diazepam (Valium®)
Benzodiazepine
Sedative – hypnotic
Anticonvulsant
Diazepam is a frequently prescribed medication to treat anxiety and stress. In emergency care, it is used to treat alcohol withdrawal and grand mal seizure activity. Diazepam potentiates the effects of inhibitory neurotransmitters (GABA), hyperpolarising the membrane potential and raising the seizure threshold in the motor cortex. It may also be used in conscious patients during cardioversion and TCP to induce amnesia and sedation. Though the drug is still widely used as an anticonvulsant because of its fast action, it is actually a relatively weak anticonvulsant because of its short duration. Rapid IV administration may be followed by respiratory depression and excessive sedation.
IV: Rapid
IM: 15-30 minutes
ET: Rapid
15 min – 1 hour
Acute anxiety states
Acute alcohol withdrawal
Sedation
Seizure activity
Premedication prior to countershock or TCP
Hypersensitivity to the drug
Substance abuse
Coma
Shock
Hypotension
Reflex tachycardia
Respiratory depression
Ataxia
Psychomotor impairment
Confusion
Nausea
Diazepam may precipitate CNS depression and psychomotor impairment when the patient is taking other CNS depressant substances (like ETOH).
Should not be administered with other drugs because of possible precipitation (incompatible with most fluids; should be administered into an IV of NS solution)
5 mg/ml vials, ampules, Tubex
5 mg over 2 min (up to 10 mg for most adults) IV every 10 – 15 min prn.
0.2 – 0.3 mg/kg IV/IO (no faster than 1mg/min) every 2-5 min prn; 0.5 mg/kg rectal dose. Max dose 5mg
5-15mg IV, 5-10 minutes prior to procedure
Pregnancy Safety: Category D
May cause local venous irritation.
Has short duration of anticonvulsant effect
Reduce dose by 50% in elderly patients
Resuscitation equipment should be readily available