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DIAZEPAM
Antianxiety agents
,sedatives/hypnotics---
Benzodiazepines
TRADE NAMES
•Valium
•valpam
DOSAGE
• Oral: 2-10mg, 2-4 times a day.
• Parenteral: 2-10 mg, may repeat it 3-4 hours if needed.
MECHANISM OF ACTION
Potentiate the effects of GABA and other inhibitory
neurotransmitters by binding to specific benzodiazepine
receptors in the limbic and cortical areas of the CNS. GABA
inhibits excitory stimulation which helps to control emotional
behaviour. Diazepam suppresses the spread of seizure activity
caused by seizure producing foci in the cortex, thalamus and
limbic system.
INDICATIONS
• Anxiety,
• skeletal muscle relaxation,
• pre anaesthesia,
• alcohol withdrawal,
• status epilepticus,
• control of increased seizure activity in patients with refractory
epilepsy who are on stable regimens of anti- convulsant,
• treatment of panic disorder , tension, headache, tremors.
CONTRA-INDICATION
•Angle closure glaucoma,
•coma,
•pre-existing CNS depression,
•respiratory depression,
•severe uncontrolled pain,
SIDE EFFECTS
• Dizziness,
• drowsiness,
• lethargy,
• hangover
• paradoxical excitation,
• mental depression,
Side Effects (cont.)
• headache,
• hypotension,
• rashes,
• blurred vision,
• nausea, vomiting,
• diarrhoea,
• constipation,
Side Effects (cont.)
•venous thrombosis,
•phlebitis,
•respiratory depression,
•psychological dependency.
NURSE’S RESPONSIBILITY
 Assess the patient’s BP, pulse rate and respiratory rate,
rhythm and depth immediately before giving diazepam.
 Assess the patient for motor responses, such as agitation,
tension and trembling, and autonomic responses, such as
cold, clammy hands and diaphoresis.
 Keep the patient recumbent for up to 3 hours after parenteral
administration to reduce drug’s hypotensive effect.
 Inform the patient that drowsiness usually disappears with
continued therapy.
 Instruct patient to change positions slowly from recumbent
to sitting, before standing to prevent dizziness.
Nurse’s Responsibility (cont.)
 Administer with food to minimize gastric irritation.
 Advice to take medication exactly as prescribed. Abrupt withdrawal may cause
insomnia, irritability and sometimes even seizures.
 Explain about adverse effects and advice to avoid activities that need alertness.
 Caution the patient to avoid alcohol or other CNS depressants along with
benzodiazepines; also instruct him not to take any over- the –counter medications.
 If IM is preferred, give deep IM.
 For IV administration, do not mix with other drugs. Give slow IV as respiratory or
cardiac arrest can occur; monitor vital signs during IV administration. Prevent
extravasations since it can cause phlebitis and venous thrombosis.
Diazepam

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Diazepam

  • 3. DOSAGE • Oral: 2-10mg, 2-4 times a day. • Parenteral: 2-10 mg, may repeat it 3-4 hours if needed.
  • 4. MECHANISM OF ACTION Potentiate the effects of GABA and other inhibitory neurotransmitters by binding to specific benzodiazepine receptors in the limbic and cortical areas of the CNS. GABA inhibits excitory stimulation which helps to control emotional behaviour. Diazepam suppresses the spread of seizure activity caused by seizure producing foci in the cortex, thalamus and limbic system.
  • 5. INDICATIONS • Anxiety, • skeletal muscle relaxation, • pre anaesthesia, • alcohol withdrawal, • status epilepticus, • control of increased seizure activity in patients with refractory epilepsy who are on stable regimens of anti- convulsant, • treatment of panic disorder , tension, headache, tremors.
  • 6. CONTRA-INDICATION •Angle closure glaucoma, •coma, •pre-existing CNS depression, •respiratory depression, •severe uncontrolled pain,
  • 7. SIDE EFFECTS • Dizziness, • drowsiness, • lethargy, • hangover • paradoxical excitation, • mental depression,
  • 8. Side Effects (cont.) • headache, • hypotension, • rashes, • blurred vision, • nausea, vomiting, • diarrhoea, • constipation,
  • 9. Side Effects (cont.) •venous thrombosis, •phlebitis, •respiratory depression, •psychological dependency.
  • 10. NURSE’S RESPONSIBILITY  Assess the patient’s BP, pulse rate and respiratory rate, rhythm and depth immediately before giving diazepam.  Assess the patient for motor responses, such as agitation, tension and trembling, and autonomic responses, such as cold, clammy hands and diaphoresis.  Keep the patient recumbent for up to 3 hours after parenteral administration to reduce drug’s hypotensive effect.  Inform the patient that drowsiness usually disappears with continued therapy.  Instruct patient to change positions slowly from recumbent to sitting, before standing to prevent dizziness.
  • 11. Nurse’s Responsibility (cont.)  Administer with food to minimize gastric irritation.  Advice to take medication exactly as prescribed. Abrupt withdrawal may cause insomnia, irritability and sometimes even seizures.  Explain about adverse effects and advice to avoid activities that need alertness.  Caution the patient to avoid alcohol or other CNS depressants along with benzodiazepines; also instruct him not to take any over- the –counter medications.  If IM is preferred, give deep IM.  For IV administration, do not mix with other drugs. Give slow IV as respiratory or cardiac arrest can occur; monitor vital signs during IV administration. Prevent extravasations since it can cause phlebitis and venous thrombosis.