Question - Accumulation of what chemical has been associated with infusions of lorazepam in critically ill patients?
Answer- Lorazepam infusions have resulted in the accumulation of propylene glycol as “lorazepam intravenous solution is suspended in a propylene glycol solution”. The cited article notes “Accumulation of propylene glycol is associated with hyperosmolar metabolic acidosis, lactic acidosis, acute tubular necrosis, intravascular hemolysis, central nervous system depression, seizures, cardiac arrhythmias, and hypotension.” (Horinek EL et al. Propylene glycol accumulation in critically ill patients receiving continuous intravenous lorazepam infusions. 2009 Anns Pharmacotherapy 43:1964-1971)