DIAZEPAM (Valium®)

CLASS:

• anticonvulsant

• sedative

• benzodiazepine (Controlled substance schedule IV)

ACTIONS:

• Depress all levels of the CNS by enhancing the action of Gamma-amminobutyric acid (GABA), a major inhibitory neurotransmitter in the brain.

• Produces anxiolytic effects, elevates seizure threshold and produces skeletal muscle relaxation.

• calms CNS to have an anti-anxiety/sedative effect

INDICATIONS:

• status epilepticus

• acute anxiety states

• sedation before elective cardioversion

• acute alcohol withdrawal symptoms: delirium, irritability, tremors

• may be ordered to blunt the major hypersympathetic response from cocaine: persistent supraventricular tachycardia

• vertigo symptoms with nystagmus

CONTRAINDICATIONS:

• hypovolemia/hypotension/shock

• pregnancy - breastfeeding

• isolated head or multisystems trauma • Myasthenia gravis

• Narrow angle-glaucoma

• pts. w/EtOH or other CNS depressants

• hypersensitivity

STANDARD PREP:

• 10 mg / 2 cc preloaded syringe

DOSAGE/ROUTE:

• See Hawaii S.O. Status Epilepticus

• pre-cardioversion or transcutaneous pacing: slow IV bolus titrated to induction of sedation

PEDS DOSE:

• See Hawaii S.O. – 0.1mg/kg IV up to 2 mg/dose • If no IV, 0.5mg/kg PR to max 10mg

SIDE EFFECTS:

• respiratory depression

• decreased level of consciousness

• hypotension (usually transient)

• HA, N/V

• pain at IV site - flush line with generous amount of NS

PRECAUTIONS:

• have resuscitation equipment readily available with supplemental oxygen

• expect short onset & duration of action, request prn order during commo with MD.

• Flumazenil (Romazicon) is used for benzodiazepine OD.