Drug Data Classification Mechanism of Action Indication Contraindications Adverse Reaction Nursing Responsibilities

Generic Name Pharmacologic It increases neuronal membrane General Indications Concentrations CNS: Transient, mild Before
Diazepam Class permeability to chloride ions by - Short-term - Hypersensitivity drowsiness initially; sedation, - Discuss risk of fetal abnormalities with
Benzodiazepine binding to stereospecific management of anxiety - Preexisting CNS depression, lethargy, apathy, patients desiring to become pregnant.
Trade Name benzodiazepine receptors on the - Insomnia associated depression or coma fatigue, disorientation, - Instruct about side effects of drug:
Valium Therapeutic Class postsynaptic GABA neuron within the with anxiety - Respiratory depression restlessness, confusion, Drowsiness, dizziness, GI upset,
Antiepileptic, CNS and enhancing the GABA - Sleepwalking - Acute pulmonary delirium, headache, slurred dreams, difficulty concentrating, fatigue,
Minimum Dose Anxiolytic, Skeletal inhibitory effects resulting in - Night terrors insufficiency or sleep speech, dysarthria, stupor, nervousness, crying.
2mg/day muscle relaxant hyperpolarisation and stabilization. - Premedication before apnea rigidity, tremor, mild - Assess for hypersensitivity.
anaesthesia - Severe hepatic paradoxical excitatory - Reduce dose of opioid analgesics with
Maximum Dose Pregnancy Risk Pharmacokinetics - Adjunct in the impairment reactions, extrapyramidal IV diazepam; dose should be reduced
60mg/day Factor management of - Acute narrow angle symptoms, visual and by at least one-third or eliminated.
D A: Readily and completely absorbed seizures glaucoma auditory disturbances - Instruct not to stop taking the drug
Contents from the GI tract, peak plasma - Muscle spasms - Children < 6 mth CV: Bradycardia, without consulting the health care
Diazepam concentrations after 30-90 min (oral). - Acute symptoms of - Pregnancy and lactation. tachycardia, CV collapse, provider.
Rapidly absorbed, peak plasma alcohol withdrawal hypertension and - Observe the 15 rights of drug
Precaution
Availability and concentrations after 10-30 min - Premedication before hypotension, edema administration.
- Impaired renal and
color (rectal). anaesthesia Dependence: Drug
hepatic function
- Tablets-2, 5, 10 D: Readily crosses the blood-brain dependence with withdrawal During
- Chronic pulmonary
mg barrier; redistributed into fat depots syndrome - Do not administer intrarterially; may
insufficiency
- Oral solution- and tissues. Protein-binding: 98-99%. Dermatologic: Urticaria, produce arteriospasm, gangrene.
- Organic cerebral
1mg/mL, 5mg/mL M: Extensively hepatic; converted to pruritus, skin rash, dermatitis - Carefully monitor P. BP, respiration
changes; elderly
- Rectal pediatric desmethyldiazepam, oxazepam and GI: Constipation, diarrhea, during IV administration.
- History of alcohol or drug
gel- 2.5, 5, 10mg temazepam. dry mouth, salivation, - Change from IV therapy to oral therapy
addiction.
- Injection- E: Urine (as free or conjugated nausea, anorexia, vomiting, as soon as possible.
5mg/mL metabolites) difficulty in swallowing, - Do not use small veins for IV injection.
Drug interaction
elevation in blood enzymes, - Instruct to take drug exactly as
Drug to drug
Routes of Drug Half Life hepatic impairment prescribed.
- Increased CNS
administration 20-80 hr GU: Incontinence, urinary
depression with alcohol,
Oral retention, changes in libido, After
omeperazole
Intramuscular menstrual irregularities - Maintain patients receiving parenteral
- Increased pharmacologic
Intravenous Hematologic: Decreased benzodiazepines in bed for 3 hours.
effects of diazepam if
Rectal Hct, blood dyscrasias - Do not permit ambulatory patients to
combined with cimetidine,
Other: Phlebitis, thrombosis, operate a vehicle following an injection.
disulfiram, hormonal
hiccups, fever, diaphoresis, - Instruct patient to report adverse
contraceptives
paresthesias, muscular reactions.
- Decreased effects of
disturbances, gynecomastia, - Monitor EEG in patients treated for
diazepam with
pain, burning, redness after status epilepticus, seizures may recur
theophyllines, ranitidine
IM injection after initial control.
- Monitor liver and renal function, CBC
Drug to food
during long term therapy.
- none reported
- Taper dosage gradually after long-term
therapy.
- Document that drug has been given.
Source: Source: Source: Source: Source: Source: Source:
Karch, Amy: 2009 Karch, Amy: 2009 http://mims.com.ph/, Karch, Amy: 2009 http://mims.com.ph/ http://mims.com.ph/ Karch, Amy: 2009 Lippincott’s Karch, Amy: 2009 Lippincott’s Nursing Drug Guide,
Lippincott’s Nursing Lippincott’s Nursing Drug Lippincott’s Nursing Drug Guide, pp. 374-376 Nursing Drug Guide, pp. 374-376 pp. 374-376
Drug Guide, pp. 374 Guide, pp. 374-376