Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Lorazepam is a drug used for treating anxiety. It
is in the benzodiazepine family, the same family that includes diazepam
(Valium), alprazolam (Xanax), clonazepam (Klonopin), flurazepam (Dalmane), and
others. It is thought that excessive activity of nerves in the brain may cause
anxiety and other psychological disorders. Gamma-aminobutyric acid (GABA) is a
neurotransmitter, a chemical that nerves in the brain use to send messages to
one another. GABA reduces the activity of nerves in the brain. Lorazepam and
other benzodiazepines may act by enhancing the effects of GABA in the brain.
Because lorazepam is removed from the blood more rapidly than many other
benzodiazepines, there is less chance that lorazepam concentrations in blood
will reach high levels and become toxic. Lorazepam also has fewer interactions
with other medications than most of the other benzodiazepines. The FDA approved
lorazepam in March 1999.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 0.5, 1, and 2 mg. Oral solution: 2 mg/ml. Injection: 2
mg/ml and 4 mg/ml
STORAGE: Tablets should be kept at room temperature 15-30°C (59-86°F). Oral
solutions should be refrigerated at 2-8°C (36-46°F). Injectable solutions should
be refrigerated.
PRESCRIBED FOR: Lorazepam is used for the management of anxiety disorders,
the short-term relief of symptoms of anxiety or anxiety associated with
depression. The effectiveness of lorazepam and other benzodiazepines has not
been adequately studied for treatment beyond 4 months. Lorazepam is effective
for insomnia, panic attacks, and is used in combination with other medications
to prevent nausea and vomiting resulting from chemotherapy. Lorazepam also is
administered before anesthesia and used for prevention and treatment of
alcohol
withdrawal.
DOSING: The dose of lorazepam is tailored to the patient's needs. The usual
dose for treating anxiety is 2-3 mg/day given in two or three divided doses.
Insomnia is treated with 2-4 mg given at bedtime.
DRUG INTERACTIONS: Lorazepam and all benzodiazepines interact with other
medications and drugs that slow the brain's processes such as alcohol,
barbiturates, narcotics, and tranquilizers. There have been cases of marked
sedation when lorazepam was given to patients taking the tranquilizer
loxapine
(Loxitane); it is unclear if there is a drug interaction, but caution should be
used if lorazepam and loxapine are used together.
PREGNANCY: Lorazepam and other benzodiazepines have been associated with
fetal damage, including congenital malformations, when taken by
pregnant women
in their first trimester. Lorazepam is best avoided if at all possible in the
first trimester and probably throughout pregnancy.
NURSING MOTHERS: It is not known if lorazepam is secreted in
breast milk.
SIDE EFFECTS: The most common side effects associated with lorazepam are
sedation (15.9% of patients), dizziness (6.9% of patients), weakness, and
unsteadiness. Other side effects include a feeling of depression, loss of
orientation, headache, and sleep disturbance.
Like all benzodiazepines, lorazepam can cause physical dependence. Suddenly
stopping therapy after a few months of daily therapy may be associated with a
feeling of loss of self-worth, agitation, and insomnia. If lorazepam is taken
continuously for longer than a few months, stopping therapy suddenly may produce
seizures,
tremors,
muscle cramping, vomiting, and sweating.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Fibromyalgia, formerly
known as fibrositis, causes chronic pain, stiffness, and
tenderness of muscles, tendons, and joints without detectable inflammation. Fibromyalgia patients have an unusually low pain threshold. Symptoms of fibromyalgia include fatigue, abnormal sleep, mental/emotional disturbances, abdominal pain, migraine and tension headaches, and irritable bladder. Treatment of fibromyalgia involves patient education, medication, exercise, and stress reduction.
Stress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
A number of vital tasks carried out during sleep help maintain good health and enable people to function at their best. Sleep needs vary from individual to individual and change throughout your life. Not getting enough sleep can hurt memory performance, health, and your mood.
Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
The shoulder is the most often dislocated joint in the body due to its mobility. Dislocation occurs when the head of the humerus is dislocated from its socket. Symptoms and signs of a shoulder dislocation include nausea and vomiting, lightheadedness, weakness, and sweating. There are various methods of reducing a dislocation and returning the humeral head to its normal place. The method for reduction of a shoulder dislocation depends upon the type of dislocation, the patient, the situation, and the clinician's experience. Intravenous narcotics and muscle relaxants are often administered to relax the muscles and relieve pain.
Agoraphobia is a fear of being outside or of being in a situation from which escape would be impossible. Symptoms include anxiety, fear, disorientation, rapid heartbeat, diarrhea, or dizziness. Treatment may incorporate psychotherapy, self-exposure to the anxiety-causing situation, and medications such as SSRIs, benzodiazepines, and beta blockers.
Phobias are unrelenting fears of activities (social phobias), situations (agoraphobia), and specific items (arachnophobia). There is thought to be a hereditary component to phobias, though there may be a cultural influence or they may be triggered by life events. Symptoms and signs of phobias include having a panic attack, shaking, breathing troubles, rapid heart beat, and a strong desire to escape the situation. Treatment of phobias typically involves desensitization, cognitive behavioral therapy, and medications such as selective serotonin reuptake inhibitors and beta blockers.
Insomnia is difficulty in falling or staying asleep, the absence of restful sleep, or poor quality of sleep. Insomnia is a symptom and not a disease. The most common causes of insomnia are medications, psychological conditions, environmental changes and stressful events. Treatments may include non-drug treatments, over-the-counter medicines, and/or prescription medications.
Dystonia disorders cause involuntary movements and prolonged muscle contraction, resulting in twisting body motions, tremor, and abnormal posture. There are many forms of dystonia. Some types of dystonia respond to dopamine, or can be controlled with dedative-type medications, or surgery.
Brief psychotic disorder is a short-term mental illness that features psychotic symptoms. There are three forms of brief psychotic disorder. The first occurs shortly after a major stress, the second has no apparent trauma that triggers the illness, and the third is associated with postpartum onset. Symptoms include hallucinations, delusions, unusual behavior, disorientation, changes in eating and sleeping, and speech that doesn't make sense. Treatment typically involves medication and psychotherapy.
Fibromyalgia causes pain, stiffness, and tenderness
of muscles, tendons, and joints without detectable inflammation.
Fibromyalgia does not cause body damage or deformity.
Fatigue occurs in 90% of patients with fibromyalgia.
Irritable bowel syndrome can occur with fibromyalgia.
Sleep disorder is common in patients with
fibromyalgia.
There is no test for the diagnosis of fibromyalgia.
Fibromyalgia can be associated with other rheumatic
conditions.
Fibromyalgia treatment is most effective with
combinations of education, stress reduction,
exercise, and medications.
What is fibromyalgia?
Fibromyalgia is a chronic condition that causes pain, stiffness, and tenderness of the muscles, tendons, and
joints. Fibromyalgia is also characterized by restless sleep, awakening feeling tired, chronic fatigue, anxiety...
Mental Health RSS
Healthy Living Tips
This site complies with the