Drug Name Dosage & Route Action Indication Adverse Effects Contraindication Nursing Responsibility

DIAZEPAM Status Epilepticus Body as a Whole: Throat

Psychotherapeutic agent Drug of choice for status Injectable form: Shock, Assessment & Drug Effects
(dye-az'e-pam) Adult: IV/IM 5–10 and chest pain. CNS:
related to epilepticus. Management coma, acute alcohol
mg, repeat if Drowsiness, fatigue,
chlordiazepoxide; of anxiety disorders, for intoxication, depressed
Apo-Diazepam, Diastat, needed at 10–15 ataxia, confusion,  Monitor for adverse
reportedly superior in short-term relief of anxiety vital signs, obstetrical
Diazemuls , E-Pam , min intervals up to paradoxic rage, dizziness, reactions. Most are dose
antianxiety and symptoms, to allay anxiety patients, infants <30 d of
Meval , Novodipam , 30 mg, then repeat vertigo, amnesia, vivid related. Physician will rely on
anticonvulsant activity, and tension prior to age. Tablet form: Infants
Valium, Valrelease, if needed q2–4h dreams, headache, slurred accurate observation and
with somewhat shorter surgery, cardioversion and <6 mo of age, acute
Vivol  Child: IV/IM <5 y, speech, tremor; EEG reports of patient response to
duration of action. Like endoscopic procedures, as narrow-angle glaucoma,
0.2–0.5 mg slowly changes, tardive the drug to determine lowest
chlordiazepoxide, it an amnesic, and treatment untreated open-angle
Classifications: q2–5min up to 5 dyskinesia. CV: effective maintenance dose.
appears to act at both for restless legs. Also used glaucoma; during or within
CENTRAL NERVOUS mg; >5 y, 1 mg Hypotension, tachycardia,  Monitor for therapeutic
limbic and subcortical to alleviate acute 14 d of MAO inhibitor
SYSTEM AGENT; slowly q2–5min up edema, cardiovascular effectiveness. Maximum effect
levels of CNS. withdrawal symptoms of therapy. Safe use during
BENZODIAZEPINE to 10 mg, repeat if collapse. Special Senses: may require 1–2 wk; patient
alcoholism, voiding pregnancy (category D)
ANTICONVULSANT; needed q2–4 h Blurred vision, diplopia, tolerance to therapeutic effects
problems in older adults, and lactation is not
ANXIOLYTIC nystagmus. GI: may develop after 4 wk of
and adjunctively for relief established.
Anxiety, Muscle Xerostomia, nausea, treatment.
of skeletal muscle spasm
Spasm, constipation, hepatic  Observe necessary
associated with cerebral
Convulsions, dysfunction. Urogenital: preventive precautions for
palsy, paraplegia,
Alcohol Incontinence, urinary suicidal tendencies that may be
athetosis, stiff-man
Withdrawal retention, gynecomastia present in anxiety states
syndrome, tetanus.
Adult: PO 2–10 mg (prolonged use), menstrual accompanied by depression.
b.i.d. to q.i.d. or 15– irregularities, ovulation  Observe patient closely and
30 mg/d sustained failure. Respiratory: monitor vital signs when
release IV/IM 2–10 Hiccups, coughing, diazepam is given parenterally;
mg, repeat if laryngospasm. Other: hypotension, muscular
needed in 3–4 h Pain, venous thrombosis, weakness, tachycardia, and
Geriatric: PO 1–2 phlebitis at injection site. respiratory depression may
mg 1–2 times/d occur.
(max: 10 mg/d)  Lab tests: Periodic CBC and
Child: PO >6 mo, liver function tests during
1–2.5 mg b.i.d. or prolonged therapy.
t.i.d.  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.
