Diazepam

 


Other Names

Valium, Vivol, Diazumul


Classification

Benzodiazepine


Action

  1. •Benzodiazepines produce major inhibitory neurotransmitters in the CNS

  2. •As the use of benzodiazepine is increased, anxiolytic effects are first produced, followed by anticonvulsant effects, a reduction in muscle tonus and finally sedation and hypnosis


Indications

  1. •Sedative/anxiolytic

  2. •Anticonvulsant

  3. •Amnestic


Contraindications

  1. •Hypersensitivity to the medication

  2. •Hypoglycemic seizures


Precautions

  1. •Patient with a compromised respiratory status

  2. • Elderly and children may react unpredictably


Adverse Reactions

  1. •Hypotension

  2. •Reflex tachycardia

  3. •Respiratory and CNS depression

  4. •Laryngospasm

  5. •Nausea and vomiting


Interactions/Compatibility/Stability

Narcotics, barbituates, alcohol and anti-depressants can potentiate effects


Special Considerations

  1. •Protect from light

  2. •Do not mix with any other injectable medication, may precipitate when administered in a D5W IV line

  3. •Diazepam should be diluted 1 mg with 1 ml in NS and administered close to the IV site

  4. •Caution is required for patients with blood dyscrasias, renal and hepatic dysfunction

  5. •Diazepam must not be administered into an endotracheal tube.  It is only for IV, IO or rectal administration.

  6. •To determine volume to be infused, double dose (in mg) and divide by 10.  i.e. 2mg = (2x2) / 10 =0.4mL


Dosages

Preparations: 10 mg/2 ml vial (5 mg/ml)

Adult:

  1. •(seizures) 2 - 20 mg slow IV at < 5 mg/min, repeat every 5 - 15 minutes, PRN, to a maximum of 30 mg

  2. •(sedation) 2 - 5 mg slow IV at < 5 mg/min, repeat every 30 minutes - 4 hours, PRN

Pediatric:

  1. •(seizures) 0.2 mg/kg slow IV at < 1 mg/min, repeat every 5 - 15 minutes, PRN, to a maximum of 20 mg

  2. •(seizures) 0.5 mg/kg for the first PR dose and 0.25 mg/kg for subsequent PR doses


Kinetics

Onset           1-5  minutes

Peak             10 minutes

Duration        20 minutes



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