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.


Lynne Kelly, Pharmacist, CCTC
Brenda Morgan, Clinical Nurse Specialist, CCTC
Last Update: August 7, 2006

 

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Last Updated January 12, 2017 | © 2007, LHSC, London Ontario Canada