Lorazepam: which statement is true?

Lorazepam: which statement is true?

• A. It has a rapid onset, which limits its usefulness as an anticonvulsant
• B. Amnestic action lasts up to 6 hours
• C. It relies on hepatic oxidation and conjugation
• D. It is not safe in hepatic impairment

Answer: (B)

Lorazepam’s main action is to enhance GABA-A receptor activity, producing anxiolysis, sedation, anticonvulsant effects, and anterograde amnesia. The amnestic effect tends to last for several hours, roughly up to about six hours, which aligns with its clinical duration when used for premedication or procedures. This makes the amnestic period long enough to obscure events for that window without prolonged daytime sedation. Unlike some benzodiazepines, lorazepam is cleared mainly by hepatic glucuronidation to an inactive metabolite, rather than by oxidative metabolism, which is why it’s often considered safer in hepatic impairment compared with agents that rely on oxidation. It is not true that its rapid onset limits anticonvulsant use (rapid onset is advantageous for seizures), nor that its metabolism primarily depends on hepatic oxidation, and it is not deemed unsafe in hepatic impairment; in fact, it’s typically preferred in liver disease for that reason.

Lorazepam’s main action is to enhance GABA-A receptor activity, producing anxiolysis, sedation, anticonvulsant effects, and anterograde amnesia. The amnestic effect tends to last for several hours, roughly up to about six hours, which aligns with its clinical duration when used for premedication or procedures. This makes the amnestic period long enough to obscure events for that window without prolonged daytime sedation. Unlike some benzodiazepines, lorazepam is cleared mainly by hepatic glucuronidation to an inactive metabolite, rather than by oxidative metabolism, which is why it’s often considered safer in hepatic impairment compared with agents that rely on oxidation. It is not true that its rapid onset limits anticonvulsant use (rapid onset is advantageous for seizures), nor that its metabolism primarily depends on hepatic oxidation, and it is not deemed unsafe in hepatic impairment; in fact, it’s typically preferred in liver disease for that reason.