From the Research
In Florida, a nurse practitioner can prescribe up to a 7-day supply of lorazepam, which is a Schedule IV controlled substance, as this limit helps balance patient access to necessary medications while minimizing risks associated with benzodiazepines such as dependence, tolerance, and potential for misuse. When prescribing lorazepam, the nurse practitioner must include their DEA number on the prescription and follow all state and federal regulations regarding controlled substances 1. The prescription should clearly indicate the exact quantity, dosage, and instructions for use. It's essential to note that nurse practitioners in Florida must have a supervisory protocol with a physician and must practice within their scope of practice when prescribing controlled substances.
Some key points to consider when prescribing lorazepam include:
- Documenting the clinical indication for lorazepam in the patient's medical record
- Conducting appropriate follow-up
- Considering non-pharmacological interventions when applicable
- Being aware of the potential for rebound insomnia and withdrawal phenomena after discontinuation of the drug 2
- Recognizing the effectiveness of lorazepam in relieving anxiety symptoms, including those associated with hypertension 3
The most recent and highest quality study on lorazepam dosing strategies, published in 2023, evaluated the incidence of refractory status epilepticus and found that patients who received less than the recommended dose of IV lorazepam experienced an increased progression to refractory status epilepticus 4. However, this study does not directly address the question of the maximum amount of lorazepam that can be prescribed by a nurse practitioner in Florida.
In terms of pharmacokinetics, lorazepam is rapidly and readily absorbed, reaching peak concentrations in the blood proportional to the dose approximately 2 hours after oral administration, with an elimination half-life of about 12 hours 5. However, this information is not directly relevant to the question of the maximum amount of lorazepam that can be prescribed.
Overall, the key consideration for nurse practitioners in Florida is to prescribe lorazepam in accordance with state regulations and to prioritize patient safety and well-being by minimizing the risks associated with benzodiazepine use. The 7-day limit on lorazepam prescriptions is a crucial aspect of this approach, as it helps to balance patient access to necessary medications with the need to minimize risks.