diazepam علاج

Name
diazepam (Valium®)

Class
Benzodiazepine

Sedative – hypnotic

Anticonvulsant

Description/Mechanism
Diazepam is a frequently prescribed medication to treat anxiety and stress. In emergency care, it is used to treat alcohol withdrawal and grand mal seizure activity. Diazepam potentiates the effects of inhibitory neurotransmitters (GABA), hyperpolarising the membrane potential and raising the seizure threshold in the motor cortex. It may also be used in conscious patients during cardioversion and TCP to induce amnesia and sedation. Though the drug is still widely used as an anticonvulsant because of its fast action, it is actually a relatively weak anticonvulsant because of its short duration. Rapid IV administration may be followed by respiratory depression and excessive sedation.

Onset
IV: Rapid

IM: 15-30 minutes

ET: Rapid

Duration
15 min – 1 hour

Indications
Acute anxiety states

Acute alcohol withdrawal

Sedation

Seizure activity

Premedication prior to countershock or TCP

Contraindications
Hypersensitivity to the drug

Substance abuse

Coma

Shock

Adverse Reactions
Hypotension

Reflex tachycardia

Respiratory depression

Ataxia

Psychomotor impairment

Confusion

Nausea

Drug Interactions
Diazepam may precipitate CNS depression and psychomotor impairment when the patient is taking other CNS depressant substances (like ETOH).

Should not be administered with other drugs because of possible precipitation (incompatible with most fluids; should be administered into an IV of NS solution)

Supplied
5 mg/ml vials, ampules, Tubex

Dose/Administration
Seizure
Adult
5 mg over 2 min (up to 10 mg for most adults) IV every 10 – 15 min prn.

Pediatric
0.2 – 0.3 mg/kg IV/IO (no faster than 1mg/min) every 2-5 min prn; 0.5 mg/kg rectal dose. Max dose 5mg

Premedication prior to Cardioversion/TCP
Adult
5-15mg IV, 5-10 minutes prior to procedure

Special Consideration
Pregnancy Safety: Category D

May cause local venous irritation.

Has short duration of anticonvulsant effect

Reduce dose by 50% in elderly patients

Resuscitation equipment should be readily available