Name of Drug Generic Name: diazepam Trade Name: Apo Diazepam Diastat Diazemuls Diazepam Intensol Valium Vivol

l Maximum Dose: 2 10 mg Minimum Dose: 1 2.5mg Availability: Tablets : 2 ,5 , 10mg SR capsule : 15 mg Oral solution : 1mg/mL, 5mg/5mL Rectal pediatric gel 2.5, 5 , 10mg Rectal adult gel 10, 15, 20 mg Injection : 5mg/ mL

Classification of Drug Therapeutic class: Benzodiazepine Pharmacologic class : Anxiolytic Antiepileptic Skeletal muscle relaxant

Mechanism of Action Diazepam is a long-acting benzodiazepine with anticonvulsant, anxiolytic, sedative, muscle relaxant and amnestic properties. It increases neuronal membrane permeability to chloride ions by binding to stereospecific benzodiazepine receptors on the postsynaptic GABA neuron within the CNS and enhancing the GABA inhibitory effects resulting in hyperpolarisation and stabilisation. Absorption: Readily and completely absorbed from the GI tract, peak plasma concentrations after 30-90 min (oral). Rapidly absorbed, peak plasma concentrations after 10-30 min (rectal). Distribution: Readily crosses the blood-brain barrier; redistributed into fat depots and tissues. Proteinbinding: 98-99%. Metabolism: Extensively hepatic; converted to desmethyldiazepam, oxazepam and temazepam. Excretion: Urine (as free or conjugated metabolites). Elimination half-life: Rapid (initial), 1-2 days (terminal), 2-5 days (desmethyldiazepam). Route Oral IM Onset 30 60 mins 15 30 mins 1 -5 mins Rapid Peak 1 -2 hrs 30 45 mins 30 mins 1.5 hrs Duratio n 3 hr 3 hr

Indication Management of anxiety disorders Acute alcohol withdrawal Muscle relaxant Parenteral : treatment of tetanus Antiepileptic

Contraindications Contraindicated to patients with Hypersensitivity; preexisting CNS depression or coma, respiratory depression; acute pulmonary insufficiency or sleep apnoea; severe hepatic impairment; acute narrow angle glaucoma; children < 6 mth; pregnancy and lactation. Caution : Impaired renal and hepatic function; chronic pulmonary insufficiency; organic cerebral changes; elderly; psychotic patients; epileptics; history of alcohol or drug addiction. Interaction : Drug drug ncreased clearance of diazepam when used with phenytoin, carbamazepine and phenobarbital. Reversible deterioration of parkinsonism may occur when given together with levodopa. Combination with lithium may produce hypothermia.

Side Effects CNS : drowsiness, sedation, depression, lethargy, apathy, crying, delirium, dysarthria, tremor, vivid dreams, retardation, nasal congestion CV: bradycardia, tachycardia, CV collapse, hypertension, hypotension, palpitations, edema Dermatologic : urticaira, pruritus, skin rash, dermatitis GI : constipation, diarrhea, dry mouth, salivation, nausea, anorexia, vomiting, gastric disorders Hematologic : decreased hematocrit, blood dyscrasias

Nursing Responsibilities Before: 1.Perform handwashing 2.Prepare right dosage of drug 3.Do not administer intraarterially because it may produce arteriospasm 4.Ask for any allergies from drug 5.Counsel patient about the severe risks of fetal abnormalities associated with the drug During: 1. Verify clients identity 2. Explain the benefits of drugs and side effects 3. Do not exceed the recommended dosage. 4. Observe strict asepsis. 5. Discuss risk of fetal abnormalities with patients desiring to become pregnant. After: 1. Thank patient for her cooperation. 2. Provide health education about drug being administered. 3. Monitor vital signs 4. Monitor liver and kidney function, CBC and EEG. 5. Advise patient to report any unsual or undesired sensation.

Pregnancy Category: D

Patients Indication:

Patients Dosage: Source: http://www.rxlist. com/valium-drugcenter.htm

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IV Rectal

15 60 Source:. mins http://epilepsy.emedtv. 3 hr com/diazepam/diazepa m-indications.html

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