Diazepam

Question 0

Drug classification (3)

Answer 0

1. Anticonvulsant
2. Sedative
3. Muscle relaxants (a benzodiazepine)

Question 1

Trade name

Answer 1

Valium

Question 2

Actions (3)

Answer 2

1. Anticonvulsant
2. Depresses the central, peripheral and autonomic nervous system
3. Decreases patient recall (amnesic effect - Cardioversion)

Question 3

Indications (2)

Answer 3

1. Active seizure activity

2. Sedation prior to cardioversion

Question 4

Contraindication (3)

Answer 4

Shock/hypotension
Alcohol intoxication
Acute narrow-angle glaucoma

Question 5

Relative contraindication

Answer 5

Head injury (with decreased CNS function)

Question 6

Adverse effects - cardiovascular (3)

Answer 6

Bradycardia
Hypotension
Tachycardia

Question 7

Adverse effects - respiratory (2)

Answer 7

Depression/hypoventilation

Apnea

Question 8

Adverse effects - neurological (5)

Answer 8

Slurred speech
Restlessness
Dizziness
Confusion
Blurred vision

Question 9

Adverse effects - other (2)

Answer 9

Worsens glaucoma

Phlebitis

Question 10

Administration

Answer 10

5-10 mg Slowly IVP at 5 mg per minute.

Titrate to stop seizure activity or until sedation occurs for Cardioversion

May repeat 5 mg/minute as needed to a maximum of 20 mg

Question 11

Pediatrics

Answer 11

0.1 - 0.3 mg/kg slowly IVP (1mg per minute) or 0.5 mg/kg per rectum (PR)

Titrate IV dose to stop seizure activity or until sedation occurs for Cardioversion

May repeat IVP dose as needed to maximum of 5 mg up to age 5 and a maximum of 10 mg for older pediatric patients

Question 12

Onset

Answer 12

1-5 minutes

Question 13

Duration

Answer 13

2-3 hours

Question 14

Precaution

Establish largest bite cannula possible in large vein and run IV wide open until administering medication

Answer 14

Rationale

Drug may cause pain, warmth or burning at IV site. Patient may develop phlebitis sclerosis or thrombosis of vein.

Question 15

Precaution

Be prepared to support the patient’s respirations

Answer 15

Rationale

May cause respiratory depression

Question 16

Precaution

Start normal saline IV

Answer 16

Rationale

Diazepam micro-precipitates in D5W

Question 17

Precaution

Inject medication as close to IV site as possible

Answer 17

Rationale

Diazepam is easily absorbed by plastic, which reduces its concentration

Question 18

Precaution

Flush IV line well before and after administration if other drugs are given

Answer 18

Rationale

Incompatible with other medication

Question 19

Precaution

Administer slow IVP to elderly patients

Answer 19

Rationale

Geriatric population may have an increased incidence of adverse effects

Question 20

Note

Answer 20

May be given for focal seizures of patients has ALOC

May alter LOC. Use with caution in patients thT have a head injury.

The antidote to reverse respiratory depression in Romazicon (flumazenil)

Is a schedule IV controlled substance

Question 21

How supplied

Answer 21

10mg/2mL pre-filled syringe or vial.