Lorazepam: beneficial for the liverPharmacodynamicsLorazepam or better known as Ativan belongs to the benzodiazepine family and produces inhibitory effects on the central nervous system. The therapeutic action of Lorazepam occurs through interaction at the level of benzodiazepine binding sites. These binding sites are found on inotropic gamma-amino butyric acid A (GABAA) receptors. The neurotransmitter used by Lorazepam is the inhibitory neurotransmitter GABA. Lorazepam and other benzodiazepines do not bind directly to the same receptor site as the endogenous neurotransmitter GABA. As you can see from Figure 1, they bind to benzodiazepine binding sites located between the alpha and gamma subunits on GABAA receptors. Once the benzodiazepine locks onto the GABAA receptor, it alters it, so the neurotransmitter GABA has a much higher affinity for it. Lorazepam does not mimic the effects of GABA, but instead enhances GABA's affinity for the GABAA receptor. Lorazepam does not directly open the gates of chloride itself. The neurotransmitter GABA is what opens doors. With higher affinity it becomes a pulsating motion of the gate opening and closing, making its effects inject more chloride. When GABA normally binds to the GABAA receptor, it opens a chloride channel allowing chloride to enter. When lorazepam binds to the benzodiazepine site on the GABAA receptor it increases the speed at which chloride channels open when GABA attaches to them. This allows for an increase in the concentration of chloride ions in the cell. This effect causes the cell to hyperpolarize, making it highly negative inside, which makes it less excitable. This reversal potential of chloride ions inhibits the activation of any new potent action... middle of paper... When the patient suffers from anxiety or alcohol withdrawal, he receives the same dose. It is administered sublingually at a dose of 2-6 mg. If the patient is in status epilepticus the recommended dose is between 0.05 mg/kg and a maximum of 4 mg by slow intravenous injection. This dose can be repeated once every 12 hours. (Wyeth & Ayerst) Local protocols may differ from this and medical directors can decide which dose of the drug they prefer to receive. As can be seen from Table 1, the dose recommended by Alberta Health Services is 1 mg sublingually and can be repeated once. It is possible to administer more, but it would be necessary to carry out a consultation with an online medical check. Lorazepam - Alcohol Withdrawal and Non-Aggressive Psychiatry Table 1: AHS Protocols (https://www.ahsems.com/secure/protocols/1#view/ 5042/Note)(Saari, Uusi-Oukari, Ahonen & Olkkola , 2011)