Anxiety/Depression Meds

Question 1

What category class is diazepam (Valium)?

Answer 1

Benzodiazepine Anxiolytic

Question 2

What is the expected pharmacological action of diazepam (Valium)?

Answer 2

It enhances the inhibitory effects of the transmitter gamma-aminobutyric acid (GABA).

Question 3

What is the therapeutic use for diazepam (Valium)?

Answer 3

It is an anxiolytic which treats anxiety and acts on the limbic system.

Question 4

What are the adverse effects of diazepam (Valium)?

Answer 4

-Dizziness, drowsiness, and lethargy.
-Impaired recall of events with high doses or with alcohol.
-Confusion and anxiety is possible, especially with older adults.
-Hypotension, tachycardia, and resp depression (with IV admin).
-Tolerance can develop.
-Overdose or toxicity (hypotension, resp depression, and cardiac arrest).

Question 5

What are contraindications for diazepam (Valium)?

Answer 5

Glaucoma, coma, shock, neonates, and in L & D. Teratogenic drug.

Question 6

What precautions to use with diazepam (Valium)?

Answer 6

Use with caution: older adults, children under 18, renal/hepatic impairment, mental health disorders, suicidal ideation, chronic resp disorders, neurotransmitter disorders, and clients prone to addiction.

Question 7

What are the interactions with diazepam (Valium)?

Answer 7

-Use with other CNS depressants increases the risk of severe sedation & resp depression
-Cimetidine can increase the drug levels and smoking can decrease its effects.
-Herbal supplements kava-kava, chamomile, and valerian increase risk of sedation.

Question 8

What nursing interventions should be taken with diazepam (Valium)?

Answer 8

-Prevent falls and injuries following admin.
-Evaluate memory and watch for paradoxical reaction.
-Monitor vitals (esp with IV admin).
-Check for signs of tolerance and dependence.
-Taper dosage over 1-2 weeks when discontinuing.
-Watch for signs of withdrawal.
-If pt overdose, reverse sedation with IV flumazenil.

Question 9

Medication administration for diazepam (Valium):

Answer 9

-If developing GI symptoms, take with food.
-Available for oral, rectal, IM, or IV.
-Use IM and IV in emergent situations only by severe reactions (resp depression) can occur.
-Admin diazepam emulsion form IV only.
-IM diazepam can cause inconsistent absorption, so if giving IM, inject slowly into a large muscle.
-If given IV, do it slowly and have emergency resuscitation equipment nearby.

Question 10

What client education is needed for diazepam (Valium)?

Answer 10

-Use with care with ambulatory/driving/activities.
-Amnesia may occur with high doses or alcohol.
-Possible paradoxical effects: insomnia or heightened anxiety.
-Avoid increasing the prescribed dose.
-Change positions slowly.
-Taper drug slowly.
-Avoid alcohol or other CNS depressants.