Benzo's - Diazepam

Question 1

What is the onset of diazepam?

Answer 1

Onset: 1-5 minutes

Question 2

What is the E ½ time of diazepam?

Answer 2

E ½ = 20-40 hours (very protein-bound)

Question 3

What is the Vd of diazepam?

Answer 3

Vd = 1-1.5 L/kg

Question 4

What metabolizes diazepam?

Answer 4

CYP3A4

Question 5

What are its primary metabolites and what is its significance?

Answer 5

Desmethyldiazepam & oxazepam

Metabolites are nearly as potent as diazepam and hit 6-8 hours after administration.

Question 6

What is the seizure dosing for diazepam?

Answer 6

0.1 mg/kg IV

Question 7

What seizures is diazepam utilized for?

Answer 7

DT’s, status epilepticus, lidocaine toxicity seizures.

Question 8

What are the EEG effects of diazepam?

Answer 8

Can produce isoelectric EEG.

Question 9

What are the pulmonary effects of diazepam?

Answer 9

Minimal; any depressant effects are reversed by surgical stimulation.

Question 10

What are diazepam’s effects on the cardiovascular system?

Answer 10

Minimal decreases in BP, CO, and SVR (used be agent for cardiac cases)

Question 11

What effects would be seen with adjunct opioids?

Answer 11

Additive BP changes when used with opioid.

Question 12

What are diazepam’s effects on the musculoskeletal system?

Answer 12

Decreases skeletal muscle tone.

Question 13

What is the induction dose of diazepam?

Answer 13

0.5-1 mg/kg IV

Question 14

When would one decrease the dose by 50%?

Answer 14

50% cut with elderly, liver patients, and with concurrent opioid use.

Question 15

What pulmonary effects does diazepam have?

Answer 15

• slight decrease in Vt
• Increases in PaCO2 after 0.2 mg/kg
• Exaggerated with opioids, etoh, COPD