Lorazepam can be safely used as a preanesthetic medication in a patient undergoing liver transplantation without fear of excessive CNS depression because the drug is
Most benzodiazepines are metabolized by liver cytochromes P450. In a patient lacking liver function, benzodiazepines that are metabolized via extrahepatic conjugation (e.g., lorazepam, oxazepam) are safer in terms of the possibility of excessive CNS depression. Lorazepam is metabolized, probably in the lungs, via glucuronidation. Although benzodiazepine actions can be reversed, the drug that acts as an antagonist is flumazenil, not naloxone.
excreted in unchanged form
actively secreted into the GI tract
conjugated extrahepatically
a selective anxiolytic devoid of CNS depressant actions
C.N.S