Prenatal benzodiazepine exposure slightly increased oral cleft risk limited or inconsistent evidence. From binding studies to the molecular biology of GABA receptors. Last reviewed on RxList: Do not discontinue diazepam abruptly in patients with a history of a seizure disorder, since seizures may be precipitated. Delayed elimination has also been reported for the active metabolite desmethyldiazepam. Prior Authorization Drugs that require prior authorization.
Giving: Diazepam iv stability chart light
|Diazepam iv stability chart light||Flumazenil is contraindicated when patients have ingested multiple medicines, especially after co-ingestion of a benzodiazepine and a tricyclic antidepressant light any other stabliity that causes seizures. It is advisable to keep diazepam patient supine for at least an hour after administration. Disulfiram Reduced metabolism of diazepam leading to prolonged half-life and increased plasma concentration of diazepam. Chronic use even at chart doses may lead to the development of physical stability cahrt dependence: Use within 24 hours.|
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|Diazepam schedule meditation quotes||Rebound insomnia and anxiety. Contact the applicable light provider for the most current information. Diazepam tablets, USP are indicated for the management diazepam anxiety disorders or for the short-term relief of the symptoms chart anxiety. Metabolic stability including metabolic acidosis, diazepam anion gap and hyperosmolality have been reported as a consequence of propylene diazpam toxicity see section 4. Stability is a known inducer of CYP3A4 and increases hepatic metabolism of diazepam. Chart is also light increase in the average time to diazepam 5mg street value price peak concentrations to about 2.|
Diltiazem shows dose-dependent, non-linear pharmacokinetics. Use within 24 hours. Keep refrigerated until use. Diltiazem hydrochloride injection was tested for compatibility with three commonly used intravenous fluids at a maximal concentration of 1 mg diltiazem hydrochloride per milliliter. Because of potential physical incompatibilities, it is recommended that diltiazem hydrochloride not be mixed with any other drugs in the same container.
If possible, it is recommended that diltiazem hydrochloride not be coinfused in the same intravenous line. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. Physical incompatibilities precipitate formation or cloudiness were observed when diltiazem hydrochloride was infused in the same intravenous line with the following drugs: Transition to Further Antiarrhythmic Therapy: Transition to other antiarrhythmic agents following administration of diltiazem hydrochloride injection is generally safe.
In controlled clinical trials, therapy with antiarrhythmic agents to maintain reduced heart rate in atrial fibrillation or atrial flutter or for prophylaxis of PSVT was generally started within 3 hours after bolus administration of diltiazem. These antiarrhythmic agents were intravenous or oral digoxin, Class 1 antiarrhythmics e. Experience in the use of antiarrhythmic agents following maintenance infusion of diltiazem hydrochloride injection is limited.
Patients should be dosed on an individual basis and reference should be made to the respective manufacturer's package insert for information relative to dosage and administration. Medical Calculators - A thru Z. Relief of agitation and tremor and prevention or symptomatic relief of delirium tremens and hallucinations associated with acute alcohol withdrawal. Adjunct to rest, physical activity, analgesics, and other measures for relief of discomfort associated with acute, painful musculoskeletal conditions.
Short- and long-term management of skeletal muscle spasticity such as reflex spasm secondary to local pathology e. Has been used to relieve anxiety associated with acute MI; however, AHA and ACC state that routine anxiolytic use is neither necessary nor recommended. Consider long half-life of diazepam and its metabolites when making dosage adjustments see Half-life under Pharmacokinetics.
In patients who have received prolonged e. Periodically reassess usefulness for treatment of anxiety. Do not discontinue diazepam abruptly in patients with a history of a seizure disorder, since seizures may be precipitated. Administer orally, a by IM or IV injection, a c or rectally. Initially, administer orally in 3 or 4 doses daily for the treatment of anxiety disorders or skeletal muscle spasticity.
Dilute oral concentrate solution e. For IV injection, administer dose directly into a large vein; if this is not possible, inject the drug into the tubing of a flowing IV solution as close as possible to the vein insertion site. Some clinicians recommend IV administration of a dilute solution to avoid extravasation; however, manufacturers do not recommend this method of administration, since precipitation may occur.
Administer dose slowly over 3 minutes. May be administered as deep IM injection; a b c however, absorption may be slow and erratic. Administer rectally as the commercially available gel via the delivery device a plastic applicator with a flexible molded tip provided by the manufacturer. Commercially available gel is provided in prefilled syringe applicators containing 2. Dose to be delivered by the AcuDial applicator is locked into the device prior to dispensing.
Prescription should indicate the appropriate dose to be locked into the applicator, the appropriate rectal tip size, and the number of packages 2 applicators per package to be dispensed. Pharmacist must dial in and lock the correct dose to be administered prior to dispensing Diastat AcuDial. While holding the barrel of the applicator in one hand, turn the cap of the applicator to select the dose. Remove the protective cap from the syringe and ensure that the seal pin is removed with the cap.
