Diazepam

Question 1

Brand Name

Answer 1

Valium

Question 2

Class

Answer 2

Benzo

Question 3

Structure

Answer 3

Benzene ring fused w/ 7 member diazepine ring

Question 4

mechanism of action

Answer 4

potentiates binding of GABA to the GABA-A receptor, keeping the Cl- channels open and hyperpolarizing the cell, making it resistant to excitation

Question 5

pharmacokinetics
PB
Lipid solubility
VD
elimination

Answer 5

highly PB
highly lipid soluble
large VD (0.7-1.7L/Kg)
rapidly crossed BBB and placenta
elimination - conjugated CYP450, excreted urine

Question 6

pharmacokinetics
onset
doa
T1/2

Answer 6

onset - 30-60 sec
doa - prolonged
T1/2 - 21-37 hrs

Question 7

active metabolite

Answer 7

desmethyldiazepam

most active, lasts 48-96 hrs

Question 8

side effects

Answer 8

lowers CBF & CMRO2
does not cause isoelectric EEG
preserves CO2 response but flattens curve
neuroprotective

lowers SVR, BP, CO with induction dose

dose dependent decrease in RR and TV
does NOT attenuate SNS response to DVL
can cause hypersensitivity and paradoxical excitation

Question 9

contraindications

Answer 9

early pregnancy
decrease dose for hepatic/renal impairment
use with caution in elderly (increased sensitivity)
DO NOT give with glaucoma

Question 10

dose

Answer 10

pre-med 0.2 mg/kg IV; 10-15 mg PO

induction: 0.5-1 mg/kg IV

Question 11

other

Answer 11

least potent benzo
pain on injection (propylene glycol)
does not effect NMB dose