with impaired liver function. In hospitals, invloving epileptic situations, it is preferred because Ativan is less soluble in lipids (fat) thus not building up in your system, allowing for more predictable pharmacokinetics.
Posted by Phillipa on March 16, 2007, at 12:19:48
In reply to Re: Why is Ativan preferred more at hospitals?, posted by djmmm on March 16, 2007, at 6:04:51
Also it can be given Im for faster acting. Love Phillipa
Posted by sukarno on March 19, 2007, at 14:35:57
In reply to Re: Why is Ativan preferred more at hospitals? » djmmm, posted by Phillipa on March 16, 2007, at 12:19:48
It's much longer-acting than Valium when given by IV. Effects can last for hours, whereas with Valium IV, effects only last for minutes, maybe an hour. It's ideal for treating status epilepticus in an ER setting. Lorazepam is also safer in IV use as diazepam (Valium) has a risk of causing thrombosis if it is not prepared correctly.
Taken orally though, diazepam is longer-acting.
Posted by tessellated on March 20, 2007, at 5:24:18
In reply to Re: Why is Ativan preferred more at hospitals?, posted by sukarno on March 19, 2007, at 14:35:57
wait, as far as i understand its one of the shorter acting benzo's/mg/hour.
that's why its used so patients can walk out later.
ativen is most often used iv. next to versed in emergencies/minor surgery due to its 1-2 hour long effect, twilight sleep etc. valium is more for long term anioxylitic effects. valium is one of the longest acting benzos, with multiple active metabolites and rarely used in er setting because of its long half life. 12-60hrs. dentist may use small oral doses for surgery, but ativan and versed are more common in the ER/ambulance/surgical contexts, as their pharmacokinetics are more predictable
sorry sukarno, our research is in complete disagreement.
Posted by sukarno on March 20, 2007, at 22:21:03
In reply to Re: Why is Ativan preferred more at hospitals?, posted by tessellated on March 20, 2007, at 5:24:18
"The use of diazepam is limited by its rapid redistribution out of the CNS. The duration of action of diazepam is approximately 20–30 minutes. Pharmacokinetic studies of lorazepam have shown it has an elimination half life of 13 hours. Lorazepam has a much longer duration of anticonvulsant action than diazepam and has an equivalent onset of action."
"Clinical bottom line -
Intravenous lorazepam is effective and safe in the treatment of status epilepticus. It should be the first line of treatment."Quoted from:
Lorazepam or diazepam for generalised convulsions in adults
http://emj.bmj.com/cgi/content/full/18/2/116-a
That's in regards to intravenous use. I used to wonder too why ER doctors would prefer IV lorazepam as it is indeed shorter-acting than diazepam when taken orally. It was explained to me that lorazepam acts differently when used intravenously.
This is the end of the thread.
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