Drug IN-tolerance!

  1. The thread about tolerance brought to mind the opposite problem: sensitivity to drugs. I gave a small dose of lorazepam to a seizing 6-year-old today, and her respiratory effort depressed to almost nothing, to the point where we had to bag-assist her for over an hour. Caused a few more grey hairs for me, lemme tell ya! When the seizures stopped I just turned her on her side and walked away for a few minutes (parents were there). The doc happened to poke his head in to check on her and when I was came back he was doing a chin lift and said "Get a bag......" All the years I've given lorazepam, I've never had this happen.
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    About TazziRN

    Joined: Apr '03; Posts: 7,569; Likes: 2,298

    7 Comments

  3. by   JentheRN05
    Hopefully you have an order for the lorazepam. You could be in a heap of trouble if you didn't (which I can't imagine you did this - but can't hurt to mention it). A small dose of lorazepam isn't usually first line of defense for a seizure. At least not to my knowledge.
  4. by   nursem2
    Ativan is a first-line treatment for seizures. Sorry your kiddo had a scary reaction to it!
  5. by   Larry77
    Quote from JentheRN05
    Hopefully you have an order for the lorazepam. You could be in a heap of trouble if you didn't (which I can't imagine you did this - but can't hurt to mention it). A small dose of lorazepam isn't usually first line of defense for a seizure. At least not to my knowledge.
    I'm sure she had an order, is not the standard to give Ativan without an order...

    I would do a lot of teaching in this situation so the parents understand what happened and will warn the next nurse who gives Ativan to their child. Glad everything turned out ok though.
  6. by   TazziRN
    Yes, I had an order. I have orders for all meds I give. And as a previous poster already said, Ativan ihas been first line drug for seizures in anyone older than a baby for years. If I didn't have an order I wouldn't have posted this the way I did, I would have been scared out of my mind.
  7. by   Altra
    Quote from JentheRN05
    Hopefully you have an order for the lorazepam. You could be in a heap of trouble if you didn't (which I can't imagine you did this - but can't hurt to mention it). A small dose of lorazepam isn't usually first line of defense for a seizure. At least not to my knowledge.
    Ativan is indeed our first-line drug for seizure activity. Then, loading w/Dilantin or other med.

    The OP was talking about a hypersensitivity to a med given ... I'm not sure where the supposition that she gave it without an order came from??

    TazziRN ... glad there was a good outcome!
  8. by   CoolhandHutch
    Tazzi, just thinking out loud here..

    I've heard that Ativan isn't tolerated real well IV for tots. Your mileage may vary- I'm sure someone in pharmacy could tell you more than you want to know about it. We usually give Valium PR/IV depending on the situation. That's another thing to consider- if EMS brought the child in, was there a chance they gave something & it was missed in report? Or perhaps mom & dad gave something at home and expected you to know this (through ESP, of course). Lastly, any indication for Romazicon?
  9. by   TazziRN
    Came in by PV, they were travelling. Ativan, to my understanding and practice, can be given to children over 5, just not babies or toddlers. I think 50# was the cutoff weight, not sure about that one. Since it was given IV all we had to do was wait for her to wake up.
    Last edit by TazziRN on Oct 16, '06

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