| Name: |
DIAZEPAM (ValiumR) |
| Classification: |
anxiolytic agent; sedative; anticonvulsant:
- used in the initial control of seizures or in the treatment of status epilepticus
- has no long-term anticonvulsant activity
- useful in the management of alcohol withdrawal and delirium tremens
- muscle relaxant - useful in patient with tetanus
|
| Dose: |
- dose must be individualized
- anxiolytic, sedative: 2-5 mg IV (moderate anxiety)
- 5-10 mg IV (severe anxiety)
- anticonvulsant: 5-10 mg IV which may be repeated at 10 - 15 min. intervals
|
| Administration: |
IV Direct
- injected into the tubing of a flowing IV solution as close as possible to the vein; small veins (eg. wrist/dorsum of the hand) should be avoided
- rate of administration should not exceed 5 mg/min
- conflicting data about diazepam's solubility and stability in an infusion, therefore not recommended
|
| Adverse Effects: |
- hypotension
- arrhythmias - if given too quickly
- respiratory depression
- laryngospasm
- paradoxical reaction (excitatory)
- may worsen depression or psychosis
- thrombophlebitis
|
| Caution: |
- adverse effects may be amplified in the presence of hepatic or renal failure
|
| Antidote: |
|
| Drug Interactions: |
- diazepam + other CNS depressants = increased sedation
|
| Monitoring Therapy: |
- HR
- ECG
- arterial blood pressure
- respiratory rate
- response to sedation
|
| CCTC Protocol: |
- May be given IV direct by an approved nurse in CCTC.
- If ordered as a sedative/anxiolytic agent for a patient receiving mechanical ventilation, must be discontinued when mechanical ventilation ceases.
- May be continued IV direct post-ventilation if specifically ordered following assessment by physician.
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