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Name: lorazepam midazolam diazepam

Description: Ativan Versed Valium

Creator: Pepper_PhD

This casebook is published and has been read 2277 times.

The author of this casebook has identified the following medical topics as being highly relevant to this casebook.

  • Sleeplessness -- Difficulty in going to sleep or getting enough sleep.
  • clinical anxiety -- chronic, intense, or pathological anxiety which drives the sufferer to seek treatment; apprehension, tension, or uneasiness stemming from anticipation of danger from a vague or unknown source, internal or external, lasting at least 6 months; compare with FEAR and ANXIETY.
Notes


Why is this medication prescribed?

Lorazepam is used to relieve anxiety.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?

Lorazepam comes as a tablet and concentrate (liquid) to take by mouth. It usually is taken two or three times a day and may be taken with or without food. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take lorazepam exactly as directed.

Lorazepam concentrate (liquid) comes with a specially marked dropper for measuring the dose. Ask your pharmacist to show you how to use the dropper. Dilute the concentrate in 1 ounce (30 milliliters) or more of water, juice, or carbonated beverages just before taking it. It also may be mixed with applesauce or pudding just before taking the dose.

Lorazepam can be habit-forming. Do not take a larger dose, take it more often, or for a longer time than your doctor tells you to. Tolerance may develop with long-term or excessive use, making the drug less effective. Do not take lorazepam for more than 4 months or stop taking this medication without talking to your doctor. Stopping the drug suddenly can worsen your condition and cause withdrawal symptoms (anxiousness, sleeplessness, and irritability). Your doctor probably will decrease your dose gradually.

Other uses for this medicine

Lorazepam is also used to treat irritable bowel syndrome, epilepsy, insomnia, and nausea and vomiting from cancer treatment and to control agitation caused by alcohol withdrawal. Talk to your doctor about the possible risks of using this drug for your condition.

What special precautions should I follow?

Before taking lorazepam,

  • tell your doctor and pharmacist if you are allergic to lorazepam, alprazolam (Xanax), chlordiazepoxide (Librium, Librax), clonazepam (Klonopin), clorazepate (Tranxene), diazepam (Valium), estazolam (ProSom), flurazepam (Dalmane), oxazepam (Serax), prazepam (Centrax), temazepam (Restoril), triazolam (Halcion), or any other drugs.
  • tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially antihistamines; digoxin (Lanoxin); levodopa (Larodopa, Sinemet); medications for depression, seizures, pain, Parkinson's disease, asthma, colds, or allergies; muscle relaxants; oral contraceptives; probenecid (Benemid); rifampin (Rifadin); sedatives; sleeping pills; theophylline (Theo-Dur); tranquilizers; valproic acid (Depakene); and vitamins. These medications may add to the drowsiness caused by lorazepam.
  • tell your doctor if you have or have ever had glaucoma; seizures; or lung, heart, or liver disease.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking lorazepam, call your doctor immediately.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking lorazepam.
  • you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
  • remember that alcohol can add to the drowsiness caused by this drug.
  • tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this drug.

What should I do if I forget a dose?

If you take several doses per day and miss a dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Side effects from lorazepam may occur and include:

  • drowsiness
  • dizziness
  • tiredness
  • weakness
  • dry mouth
  • diarrhea
  • nausea
  • changes in appetite

Tell your doctor if any of these symptoms are severe or do not go away:

  • restlessness or excitement
  • constipation
  • difficulty urinating
  • frequent urination
  • blurred vision
  • changes in sex drive or ability

If you experience any of the following symptoms, call your doctor immediately:

  • shuffling walk
  • persistent, fine tremor or inability to sit still
  • fever
  • difficulty breathing or swallowing
  • severe skin rash
  • yellowing of the skin or eyes
  • irregular heartbeat

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/index.html] or by phone [1-800-332-1088].

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to lorazepam.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

 

IMPORTANT WARNING:

Midazolam may cause serious or life-threatening breathing problems such as shallow, slowed, or temporarily stopped breathing. Your child should only receive this medication in a hospital or doctor's office that has the equipment that is needed to monitor his or her heart and lungs and to provide life-saving medical treatment quickly if his or her breathing slows or stops. Your child's doctor or nurse will watch your child closely after he or she receives this medication to make sure that he or she is breathing properly. Tell your child's doctor if your child has a severe infection or if he or she has or has ever had any airway or breathing problems or heart or lung disease. Tell your child's doctor and pharmacist if your child is taking any of the following medications: antidepressants; barbiturates such as secobarbital (Seconal); droperidol (Inapsine); medications for anxiety, mental illness, or seizures; narcotic medications for pain such as fentanyl (Actiq, Duragesic, Sublimaze, others), morphine (Avinza, Kadian, MS Contin, others), and meperidine (Demerol); sedatives; sleeping pills; or tranquilizers.

