NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

What is the starting recommendation for Lorazepam (Ativan) when used for CINV?

1. Start on the morning of chemotherapy

2. Start one week before chemotherapy

3. Start the evening prior to chemotherapy

4. As needed basis only

The correct answer is: Start the evening prior to chemotherapy

Lorazepam (Ativan) is commonly used to prevent chemotherapy-induced nausea and vomiting (CINV). The starting recommendation for Lorazepam is to take it the evening prior to chemotherapy, also known as pre-chemotherapy. This ensures that the medication is in the system and has enough time to start working before the chemotherapy drugs are administered. Option A, starting on the morning of chemotherapy, is not recommended because by this time, the patient may have already started experiencing symptoms of nausea and vomiting. Option B, starting one week before chemotherapy, is also not recommended because Lorazepam is not intended for long-term use and can cause dependence if taken for an extended period of time. Option D, as needed basis only, is not recommended because Lorazepam needs to be taken consistently to effectively prevent CINV. As-needed use may result in inconsistent levels of the medication in the body and may not provide adequate protection against CINV.