Critical Care Trauma Centre

DIAZEPAM (Valium)

 

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:
  • IV site
  • heart rate
  • blood pressure
  • respiratory rate
  • response to sedation
Adult Critical Care Protocol:
  • May be administered IV direct or by IV infusion by a nurse in Adult Critical Care
  • May be titrated by a nurse in Adult Critical Care.
  • Continuous infusions must be administered by infusion device and the pump library must be enabled.
  • Central venous acess preferred due to vein irritation (consider alternate benzodiazepine for IV use)
  • Order written to provide sedation during mechanical ventilation should be discontinued when patient is not longer receiving mechanical ventilation support.


Lynne Kelly, Pharmacist, CCTC
Brenda Morgan, Clinical Nurse Specialist, CCTC
Last Update: September 19, 2018