Skip to content
Disclaimer to the On-line Edition
This Manual has been designed for use in the NICU at London Health Sciences Centre (LHSC), London, Ontario, Canada, and represents clinical practice at this institution. The information contained within the Manual may not be applicable to other centres. If users of this Manual are not familiar with a drug, it is recommended that the official monograph be consulted before it is prescribed and administered. Any user of this information is advised that the contributors, Editor and LHSC are not responsible for any errors or omissions, and / or any consequences arising from the use of the information in this Manual.

DIAZEPAM

Indication

  • to provide sedation
  • also used (but not a first line agent) as an anticonvulsant

Pharmacology

  • diazepam is a benzodiazepine; this class of drugs appears to act through the action of the inhibitory neurotransmitter, gamma-aminobutyric acid (GABA)
  • diazepam is metabolized primarily to desmethyldiazepam, an active metabolite; the metabolism of diazepam is slower in the premature, compared to a full-term, neonate with the apparent plasma half-lives reported as 40 to 400 hours and 20 to 50 hours respectively

Side Effects

  • respiratory depression/arrest, apnea; hypotension, bradycardia, cardiovascular collapse
  • phlebitis; local pain with injection; tissue necrosis may occur if infiltration occurs
  • rarely, paradoxical excitement
  • repeated doses over time may cause accumulation of the parent drug and the metabolite, resulting in severe hypotonia and CNS depression

Precautions

  • monitor respirations every 5-15 minutes after each dose and before each IV repeated dose; diazepam can sometimes cause cardiac and respiratory arrest and therefore, if giving IV, have emergency resuscitative equipment available and be prepared to ventilate the baby
  • do not mix with any drugs or IV solutions because diazepam will precipitate out of solution
  • do not store in plastic syringes
  • do NOT give IM
  • contains propylene glycol, ethanol and benzyl alcohol

Dose

  • AS A SEDATIVE
    • 0.1 to 0.25 mg/kg IV push or po q6-q8h
    • IV push by physician only
    • do NOT give IM
  • AS AN ANTICONVULSANT
    (Diazepam is NOT a first-line anticonvulsant)
    • 0.1 to 0.3 mg/kg IV push q2min to a maximum total dose of 1 mg/kg
      CAN BE DILUTED IN 0.9% NaCl IMMEDIATELY PRIOR TO USE
    • if infant is on a respirator, may increase the dose to 0.5 mg/kg IV push by physician only

Supplied

  • 5 mg/mL, 2 mL ampoule
  • 1 mg/mL oral suspension, prepared by Pharmacy

References

  1. McEvoy G K (ed): AHFS Drug Information, American Society of Hospital Pharmacists, 1991.
  2. Roberts, RJ: Drug Therapy in Infants, W.B. Saunders, Toronto, 1984.
  3. Gomella TL (Ed): Neonatology - Management, Procedures, On-Call Problems, Diseases, Drugs, 1992, Appleton and Lange, Norwalk, Connecticut.
  4. Bhatt DR, Furman GI, Reber DJ et al: Neonatal Drug Formulary, 1990-1991, 2nd Edition, Fontana, California 92334.
  5. Taketomo CK, Hodding JH and Kraus DM: Pediatric Dosage Handbook, Lexi-Comp Inc., Cleveland, 1992.
  6. Ford DC, Leist ER and Phelps SJ: Guidelines for administration of intravenous medications to pediatric patients, American Society of Hospital Pharmacists, Bethesda, MD, 1988.



Last Uploaded: Thursday, 26-May-2011 00:53:33 EDT
About Us Patients, Families & Visitors For Health Professionals Careers Research & Training Ways to Give
LHSC Maps & Directions Programs & Services Media Room Contact Us For Our Employees Privacy Statement Terms & Conditions