Diazepam/ Valium, Diastat

Question 1

Diazepam Class

Answer 1

• Benzodiazepine (nonbarbiturate sedative-hypnotic agent)
• Anticonvulsant
• Skeletal Muscle Relaxant
• Schedule IV Controlled Substance

Question 2

Diazepam Action

Answer 2

• Acts at the level of the limbic, thalamic, and hypothalamic regions of the CNS through potentiation of GABA (inhibitory neurotransmitter).
• Decreases neural cell activity in all regions of CNS.
• Anxiety is decreased by inhibiting cortical and limbic arousal.
• Promotes relaxation through inhibition of spinal motor reflex pathway, also depresses muscle and motor nerve function directly.
• As an anticonvulsant, augments presynaptic inhibitions of neurons, limiting the spread of electrical activity. However, they do not alter the electrical activity of the seizure’s focus.

Question 3

Diazepam Indications

Answer 3

• Major motor seizures
• Status Epilepticus
• Acute anxiety
• Skeletal muscle relaxant
• Management of alcohol withdrawal symptoms
• Vertigo

Question 4

Diazepam Contraindications

Answer 4

• Shock
• Coma
• Respiratory Depression
• Hypersensitivity
• Closed Angle Glaucoma

Question 5

Diazepam Precautions

Answer 5

• Reduced dose for Geriatrics 50%
• Use caution w/ patients with:Hepatic dysfunction
• Current Substance Abuse (CNS depressants, including alcohol)
• Renal insufficiency
• History of drug addiction
• Parkinson’s Disease
• Myasthenia gravis
• Pregnancy (D)

Question 6

Diazepam Dosage

Answer 6

Adults: (No faster than 5 mg/min)
• Seizures: 2-10 mg SIVP (5-10mg rectally). Max 20 mg
• Behavioral Emergencies: 2-5 mg SIVP q 5-10 minutes repeated once in 20 min, Max 20 mg
• Sedation/Cardioversion/Pacing: 2-5 mg SIVP q 5-10 min.
Max 10 mg
Pediatrics:
• Seizures—0.2 mg/kg SIVP IV/IO (q 5 min.)0.5 mg/kg PRN.
• Max 10 mg

Question 7

Diazepam Onset. Duration

Answer 7

Onset: IV—5 min
Duration: IV—15-60 min

Question 8

Diazepam Side Effects

Answer 8

Minor:
• CNS Depression
• Dizziness
• Drowsiness
• Lethargy
• Ataxia 
Major:
• Respiratory Depression
• Apnea
• Hypotension
• Cardiac Arrest
• Valium Rage

Question 9

Diazepam Interactions

Answer 9

• Incompatible with all other drugs, NS flush should precede and follow administration.
• Additive with other CNS depressants