From the Guidelines
For a 7 kg child, the appropriate lorazepam dose would be 0.35-0.7 mg (0.175-0.35 mL), based on the recommended dose of 0.05-0.1 mg/kg for sedation/anxiolysis 1. This is calculated by multiplying the child's weight (7 kg) by the dose (0.05-0.1 mg/kg), resulting in 0.35-0.7 mg. To convert this to volume, we divide 0.35-0.7 mg by the concentration (2 mg/mL), resulting in 0.175-0.35 mL. Key considerations when administering lorazepam to a child include:
- Monitoring for respiratory depression
- Having resuscitation equipment readily available
- Avoiding oversedation by dose/observe and redose/observe every 3-5 min
- Being aware of the potential for paradoxical agitation, especially in younger children 1. Lorazepam is a benzodiazepine that works by enhancing the effect of GABA, an inhibitory neurotransmitter in the brain, producing sedative and anxiolytic effects. The dose may be repeated if necessary, but typically not more frequently than every 3-5 min, with close attention to the child's vital signs and level of sedation. It is essential to use a tuberculin or insulin syringe to accurately measure the small volume required for a 7 kg child. In pediatric emergencies, careful consideration of the dose and potential side effects is crucial to ensure the child's safety and effective management of their condition 1.
From the Research
Calculating the Dose of Lorazepam for a 7 kg Boy
To calculate the dose of lorazepam for a 7 kg boy, we need to consider the recommended dose per kilogram of body weight.
- According to the study 2, a minimum dose of 0.04 mg/kg is recommended for lorazepam to be effective.
- For a 7 kg boy, the dose would be 7 kg x 0.04 mg/kg = 0.28 mg.
- The available ampule is 2 ml with a concentration of 2 mg per ml, so the total amount of lorazepam in the ampule is 2 ml x 2 mg/ml = 4 mg.
- Since the calculated dose is 0.28 mg, which is much less than the total amount in the ampule, the dose can be administered using a fraction of the ampule.
Considerations for Administration
- The study 2 also mentions that increasing the dose to 0.05 mg/kg can increase the chances of provoking complete or incomplete amnesia, but administering a dose of 0.06 mg/kg may provoke undesirable side effects.
- Other studies, such as 3, discuss the use of lorazepam in pediatric patients, but the context is different (status epilepticus), and the dose is 0.1 mg/kg, which is higher than the calculated dose for the 7 kg boy.
- The study 4 discusses the use of lorazepam for acute agitation in psychiatric patients, but it does not provide specific guidance for calculating the dose for a 7 kg boy.
Conclusion is not allowed, so the response will be ended here.
- The dose for the 7 kg boy would be 0.28 mg, which is a fraction of the available ampule.