Valproic Acid, Divalproex Sodium: Methyldopa can potentiate the effects of CNS depressants such as barbiturates, benzodiazepines, opiate agonists, or phenothiazines when administered concomitantly. Moderate Concomitant administration of benzodiazepines with zolpidem can potentiate the CNS effects e. Strict aseptic technique must always be maintained during handling of parenteral products. Elevated hepatic enzymes e.
Great: How to give diazepam injection for seizures
|DIAZEPAM MEDSCAPE CEU||When diazepam is used with a narcotic analgesic, the dosage of the narcotic should for reduced by at least one-third and administered in small increments. Some experts suggest that occasional maternal treatment with usual doses of lorazepam or oxazepam would pose little risk to a breast-feeding infant. Consult your doctor for injection details. They are ideal to be used alongside training in giving emergency medication and within the context of a written protocol or care plan for the individual seizures epilepsy. This document does not contain all possible proneuron metamizole diazepam information side interactions. Concomitant how of barbiturates, alcohol or other central nervous system depressants increases depression with diazepam risk of apnea. Finding the give doctor is daunting.|
|DIAZEPAM IV COMPATIBILITY REFERENCE CHECK||Minor No how drug interactions were identified with systemic agents and apraclonidine during clinical trials. This medication belongs to a class of drugs called benzodiazepineswhich act diazepam the brain injection nerves give nervous system to produce a calming effect. You are encouraged to report negative side effects of prescription drugs givd the FDA. Seizures, caution is advisable when combining anxiolytics, sedatives, and hypnotics or other psychoactive medications with levomilnacipran. Limit the for of opiate pain medications with benzodiazepines to only patients for whom alternative treatment options are inadequate.|
|How to give diazepam injection for seizures||713|
For cats use 0. If you cannot get IV access give double the IV dose rectally. Use a red rubber feeding tube inserted about 4 - 6 inches in the rectum and given as a bolus. If after giving a dose of diazepam the seizure does not stop within 2 - 3 minutes IV or 5 min rectal then give another dose. It is not that uncommon to have to give 2 - 4 doses of valium before the seizure stops.
It sounds like a lot but it is very safe. If an animal has compromised liver function or you are suspicious of liver disease shunt or cirrhosis etc Once the seizure is stopped you can give a loading dose of phenobarbital or potassium bromide. If you are going to refer the patient immediately, it might be better to wait on the loading dose so a more accurate exam can be performed.
If the patient continues to have seizures after the initial doses of valium, they should be placed on a valium constant rate infusion. Use the amount of valium that it took to stop the seizure and give it over one hour as a CRI. Dilute the phenobarbital in 1 part saline to one part phenobarbital and give it IV slowly. There have been anecdotal reports of animals having an anaphylactic reaction to components of the injectable form of phenobarbital.
You can also give the loading dose orally, if you are certain that the patient is alert enough to take oral medications. Prior to referral, a CBC, biochemical profile and urinalysis can be performed. It is a colorless crystalline compound, insoluble in water, with the following molecular structure:. In animals, diazepam appears to act on parts of the limbic system, the thalamus and hypothalamus, and induces calming effects.
Diazepam, unlike chlorpromazine and reserpine, has no demonstrable peripheral autonomic blocking action, nor does it produce extrapyramidal side effects; however, animals treated with diazepam do have a transient ataxia at higher doses. Diazepam was found to have transient cardiovascular depressor effects in dogs. Long-term experiments in rats revealed no disturbances of endocrine function.
Injections into animals have produced localized irritation of tissue surrounding injection sites and some thickening of veins after intravenous use. Diazepam is indicated for the management of anxiety disorders or for the short-term relief of the symptoms of anxiety. Anxiety or tension associated with the stress of everyday life usually does not require treatment with an anxiolytic.
In acute alcohol withdrawal, diazepam may be useful in the symptomatic relief of acute agitation, tremor, impending or acute delirium tremens and hallucinosis. Diazepam is a useful adjunct for the relief of skeletal muscle spasm due to reflex spasm to local pathology such as inflammation of the muscles or joints, or secondary to trauma ; spasticity caused by upper motor neuron disorders such as cerebral palsy and paraplegia ; athetosis; stiff-man syndrome; and tetanus.
Diazepam is a useful premedication the I. Diazepam is contraindicated in patients with a known hypersensitivity to this drug; acute narrow angle glaucoma; and open angle glaucoma unless patients are receiving appropriate therapy. When used intravenously, the following procedures should be undertaken to reduce the possibility of venous thrombosis, phlebitis, local irritation, swelling, and, rarely, vascular impairment; the solution should be injected slowly, taking at least one minute for each 5 mg 1 mL given; do not use small veins, such as those on the dorsum of the hand or wrist; extreme care should be taken to avoid intra-arterial administration or extravasation.
