Diazepam

Question 1

Generic Name:

Answer 1

Diazepam

Question 2

Trade Name:

Answer 2

Valium

Question 3

Supplied:

Answer 3

10mg/2mL vial

Question 4

Class:

Answer 4

Benzodiazepine, Anti-convulsant, Sedative

Question 5

Mechanism of Action:

Answer 5

Acts on parts of the limbic system, the thalamus, and hypothalamus producing calming effects; decreases seizures by increasing the seizure threshold; transient analgesia; amnesic; sedative.

Question 6

Indications and Field Use:

Answer 6

• Grand mal seizures, especially status epilepticus.
• Transient analgesia/amnesia for medical procedures (e.g., fracture reduction, cardioversion, pacing).
• Delirium tremens.
• Treat the cause first.

Question 7

Contraindications:

Answer 7

Hypersensitivity (allergy)

Glaucoma, acute narrow angle (relative)

Question 8

Adverse Reactions:

Answer 8

CV: Bradycardia, hypotension, cardiovascular collapse; venous thrombosis; phlebitis; vascular spasm

Resp: Respiratory arrest; may be prolonged in neonate

CNS: Somnolence, confusion, coma, diminished reflexes; s/s may be prolonged in
neonate

Other: Burning proximal to IV injection site; local irritation; swelling; extravasation will
cause tissue necrosis

Question 9

Incompatibilities/Drug Interactions:

Answer 9

Do not mix or dilute diazepam with other solutions or drugs in syringe, tubing or IV container.

Question 10

Adult Dosage:

Answer 10

2mg increments slow IV push. Administer no faster than 2mg/min

Question 11

Pediatric Dosage:

Answer 11

IV Dose: 0.2 - 0.3mg/kg every 15-30 min (max of 1.0mg/kg); administer IV over at least 3 minutes or until seizure activity subsides

IV Dose after rectal dose: 0.1mg/kg with same administration instructions

Question 12

Pediatric Dosage: Rectal Dose (<6 years):

Answer 12

0.3-0.5 mg/kg rectally at IV push rate; may repeat in 15-30 min at 0.25 mg/kg.

Question 13

Routes of Administration:

Answer 13

• Slow IV push

- Rectally for children <6 years

Question 14

Onset of Action:

Answer 14

Minutes

Question 15

Peak Effects:

Answer 15

Minutes

Question 16

Duration of Action:

Answer 16

20 to 50 minutes

Question 17

Arizona Drug Box Minimum Supply:

Answer 17

20mg

Optional: Diazepam Rectal Gel 20mg

Question 18

Special Notes:

Answer 18

- Valium must be injected slowly and small veins such as those on the dorsum of the hand or wrist should be avoided. Risk of venous thrombosis, phlebitis, local irritation, swelling and vascular spasm is increased.

•  Extreme care must be taken to avoid intra-arterial injection or extravasation.
•  Diazepam may cause prolonged CNS depression in the neonate (30 days of age or less).