Diazepam
Class
Benzodiazepine, sedative-hypnotic, anticonvulsant
Description
Diazepam is frequently prescribed to treat anxiety and stress. In emergency
care, it is used to treat alcohol withdrawal and grand mal seizure activity.
Diazepam acts on the limbic, thalamic, and hypothalamic regions of the CNS to
potentiate the effects of inhibitory neurotransmitters, raising the seizure
threshold in the motor cortex. It may also be used in conscious patients during
cardioversion to induce amnesia and sedation. Though the drug is still widely
used as an anticonvulsant, it is relatively weak and of short duration. Rapid IV
administration may be followed by respiratory depression and excessive sedation.
Onset & Duration
Onset: (IV) 1-5 min. (IM) 15-30 min.
Duration: (IV) 15 min-1 hr (IM) 15 min-I hr
Indications
1. Status epilepticus
2. Acute anxiety states
3. Acute alcohol withdrawal
4. Muscle relaxant
5. Preoperative sedation
Contraindications
1. Hypersensitivity to the drug
2. Acute narrow angle glaucoma
3. Open angle glaucoma
4. Hypotension
5. Head injury
6. CNS depression
7. Respiratory depression
Adverse Reactions
1. Hypotension
2. Reflex tachycardia
3. Respiratory depression
4. Ataxia
5. Psychomotor impairment
6. Confusion
7. Nausea
Drug Interactions
1. Diazepam may precipitate CNS depression and psychomotor impairment when the
patient is taking CNS depressant medications.
2. Should not be administered with other drugs because of possible precipitation
(incompatible with most fluids; should be administered into an IV of normal
saline solution).
Special Considerations
1. Pregnancy safety: Category D
2. May cause local venous irritation
3. Has short duration of anticonvulsant effect
4. Reduce dose by 50% in elderly patients
5. Resuscitation equipment should be readily available
6. Antidote: Flumazenil (Ramazicon)
Note: Feel free to discuss this medication and your experiences in administering it in an emergency or hospital based setting on our message board
