I need advice about Advil (Lorazepam)

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I have some questions about the use of Ativan that I hope you can answer for me. I am interested in correct dosages. Firstly , what is the range of PO dosages from smallest to largest. Do you give Ativan to patients detoxing from opiates? What would you typically give to help a patient with difficulty sleeping? What would be the highest dose you would go to? What dose would be given for anxiety? What about for a panic attack? I have looked this up in searches and can't get anything specific on correct dosages. Thank you for any help you can give me. Also what dosages do they come in? Thanks Krisssy

In all my years of psych nursing, I've never seen Ativan (lorazepam) used for opiate detox. When I was doing psych consultation-liaison work at a big teaching hospital a few years ago, supervised by a boarded addictionologist, we used Lopressor and Klonopin for opiate detox. Neither have I ever seen a doc Rx Ativan for insomnia -- there are plenty of hypnotics that will do the job without getting you hooked on benzos ...

Ativan is a benzodiazepine, a cousin of Valium and Xanax. It is just as addictive as the rest of the benzo family when used over extended periods of time. Most the psychiatrists I have known go out of their way to avoid Rxing it unless there is just no other option. Most people have enough problems already without adding a benzo addiction to the pile ...

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Specializes in Geriatrics/Oncology/Psych/College Health.
In all my years of psych nursing, I've never seen Ativan (lorazepam) used for opiate detox. When I was doing psych consultation-liaison work at a big teaching hospital a few years ago, supervised by a boarded addictionologist, we used Lopressor and Klonopin for opiate detox. Neither have I ever seen a doc Rx Ativan for insomnia -- there are plenty of hypnotics that will do the job without getting you hooked on benzos ...

Ativan is a benzodiazepine, a cousin of Valium and Xanax. It is just as addictive as the rest of the benzo family when used over extended periods of time. Most the psychiatrists I have known go out of their way to avoid Rxing it unless there is just no other option. Most people have enough problems already without adding a benzo addiction to the pile ...

Ditto that. (Elkpark - you always save me from having to type anything extensive in the psych forum because I always agree with your assessment! :chuckle)

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(Elkpark - you always save me from having to type anything extensive in the psych forum because I always agree with your assessment! )

(Back atcha, Nurse Ratched! :kiss )

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Specializes in Oncology/Haemetology/HIV.

Ativan is a benzodiazipine. It is used for treating anxiety and nausea in oncology nursing. Doses generally range from 0.25mg to 2 mg for us. I have never seen more than 4 mg given and that was for major sedation of the patient.

Ativan can also be a very dangerous drug to give as the timespan of its effect is not stable. PO or IV it can stay in the system for a long time compared to many other drugs of its class.

I have never seen ativan used as the primary drug to detox someone. I have seen alcohol hdetox protocols use phenobarb, librium, tranxene or chloral hydrate.

Some places do give it for sleep.

The po form can be dissolved in a drop of water and given SL or buccally for more rapid effect, or for patients that are unable to swallow.

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Specializes in psych, addictions, hospice, education.

I use Ativan to detox patients from alcohol, but not opiates. It's used on a prn basis, as a substitute for Librium, since Librium sometimes gives people "librium legs" especially if their liver has been damaged by their alcohol use. (They have trouble walking). Also used are Serax, Phenobarbital, and Pentobarbital.

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Specializes in Ante-Intra-Postpartum, Post Gyne.
(Heartsopenwide check your spelling of Ativan, you're confusing us. LOL)

Ahh, darn it! I KNOW how to spell it, I have to call in refills for patients all the time, I do not knw why I did that!!! Thanks for pointing that out! :smackingf

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Specializes in Med-Surg, Geriatric, Behavioral Health.

When I worked detox, Valium PO was used as the detox drug from ETOH, 5-20 mg q hour if needed (max: 200mg in a 24 hr period) which was based upon objective criteria (labs, vital signs, degree of tremor, etc). The detox typically lasted about 3 days with fairly good outcomes. Librium was totally avoided because it being more sedative and prone to inducing ataxia than Valium. No other benzos were used. Vistaril or Desyrel for sleep was about it. Opiate users were detoxed with Ultram...also on a 3 day titer down schedule, also utilizing objective criteria. Worked extremely well...even with the hardest hitters of IV Heroin. Again, no Benzos. Vistaril or Desyrel only for sleep. What was also very helpful with the Opiate users was the use of Neurontin 400-800 mg PO q 6 hrs prn in reducing restlessness and/or agitation...especially if caused from anticipatory anxiety (Max: 4,800 mg/24 hr). Bentyl prn was used for abdominal cramping. No, Ativan wasn't used in our detox program ...too short a half life. Also, short half life Benzos run more of the risk of dependency. So, Valium was only used, but only in the active ETOH withdrawal patient. And, detox was highly supervised...so as my public service announcement...ETOH Detox is NOT done at home...but under the close supervision of care by highly trained nurses and physicians. Although Opiate withdrawal is not fatal, ETOH withdrawl can be....so it needs to be supervised closely by trained staff....NOT by family members at home and not by the user taking it upon oneself.

So, Krisssy, to make a long story short...Ativan has a high potential for misuse and dependency. It is a drug that deserves to be respected. It really has no place in Opiate withdrawal treatment...not when other medications are available that are non-addictive or have a lower risk of abuse/dependency. I encourage you to discuss these other options with your physician. Do not trade one addictive drug for another. Seen it happen too many times. The goal in using addictive prone drugs when prescribed by a physician is to shortly come off of them or to be only on them for a determined period of time. And some folks need to stay totally clear from them due to strong psychological dependencies they have which encourage medication abuse. I hope this helps.

Wolfy

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Dear Krissy,

I'm Getting Worried Abput You. First You Posted About Percocet Withdrawal And Drinking On Wellbuitrin. Now You're Asking Us About Ativan-please Talk To Your Psychiatrist. As An Aside, I Use Buspar For Patient's I Worry Are At Risk Of Addiction.

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Specializes in ICUs, Tele, etc..

i guess sometimes benzo's are needed as a supplement with methadone when it comes to opiod withdrawal therapy, i mean alot of those patients go through alot of physical sx than can lead to anxiety, so why not if it helps, it sure wont hurt a patient given the right dosages.

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Specializes in Obstetrics, M/S, Psych.
i guess sometimes benzo's are needed as a supplement with methadone when it comes to opiod withdrawal therapy, i mean alot of those patients go through alot of physical sx than can lead to anxiety, so why not if it helps, it sure wont hurt a patient given the right dosages.

Still best to avoid giving these people something else to become addicted to, IMO. Clonidine is a better option for the withdrawal symptoms.

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Specializes in ICUs, Tele, etc..

sorry but correct me if im wrong but isn't klonopin also a benzo, i mean i dont work psych nursing and haven't encountered as much narcotic addicted patients. but is there a study that says klonopin is better than any other benzo such as ativan or xanax, just a question, interested in an answer. i mean i always thought a benzo is a benzo is a benzo, though some are short acting like diprivan(milk of amnesia). if we worry about people getting addicted to benzo after they have been addicted to something else can and will lead to these patients being undermedicated which is a terrible thing for them, i know nurses who's so judicious about pain control that it hurts the patient, for fear of overmedicating patients....just a thought, i'd like to know what everyone thinks. thanks

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Are you talking about Advil or Ativan?

Ativan SORRY Krissy

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