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Ativan can significantly affect the reaction rate when driving vehicles or other mechanisms. Such an effect is enhanced by the action of alcohol.
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As with other drugs that depress CNS function, patients who are prescribed Ativan should refrain from managing hazardous machinery or driving until it is established that the drug doesn’t cause drowsiness or dizziness.
Way of use and dosage
Ativan dose is selected based on the needs of the individual patient:
• The lowest therapeutic dose and the shortest treatment term should be prescribed.
• The risk of withdrawal syndrome, as well as rebound syndrome in case of a sharp cessation of therapy. Therefore, treatment should be stopped gradually.
• According to the severity of symptoms and duration of therapy, it is recommended to take 1.0 mg of lorazepam 2-3 times a day.
• For sleep disorder: as a rule, 1.0 mg of lorazepam 30 minutes before sleep is enough.
• In psychiatric practice: take 3.0-7.5 mg of lorazepam per day, divided into 3-4 intakes.
• For preoperative sedation: 1.0-2.0 mg of lorazepam before surgery and / or 1-2 hours before the intervention.
Ativan must not be used by children under the age of 12 since safety and efficiency in this age group have not been established.
In case of overdose, it should be taken into account that the patient could take a few drugs at the same time.
As in the case of other benzodiazepines, an overdose is usually non-life threatening, except the cases when Ativan is taken in сombination with other drugs suppressing the function of CNS (including alcohol).
As a rule, the overdose of Ativan leads to depression of CNS, the symptoms of which, depending on severity, can be expressed in the range from a state of depression to coma.
If you use only Ativan, you may experience such mild symptoms as depression, confusion, paradoxical reactions, and lethargy. Severe cases can lead to ataxia, decreased muscle tone, hypotension, depression of the cardiovascular system and respiration, rarely- coma and death.
In case of overdose, maintenance therapy is mainly recommended, until the drug is excreted from the body.
It is necessary to carefully monitor the signs of vital activity and the balance of fluid in the body. You need to monitor the airway patency and, if necessary, use mechanical ventilation.
In case of hypotension and respiratory depression, one should apply general emergency techniques.
Blood system and lymphatic system: unknown frequency- thrombocytopenia, agranulocytosis, and pancytopenia.
Psyche: the intake of benzodiazepines and benzodiazepine-like substances led to such reactions as anxiety, agitation, uneasiness, hostility, anger, irritability, aggressiveness, delirium, manias, nightmares, hallucinations, psychoses, abnormal behavior and other types of unwanted behavior.
Symptoms of depression may be observed during the treatment with benzodiazepines.
Nervous system: very frequent - sedation, exhaustion, and sleepiness; frequent - ataxia, confusion, depression, and severe depression; individual - libido change, impotence, and anorgasmia.
Unknown frequency - extrapyramidal symptoms, tremor, vertigo, visual impairment (diplopia and blurry vision), dysarthria / incomprehensible speech, headache, cramps / convulsive seizures, amnesia, disinhibition, coma, suicidal thoughts/attempts, impaired concentration, and imbalance.
Temporary anterograde amnesia or memory impairment has been reported in connection with the administration of benzodiazepines. Such side effects were mainly caused by the use of high doses of lorazepam, and (in certain cases) were desirable.
Cardiovascular system: unknown frequency – hypotension and reduced blood pressure.
Respiratory system, chest and mediastinal organs: unknown frequency – respiratory depression, apnea, exacerbation of sleep apnea, and obstructive pulmonary disease. The severity of these symptoms depends on the drug dose.