Why is this medication prescribed?

Midazolam is given to children before medical procedures or before anesthesia for surgery to cause drowsiness, relieve anxiety, and prevent any memory of the event. Midazolam is in a class of medications called benzodiazepines. It works by slowing activity in the brain to allow relaxation and sleep.

How should this medicine be used?

Midazolam comes as a syrup to take by mouth. It is usually given as a single dose by a doctor or nurse before a medical procedure or surgery.

Other uses for this medicine

This medication may be prescribed for other uses; ask your child's doctor or pharmacist for more information.

What special precautions should I follow?

Before your child receives midazolam,

  • tell your child's doctor and pharmacist if he or she is allergic to midazolam, any other medications, or cherries.
  • tell your child's doctor if your child is taking certain medications for human immunodeficiency virus (HIV) including amprenavir (Agenerase), atazanavir (Reyataz), darunavir (Prezista), delavirdine (Rescriptor), efavirenz (Sustiva, in Atripla), fosamprenavir (Lexiva), indinavir (Crixivan),lopinavir (in Kaletra), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), saquinavir (Invirase), and tipranavir (Aptivus). Your child's doctor may decide not to give midazolam to your child if he or she is taking one or more of these medications.
  • tell your child's doctor and pharmacist what other prescription and nonprescription medications, vitamins, and nutritional supplements your child is taking or plans to take. Be sure to mention the medications listed in the IMPORTANT WARNING section and any of the following: amiodarone (Cordarone, Pacerone); aminophylline (Truphylline); antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral); certain calcium channel blockers such as diltiazem (Cartia, Cardizem, Tiazac, others) and verapamil (Calan, Isoptin, Verelan, others); cimetidine (Tagamet); clarithromycin (Biaxin); dalfopristin-quinupristin (Synercid); erythromycin (E-mycin, E.E.S.); fluvoxamine (Luvox); certain medications for seizures such as carbamazepine (Tegretol), phenobarbital, and phenytoin (Dilantin); methylphenidate (Concerta, Metadate, Ritalin, others); nefazodone; ranitidine (Zantac); rifabutin (Mycobutin); and rifampin (Rifadin, Rimactane). Your child's doctor may need to change the doses of your child's medications or monitor your child carefully for side effects. Many other medications may also interact with midazolam, so be sure to tell your child's doctor about all the medications your child is taking, even those that do not appear on this list.
  • tell your child's doctor what herbal products your child is taking, especially St. John's wort.
  • tell your child's doctor if your child has glaucoma. Your child's doctor may decide not to give your child midazolam.
  • tell your child's doctor if your child has or has ever had kidney or liver disease.
  • tell your child's doctor if your child is or may be pregnant, or is breast-feeding.
  • you should know that midazolam may make your child very drowsy and may affect his or her memory, thinking, and movements. Do not allow your child to ride a bicycle, drive a car, or do other activities that require him or her to be fully alert for at least 24 hours after receiving midazolam and until the effects of the medication have worn off. Watch your child carefully to be sure that he or she does not fall while walking during this time.
  • you should know that alcohol can make the side effects of midazolam worse.

What special dietary instructions should I follow?

Do not let your child eat grapefruit or drink grapefruit juice while taking this medication.

What side effects can this medication cause?

Midazolam may cause side effects. Tell your child's doctor if any of these symptoms are severe or do not go away:

  • nausea
  • vomiting
  • rash

Some side effects can be serious. If your child experiences any of these symptoms, call his or her doctor immediately:

  • agitation
  • restlessness
  • uncontrollable shaking of a part of the body
  • stiffening and jerking of the arms and legs
  • aggression
  • slow or irregular heartbeat

Midazolam may cause other side effects. Call your child's doctor if your child has any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/index.html] or by phone [1-800-332-1088].

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

  • drowsiness
  • confusion
  • problems with balance and movement
  • slowed breathing and heartbeat
  • loss of consciousness

What other information should I know?

Keep all appointments with your child's doctor.

Ask your child's pharmacist or doctor if you have any questions about midazolam.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines your child is taking, as well as many products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time your child visits a doctor or if he or she is admitted to a hospital. It is also important information to carry with you in case of emergencies.

 

Why is this medication prescribed?

Diazepam is used to relieve anxiety, muscle spasms, and seizures and to control agitation caused by alcohol withdrawal.

How should this medicine be used?

Diazepam comes as a tablet, extended-release (long-acting) capsule, and concentrate (liquid) to take by mouth. Do not open, chew, or crush the extended-release capsules; swallow them whole. It usually is taken one to four times a day and may be taken with or without food. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take diazepam exactly as directed.

