Valium (Diazepam)

Question 1

Class (3)

Answer 1

• Anticonvulsant
• Sedative
• Benzodiazepine (controlled substance schedule IV)

Question 2

Actions (2)

Answer 2

• Inhibits the spread of electrical activity from the irritable focus in the irritable neurons in the brain
• Calms CNS to have an anti-anxiety/sedative effect

Question 3

Indications (5)

Answer 3

• Status epilepticus
• Acute anxiety states
• Sedation before elective cardioversion
• Acute alcohol withdrawal symptoms: delirium, irritability, tremors
• May be ordered to blunt the major hypersympathetic response from cocaine: persistent SVT

Question 4

Dosage/Route

Answer 4

• SZ SO: 5 mg slow IVP, may be repeated once if sz activity doesn’t stop after 2 min
• Agitation SO: 5 mg IV initial dose, repeat every 2 min up to a max of 3 doses (15 mg total IV dose)
• Pre-cardioversion or transcutaneous pacing: slow IV bolus titrated to induction of sedation

Question 5

Standard Prep

Answer 5

• 10 mg/2 cc preloaded syringe

- 5 mg/cc vial

Question 6

Peds Dose

Answer 6

0.5 mg/kg rectally up to 10 mg max

Question 7

Side Effects (4)

Answer 7

• Respiratory depression
• Decreased level of consciousness
• Hypotension (usually transient)
• Pain at IV site–flush line with generous amounts of NS

Question 8

Contraindications (5)

Answer 8

• Hypovolemia/hypotension/shock
• Pregnancy
• Isolated head or multisystems trauma
• Pain, unknown etiology
• Pts with EtOH or other CNS depressants

Question 9

Precautions

Answer 9

• Have resuscitation equipment readily available with supplemental oxygen
• Expect short onset and duration of action
• Request PRN order during commo with MD