Medication Monday: Diazepam (Valium)

Introduction

• Medication Focus: Diazepam
• Common Name: Valium
• Class: Benzodiazepines
• Reminder: Follow local protocol and scope of practice.

Mechanism of Action

• Interacts with GABA receptors in the 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: 2 to 10 mg IV/IO/IM
• Pediatric: 0.05 to 0.1 mg/kg
• Administration Note: Slow IV/IO push

Contraindications

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

Adverse Reactions

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

Drug Interactions

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

Supply

• Typically supplied as 5 mg in 1 ml vial.

Administration Notes

• Can irritate the vein; use larger, healthier veins.
• Flush IV line to avoid excess medication.
• Do not dilute with other solutions.

Onset

• 1 to 5 minutes; fast acting.

Special Considerations

• Reduce dose by half for elderly patients.
• Risk of respiratory depression or arrest post-administration.
• Apnea in children may occur post-administration.
• Be cautious with patients having CNS depressants.

Conclusion

• Always adhere to local protocol and scope of practice.
• Information is purely educational for EMS field use.