- to provide sedation
- also used (but not a first line agent) as an anticonvulsant
- 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
- 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
- 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
- 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
- 5 mg/mL, 2 mL ampoule
- 1 mg/mL oral suspension, prepared by Pharmacy
- 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.
- Ford DC, Leist ER and Phelps SJ: Guidelines for administration of intravenous medications to pediatric patients, American Society of Hospital Pharmacists, Bethesda, MD, 1988.