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Diazepam (Valium)

Category:

  • Sedative

  • Muscle relaxant

Description:

  • Benzodiazapine

  Indications:

  • Antianxiety

  • Sedative

  • Acute alcohol withdrawal

  • Anticonvulsant

  • Skeletal muscle relaxant

  • Pre-surgery/procedure relaxation

  Contraindications:

  • Psychoses

  • Acute narrow-angle glaucoma

  • Lactation

  • Co-administration with ketoconazole or itraconazole (P450 enzyme inhibition)

  Precautions:

  • Pregnancy category D

  • Controlled Substance: Schedule IV

  • Closely monitor patients with suicidal tendencies.

  • Use with caution in psychiatric patients due to paradoxical reactions of excitement, over stimulation and acute rage.

  • Use with caution in seizure disorder patients due to an increase in occurance of grand mal seizures.

  • Will impair higher order motor function, therefore use caution when operating machinery or automobiles.

  • Do not drink alcohol and use with caution when administering with other CNS depressive medications.

  • When administering IV or IM to children, have respiratory assistance available.  Give slowly over 3 minutes in a dosage not to exceed 0.25mg/kg. After 15-30 minutes, if children is stable, may repeat initial dosage.  If no relief after three doses, commence adjunctive therapy.

  • May take with food if gastrointestinal upset occurs.

  Adverse Reactions (Side Effects):

  • Central nervous system: drowsiness, dizziness, fatigue, blurred vision, headache, nervousness

  • Cardiovascular: bradycardia, tachycardia, hypertension, hypotension

  • GI: constipation, diarrhea, dry mouth

Dosage:

Administered orally, rectally, intravenously

  • Adult:

    • Anxiety/convulsive disorders: 

      • PO 2-10mg 3-4 times daily

    • Sedative-hypnotic, alcohol withdrawal: 

      • PO 10mg 3-4 times daily, tapered as needed

    • Skeletal muscle relaxant: 

      • PO 2-10mg 3-4 times daily

    • Status epilepticus: 

      • IV bolus 5-20mg infused at a rate of 2 mg/minute

      • may repeat every 5-10 minutes, not to exceed 60mg

      • may repeat in 30 minutes if seizures reappear

    • Adjunct for epilepsy: 

      • PR 0.2 mg/kg as needed

  • Geriatric:  
    • 2-2.5mg 1-4 times daily
    • titrated as needed
  • Child: 

    • IV bolus 0.1-0.3 mg/kg (over 3 minutes)

    • may repeat every 15 minutes for 2 doses

  • Tetanic muscle spasms: 

    • Infants >30 days to <5years IM/IV 1-2mg to 5-10mg every 3-4 hours as needed

  • Anxiety/convulsive disorders: 

    • > 6 months PO 1-2.5mg 3-4 times daily (0.04-0.2 mg/kg 3-4 times daily as needed)

  • Adjunct for epilepsy: 

    • PR: age 2-5 years 0.5 mg/kg as needed

    • age 6-11 years 0.3 mg/kg as needed

    • age > 12 years 0.2 mg/kg as needed

 

 


The information contained here is an abbreviated summary. For more detailed and complete information, consult the manufacturer's product information sheets or standard textbooks

Source: Operational Medicine 2001,  Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300

This information is provided by The Brookside Associates.  The Brookside Associates, LLC. is a private organization, not affiliated with any governmental agency. The opinions presented here are those of the author and do not necessarily represent the opinions of the Brookside Associates or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. All material presented here is unclassified.

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