Medication Monday: Diazepam

Overview

• Purpose: Review EMT drug in field application
• Focus: Diazepam (Valium) - a benzodiazepine

Mechanism of Action

• Interacts with GABA receptors in CNS
• Effects include:
  • Anticonvulsant
  • Hypnotic
  • Sedative
  • Anxiolytic
  • Amnesic
  • Muscle relaxant

Indications

• Seizures or seizure-like activity
• Anxious, agitated, or violent patients
• Behavioral emergencies
• Sedation for certain procedures

Dosage

• Adult Dose: 2 to 10 mg IV, IO, or IM
  • Slow IV/IO push
• Pediatric Dose: 0.05 to 0.1 mg/kg
• Note: Follow local protocol as dosages vary

Contraindications

• Hypersensitivity
• Coma
• Head injury
• Severe CNS or respiratory depression

Adverse Reactions

• Headache
• Pain at injection site
• Phlebitis
• Tissue necrosis
• Respiratory and CNS depression
• Hypotension
• Apnea
• Cardiac or respiratory arrest

Drug Interactions

• Interacts with narcotics, benzos, sedatives, hypnotics, alcohol
  • Increases CNS depression and hypotension

Administration Notes

• Typically supplied in 5 mg/1 ml vial
• Irritant to veins; use larger, healthier veins
• Flush IV line, avoid excess medication in line
• Do not dilute with other solutions

Onset and Special Considerations

• Onset: 1 to 5 minutes (fast-acting)
• Reduce dose by half for elderly patients
• Risk of respiratory depression, arrest, apnea, especially in children
• Be cautious with patients sensitive to CNS depressants

Final Reminders

• Abide by local protocol and scope of practice
• Information is educational; not a substitute for formal education or protocol

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Next Session: Upcoming Medication Monday review.