Diazepam concentrate (liquid) comes with a specially marked dropper for measuring the dose. Ask your pharmacist to show you how to use the dropper. Dilute the concentrate in water, juice, or carbonated beverages just before taking it. It also may be mixed with applesauce or pudding just before taking the dose.

Diazepam can be habit-forming. Do not take a larger dose, take it more often, or for a longer time than your doctor tells you to. Tolerance may develop with long-term or excessive use, making the drug less effective. This medication must be taken regularly to be effective. Do not skip doses even if you feel that you do not need them. Do not take diazepam for more than 4 months or stop taking this medication without talking to your doctor. Stopping the drug suddenly can worsen your condition and cause withdrawal symptoms (anxiousness, sleeplessness, and irritability). Your doctor probably will decrease your dose gradually.

Other uses for this medicine

Diazepam is also used to treat irritable bowel syndrome and panic attacks. Talk to your doctor about the possible risks of using this drug for your condition.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking diazepam,

  • tell your doctor and pharmacist if you are allergic to diazepam, alprazolam (Xanax), chlordiazepoxide (Librium, Librax), clonazepam (Klonopin), clorazepate (Tranxene), estazolam (ProSom), flurazepam (Dalmane), lorazepam (Ativan), oxazepam (Serax), prazepam (Centrax), temazepam (Restoril), triazolam (Halcion), or any other drugs.
  • tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially antihistamines; cimetadine (Tagamet); digoxin (Lanoxin); disulfiram (Antabuse); fluoxetine (Prozac); isoniazide (INH, Laniazid, Nydrazid); ketoconazole (Nizoral); levodopa (Larodopa, Sinemet); medications for depression, seizures, pain, Parkinson's disease, asthma, colds, or allergies; metoprolol (Lopressor, Toprol XL); muscle relaxants; oral contraceptives; probenecid (Benemid); propoxyphene (Darvon); propranolol (Inderal); ranitidine (Zantac); rifampin (Rifadin); sedatives; sleeping pills; theophylline (Theo-Dur); tranquilizers; valproic acid (Depakene); and vitamins. These medications may add to the drowsiness caused by diazepam.
  • if you use antacids, take diazepam first, then wait 1 hour before taking the antacid.
  • tell your doctor if you have or have ever had glaucoma; seizures; or lung, heart, or liver disease.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking diazepam, call your doctor immediately.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking diazepam.
  • you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
  • remember that alcohol can add to the drowsiness caused by this drug.
  • tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this drug.

What should I do if I forget a dose?

If you take several doses per day and miss a dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Side effects from diazepam are common and include:

  • drowsiness
  • dizziness
  • tiredness
  • weakness
  • dry mouth
  • diarrhea
  • upset stomach
  • changes in appetite

Tell your doctor if any of these symptoms are severe or do not go away:

  • restlessness or excitement
  • constipation
  • difficulty urinating
  • frequent urination
  • blurred vision
  • changes in sex drive or ability

If you experience any of the following symptoms, call your doctor immediately:

  • seizures
  • shuffling walk
  • persistent, fine tremor or inability to sit still
  • fever
  • difficulty breathing or swallowing
  • severe skin rash
  • yellowing of the skin or eyes
  • irregular heartbeat

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/index.html] or by phone [1-800-332-1088].

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to diazepam.

Diazepam can cause false results in urine tests for sugar using Clinistix and Diastix. Diabetic patients should useTesTape to test their urine for sugar.

If you are taking diazepam to control seizures and have an increase in their frequency or severity, call your doctor. Your dose may need to be adjusted. If you use diazepam for seizures, carry identification (Medic Alert) stating that you have epilepsy and that you are taking diazepam.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Bookmarks The following information, which has been distilled by the casebook author from this and other websites is particularly relevant to this casebook.
Bookmarks - Web
Web Page Notes Concepts
 Lorazepam: MedlinePlus Drug Information U.S. National Library of Medicine (clinical anxiety)
 
 Midazolam : MedlinePlus Drug Information U.S. National Library of Medicine (clinical anxiety)
 
 Diazepam: MedlinePlus Drug Information U.S. National Library of Medicine (clinical anxiety)
 
Bookmarks - Medicines
Web Page Notes Concepts
 Resounding Health: Medicine: Lorazepam Lorazepam (Ativan) (clinical anxiety)
 
 Resounding Health: Medicine: MIDAZOLAM Hydrochloride Versed (clinical anxiety)
 
 Resounding Health: Medicine: Diazepam Diazepam (Valium) (clinical anxiety)
 

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