Comprehensive exams for Mental Health Q 163
Mark, with a diagnosis of generalized anxiety disorder, wants to stop taking his lorazepam (Ativan). Which of the following important facts should nurse Betty discuss with the client about discontinuing the medication?
A. Stopping the drug may cause depression.
B. Stopping the drug increases cognitive abilities.
C. Stopping the drug decreases sleeping difficulties.
D. Stopping the drug can cause withdrawal symptoms.
Correct Answer: D. Stopping the drug can cause withdrawal symptoms
Stopping anti-anxiety drugs such as benzodiazepines can cause the client to have withdrawal symptoms. Lorazepam, like other benzodiazepine medications, is a highly addictive medication. Great care is necessary when prescribing lorazepam at high doses or prolonged durations, particularly in patients with a history of substance use disorder or concurrent opioid prescriptions.
Option A: Lorazepam and other benzodiazepines have increased risk of abuse, misuse, and dependence these medications are contraindicated in the patient who is actively using illicit substances and drugs. Except for use in Alcohol withdrawal disorder symptoms and for detoxifications Lorazepam and other benzodiazepines are contraindicated in patients with h/o alcohol dependence and abuse and not in remission. Increased risk of fatality with the combined use of alcohol and lorazepam in overdose, including death.
Option B: Lorazepam can cause CNS and respiratory depression in overdose. It can lead to hypotension, ataxia, confusion, coma, and can be fatal. Concurrent use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. Concomitant prescribing of benzodiazepines and opioids must be reserved for patients for whom alternative treatment options are inadequate. Dosage and duration of lorazepam must be limited to the minimum required.
Option C: Stopping a benzodiazepine doesn’t tend to decrease sleeping difficulties. If administered to patients who on chronic benzodiazepine therapy, the sudden interruption of benzodiazepine antagonism by flumazenil can induce benzodiazepine withdrawal, including seizures. Flumazenil has minimal effects on benzodiazepine-induced respiratory depression, and suitable ventilatory support should be available in treating acute benzodiazepine overdose.