Do not mix or dilute diazepam with other solutions or drugs in syringe or infusion container. If it is not feasible to administer diazepam directly I. Extreme care must be used in administering Diazepam Injection, particularly by the I. Concomitant use of barbiturates, alcohol or other central nervous system depressants increases depression with increased risk of apnea. Resuscitative equipment including that necessary to support respiration should be readily available. When diazepam is used with a narcotic analgesic, the dosage of the narcotic should be reduced by at least one-third and administered in small increments.
In some cases the use of a narcotic may not be necessary. Diazepam Injection should not be administered to patients in shock, coma, or in acute alcoholic intoxication with depression of vital signs. As is true of most CNS-acting drugs, patients receiving diazepam should be cautioned against engaging inhazardous occupations requiring complete mental alertness, such as operating machinery or driving a motor vehicle. Tonic status epilepticus has been precipitated in patients treated with I.
An increased risk of congenital malformations associated with the use of minor tranquilizers diazepam, meprobamate and chlordiazepoxide during the first trimester of pregnancy has been suggested in several studies. Because use of these drugs is rarely a matter of urgency, their use during this period should almost always be avoided.
The possibility that a woman of childbearing potential may be pregnant at the time of institution of therapy should be considered. Patients should be advised that if they become pregnant during therapy or intend to become pregnant they should communicate with their physicians about the desirability of discontinuing the drug. In humans, measurable amounts of diazepam were found in maternal and cord blood, indicating placental transfer of the drug.
Until additional information is available, Diazepam Injection is not recommended for obstetrical use. Efficacy and safety of parenteral diazepam has not been established in the neonate 30 days or less of age. Prolonged central nervous system depression has been observed in neonates, apparently due to inability to biotransform diazepam into inactive metabolites. In pediatric use, in order to obtain maximal clinical effect with the minimum amount of drug and thus to reduce the risk of hazardous side effects, such as apnea or prolonged periods of somnolence, it is recommended that the drug be given slowly over a three-minute period in a dosage not to exceed 0.
After an interval of 15 to 30 minutes the initial dosage can be safely repeated. If, however, relief of symptoms is not obtained after a third administration, adjunctive therapy appropriate to the condition being treated is recommended. Benzyl alcohol has been reported to be associated with a fatal gasping syndrome in premature infants. Although seizures may be brought under control promptly, a significant proportion of patients experience a return to seizure activity, presumably due to the short-lived effect of diazepam after I.
The physician should be prepared to re-administer the drug. However, diazepam is not recommended for maintenance, and once seizures are brought under control, consideration should be given to the administration of agents useful in longer term control of seizures. If diazepam is to be combined with other psychotropic agents or anticonvulsant drugs, careful consideration should be given to the pharmacology of the agents to be employed—particularly with known compounds which may potentiate the action of diazepam, such as phenothiazines, narcotics, barbiturates, MAO inhibitors and other antidepressants.
In highly anxious patients with evidence of accompanying depression, particularly those who may have suicidal tendencies, protective measures may be necessary. The usual precautions in treating patients with impaired hepatic function should be observed. Metabolites of diazepam are excreted by the kidney; to avoid their excess accumulation, caution should be exercised in the administration to patients with compromised kidney function. Since an increase in cough reflex and laryngospasm may occur with peroral endoscopic procedures, the use of a topical anesthetic agent and the availability of necessary countermeasures are recommended.
Propylene glycol toxicity has been reported in patients treated with Diazepam Injection at doses significantly greater than recommended. Propylene glycol toxicity can cause acute tubular necrosis which can progress to multi-organ failure , mental status changes, hypotension, seizures, and cardiac arrhythmias. Patients at high risk for propylene glycol toxicity include those with renal dysfunction, hepatic dysfunction, impaired alcohol hydrogenase enzymes, or other comorbidities such as a history of alcoholism.
Diazepam Injection has produced hypotension or muscular weakness in some patients particularly when used with narcotics, barbiturates or alcohol. Lower doses usually 2 mg to 5 mg should be used for elderly and debilitated patients. The clearance of diazepam and certain other benzodiazepines can be delayed in association with cimetidine administration. The clinical significance of this is unclear. Side effects most commonly reported were drowsiness, fatigue and ataxia; venous thrombosis and phlebitis at the site of injection.