Diazepam (Valium)

Question 1

Classification

Answer 1

Benzodiazepine

Question 2

Mechanism of Action

Answer 2

• Binds to benzodiazepine receptors & enhances the effects of GABA.
• Acts at the level of the limbic, thalmic, & hypothalmic regions of the CNS and can produce any level of CNS depression (including sedation, muscle relaxation, anticonvulsant activity)

Question 3

Indications

Answer 3

• Anxiety
• Skeletal muscle relaxation
• Alcohol withdrawal
• Seizures
• Sedation for cardioversion

Question 4

Contraindications

Answer 4

• Acute-angle glaucoma
• CNS depression
• Alcohol intoxication
• Known sensitivity

Question 5

Adverse Effects

Answer 5

• Respiratory depression
• Drowsiness, fatigue
• Headache, nausea
• Confusion, oversedation
• Hypotension

Question 6

Administration

Answer 6

• Anxiety
  
  • Adult:
    
    • Moderate: 2-5 mg slow IV/IM
    • Severe: 5-10 mg slow IV/IM
  • Peds: 0.04-0.3 mg/kg/dose IV/IM every 4 hours (max 0.6 mg/kg)
• Delirium Tremens from Acute Alcohol Withdrawal
  
  • Adult: 10mg
• Seizure
  
  • ​Adult: 5-10 mg slow IV/IO every 10-15 minutes, max 30 mg.
  • Peds: Refer length-weight-based chart
• Premedication before Cardioversion
  
  • ​Adult: 5-15 mg

Question 7

Special Considerations

Answer 7

• Extravasation of diazepam causes tissue necrosis.
• Diazepam is insoluble in water and must be disolved in propylene glycol. This produces a viscous solution. Give slowly to prevent pain on injection.