Drug Study: Diazepam (Valium)

GENERIC NAME:
Diazepam

BRAND NAME:
Valium

CLASSIFICATION:
Antianxiety agents, anticonvulsants, sedative/hyptonics, skeletal muscle relaxants (centrally acting)

DOSAGE:
10 mg IM

MECHANISM OF ACTION:
- Depress the CNS, probably by potentiating GABA, an inhibitory neurotransmitter.
- Produces skeletal muscle relaxation by inhibiting spinal polysynaptic afferent pathways.
- Has anticonvul-sant properties due to enhanced presynaptic inhibi-tion.Therapeutic effects:
(1) Relief of Anxiety
(2) Sedation
(3) Amnesia
(4) Skeletal muscle relaxant
(5) Decreased seizure activity

INDICATION:
-Adjunct in the management of:
1) Anxiety
2) Preoperative sedation
3) Conscious sedation
- Provides light anesthesia and anterograde amnesia
- Treatment of status epilepticus/ uncontrolled seizures
- Skeletal muscle relaxant
- Management of the symptoms of alcohol withdrawal

CONTRAINDICATIONS:
- Hypersensitivity
- Cross-sensitivity with other benzodiazepines may occurs
- Comatose patients
- Pre-existing CNS depression
- Uncontrolled severe painUse cautiously in:
1) Hepatic dysfunction
2) Severe renal impairment
3) History of suicide attempt or drug dependence

SIDE EFFECTS/ ADVERSE EFFECTS:
- CNS:
1) dizziness
2) drowsiness
3) lethargy
4) hangover
5) headache
6) depression
- EENT:
1) blurred vision
- RESP:
1) respiratory depression
- CV:
1) hypotension
- GI:
1) constipation
2) diarrhea
3) nausea
4) vomiting
- DERM:
1) rashes
- LOCAL:
1) pain (IM)
2) phlebitis (IV)
3) venous thrombosis
- MISC:
1) physical & psychological depen-dence
2)tolerance

NURSING IMPLICATIONS/RESPONSIBILITIES:

- Monitor BP, PR,RR prior to periodically throughout therapy and frequently during IV therapy.
- Assess IV site frequently during administration, diazepam may cause phlebitis and venous thrombosis.
- Prolonged high-dose therapy may lead to psychological or physical dependence. Restrict amount of drug available to patient. Observe depressed patients closely for suicidal tendencies.
- Observe and record intensity, duration and location of seizure activity. The initial dose of diazepam offers seizure control for 15-20 min after administration.
- IM injections are painful and erratically absorbed. If IM route is used, inject deeply into deltoid muscle for maximum absorption.
- Caution patient to avoid taking alcohol or other CNS depressants concurrently with this medication.
- Effectiveness of therapy can be demonstrated by decrease anxiety level; control of seizures; decreased tremulousness.


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