Generic name: Diazepam

Brand name:

Antenex,Apo-
Diazepam,Diastat,Diazemuls,DiazepamIntensol,Ducene,No
vo-Dipam,PMS-Diazepam,Valium,Vivol

Classification:

central nervous system agent;

benzodiazepine anticonvulsant; anxiolytic

Mode of action:

Psychotherapeutic agent related to chlordiazepoxide; reportedly

superior in ant ianxiety and anticonvulsant activity, with
somewhat shorter duration of action. Like chlordiazepoxide, it
appears to act at both limbic and sub cortical levels of CNS

Adverse effects:

CNS: Drowsiness, fatigue, ataxia, confusion, paradoxic rage,

dizziness, vertigo, amnesia, vivid dreams, headache, slurred
 speech, tremor; EEG changes, tardive dyskinesia.
CV: Hypotension, tachycardia, edema, cardiovascular collapse
SpecSenses: Blurred vision, diplopia, nystagmus.
GI: Xerostomia, nausea, constipation, hepatic dysfunction.
Urogenital: Incontinence, urinary retention, gynecomastia
(prolonged use), menstrual irregularities, ovulation failure.
Respiratory: Hiccups, coughing, laryngospasm.
Other: Pain, venous thrombosis, phlebitis at injection site.

Indication

Anxiety

Acute alcohol withdrawal

Before endoscopic procedures

Muscle spasm

Preoperative sedation

Cardio version

Adjunct treatment for seizure disorders

Status epilepticus, severe recurrent seizures

Patients on stable regimens of anti epilepticdrugs who need

diazepam intermittently to control bouts of increased seizure
activity

Dosage

Oral solution: 5 mg/5 ml, 5mg/m

Contraindication:
 inpatients hypersensitiveto drug or soy protein; in patients
experiencing shock, coma, or acute alcohol
intoxication(parenteral form); inpregnant women,especially in
first trimester; and in children younger than age 6 months (oral
form).

Use cautiously inpatients with liver or renal impairment,

depression, or chronicopen-angle glaucoma.
Use cautiously in elderly and debilitated patients.

Side effects

CNS:drowsiness,dysarthria,slurred

CV:hypotension,CV collapse,bradycardia.

EENT:diplopia,blurred vision,nystagmus.

GI: nausea,constipation,diarrhea withrectal form.

Hematologic:neutropenia.

Hepatic: jaundice.

Respiratory:respiratorydepression,apnea.

Skin: rash.

Other: alteredlibido, physicalor psychologicaldependence,pain,

phlebitisat injectionsite

Nursing responsibilities

Monitor for adverse reactions. Most are dose related. Physician will
rely on accurate observation and reports of patient response to the
drug to determine lowest effective maintenance dose.
 Monitor for therapeutic effectiveness. Maximum effect may require 1
2 wk; patient tolerance to therapeutic effects may develop after 4 wk
of treatment.
Observe necessary preventive precautions for suicidal tendencies
that may be present in anxiety states accompanied by depression.
Observe patient closely and monitor vital signs when diazepam is
given parenterally; hypotension, muscular weakness, tachycardia,
and respiratory depression may occur.
Lab tests: Periodic CBC and liver function tests during prolonged
therapy.
Supervise ambulation. Adverse reactions such as drowsiness and
ataxia are more likely to occur in older adults and debilitated or those
receiving larger doses. Dosage adjustment may be necessary.
Monitor I&O ratio, including urinary and bowel elimination.
Note: Smoking increases metabolism of diazepam; lowering clinical
effectiveness. Heavy smokers may need a higher dose than the
nonsmoker.
Note: Psychic and physical dependence may occur in patients on
long-term high dosage therapy, in those with histories of alcohol or
drug addiction, or in those who self-medicate.
Avoid alcohol and other CNS depressants during therapy unless
otherwise advised by physician. Concomitant use of these agents can
cause severe drowsiness, respiratory depression, and apnea.
Do not drive or engage in other potentially hazardous activities or
those requiring mental precision until reaction to drug is known.
Tell physician if you become or intend to become pregnant during
therapy; drug may need to be discontinued.
Take drug as prescribed; do not change dose or dose intervals.
Check with physician before taking any OTC drugs.
Do not breast feed while taking this drug without consulting physician.