- to reduce blood pressure during a hypertensive crisis
- to treat persistent hypoglycemia associated with hyperinsulinism
- reduces peripheral vascular resistance and blood pressure by a direct vasodilatory effect on the smooth muscle of peripheral arterioles. The onset of action is within 2 to 5 minutes, and usually lasts 3 to 12 hours. The degree of vasoconstriction present appears to be an important factor in the hypotensive response to diazoxide; greatest effects occur in patients with malignant hypertension
- diazoxide causes reduced excretion of K, Cl, bicarbonate, uric acid, and Na and leads to water retention
- inhibits pancreatic insulin secretion and stimulates catecholamine release, thereby increasing blood glucose concentration; diazoxide may also act by increasing the hepatic release of glucose; the hyperglycemic effect begins within an hour
- diazoxide induced hyperglycemia may be reversed by the administration of insulin (see Insulin Monograph)
- side effects are rare when given for short periods
- may cause a non dose-related hyperglycemia, tachycardia, vomiting, flushing, rash, burning or pain at the site of administration, hypotension, thrombocytopenia
- monitor blood pressure and serum glucose
- shake suspension well before using
- HYPERTENSIVE CRISIS
- 1 to 2 mg/kg IV (undiluted) over 15-30 seconds by physician only
- repeat dose every 5 to 15 minutes until desired BP effect is achieved
MAXIMUM TOTAL DOSE: 5 mg/kg
- do NOT give IM or SC
- repeat effective dose every 2 to 24 h as required for control
Note: slow IV infusion may not influence the antihypertensive effect and will minimize the possible danger of ischemic injury to the heart and brain resulting from a sudden drop in blood pressure
- 4 to 7.5 mg/kg po or IV (over 1 hour) q12h as required for control
- 15 mg/mL, 20 mL ampoule
- 50 mg/mL oral suspension
- McEvoy G K (ed): AHFS Drug Information, American Society of Hospital Pharmacists, 1991.
- Roberts, RJ: Drug Therapy in Infants, W.B. Saunders, Toronto, 1984.
- Gomella TL (Ed): Neonatology - Management, Procedures, On-Call Problems, Diseases, Drugs, 1992, Appleton and Lange, Norwalk, Connecticut.
- Bhatt DR, Furman GI, Reber DJ et al: Neonatal Drug Formulary, 1990-1991, 2nd Edition, Fontana, California 92334.
- Taketomo CK, Hodding JH and Kraus DM: Pediatric Dosage Handbook, Lexi-Comp Inc., Cleveland, 1992.