Lubricate the rectal applicator tip with the water-soluble lubricant jelly provided by the manufacturer. Leave the patient on their side facing the caregiver, note the time the dose was given, and observe the patient. If bowel leakage occurs, a supplemental dose may be required. Discard Diastat and Diastat AcuDial rectal delivery systems and all unused materials in the garbage in a safe place away from children; do not reuse. Prior to discarding AcuDial applicator in the garbage, dispose of any gel remaining in the applicator.
Children 30 days to 5 years of age: Initially, 1 mg; may repeat every 2—5 minutes to a maximum total dose of 10 mg. Children 2—5 years of age: Children 6—11 years of age: Initially, 2—5 mg for moderate or 5—10 mg for severe acute anxiety; may repeat in 3—4 hours. Titrate dosage to obtain desired sedative response e.
Initially, 10 mg some clinicians recommend up to 20 mg , then 5—10 mg every hour if necessary, although an interval of 3—4 hours may be satisfactory. Alternatively, some clinicians recommend 10 mg initially, followed by 10 mg at 20—30 minutes intervals until patient is calm. Maximum recommended frequency for administration by caregivers outside hospital is 1 treatment course every 5 days and 5 treatment courses per month. Initially, 2—5 mg as a single dose.
Dosage to be administered should be adjusted downward for the commercially available prefilled applicators of rectal gel. Use the smallest effective dosage in debilitated patient and patients with low serum albumin concentrations. See Geriatric Patients under Dosage and Administration. Known hypersensitivity to diazepam or any ingredient in the formulation. Manufacturers state that diazepam is contraindicated in patients with acute angle-closure glaucoma, but may be administered to patients with open-angle glaucoma who are receiving appropriate therapy; b c however, clinical rationale for this contraindication has been questioned.
Concomitant use of benzodiazepines, including diazepam, and opiates may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant use of diazepam and opiates for patients in whom alternative treatment options are inadequate. Performance of activities requiring mental alertness and physical coordination may be impaired. Do not use in patients with depressive neuroses or psychotic reactions in which anxiety is not prominent. Consider possibility of respiratory depression with rectal administration.
Equipment for resuscitation should be readily available whenever diazepam is administered IV. Concomitant use of other CNS depressants may increase the risk of apnea. Patients with a history of drug or alcohol dependence or abuse are at risk of habituation or dependence; use only with careful surveillance in such patients. Abrupt discontinuance may result in symptoms of withdrawal similar to barbiturates.
Abrupt withdrawal may be associated with a temporary increase in seizure frequency or severity. Effect on seizure activity after IV administration is short-lived; repeated administration may be necessary. Tonic status epilepticus has occurred following IV administration to control absence status or Lennox-Gastaut syndrome status epilepticus. Potential for local reactions e. Only caregivers who are deemed competent to recognize seizure episodes suitable for treatment, make the decision to initiate treatment, administer the drug, monitor the patient, and assess adequacy of response should administer diazepam rectal gel.
Use with caution in depressed patients; potential for suicidal tendencies. Perform blood counts and liver function tests periodically during long-term therapy. Diazepam and its metabolites are distributed into milk; discontinue nursing or the drug. CNS depression in neonates may be prolonged because of apparent inability to convert drug to inactive metabolites.
Increased risk of adverse CNS effects. Clearance may be decreased. Clearance of metabolites may be decreased. Drowsiness, c b ataxia, c b fatigue. Potential pharmacokinetic interaction altered diazepam elimination. Increased plasma diazepam concentrations c. Possible decreased renal excretion and increased plasma concentrations of digoxin Monitor serum digoxin concentrations; reduction of digoxin dosage may be necessary Clinical importance not determined; consider possible need for diazepam dosage reduction Risk of profound sedation, respiratory depression, coma, or death Whenever possible, avoid concomitant use Use concomitantly only if alternative treatment options are inadequate; use lowest effective dosages and shortest possible duration of concomitant therapy; monitor closely for respiratory depression and sedation In patients receiving diazepam, initiate opiate analgesic, if required, at reduced dosage and titrate based on clinical response Reduce opiate dosage by at least one-third and administer in small increments when diazepam is administered IV concurrently with an opiate analgesic b c.
In patients receiving an opiate analgesic, initiate diazepam, if required for any indication other than epilepsy, at lower dosage than indicated in the absence of opiate therapy and titrate based on clinical response Consider offering naloxone to patients receiving benzodiazepines and opiates concomitantly Possible false positive reactions for glucose with Clinistix and Diastix a. Onset of anticonvulsant, anxiolytic, or sedative action occurs in 1—5 minutes following IV administration.
Duration of anticonvulsant, anxiolytic, or sedative action is 15—60 minutes following IV administration. Diazepam and its metabolites cross the placenta and are distributed into milk. Geriatric patients and patients with hepatic impairment may have prolonged elimination half-lives of diazepam and its metabolites.
Addition of diazepam injection to an IV infusion solution or plastic syringes may result in adsorption of diazepam to the plastic container and tubing. Effects appear to be mediated through the inhibitory neurotransmitter GABA; the site and mechanism of action within the CNS appear to involve a macromolecular complex GABA A -receptor-chloride ionophore complex that includes GABA A receptors, high-affinity benzodiazepine receptors, and chloride channels. Importance of taking only as prescribed; do not increase dosage or duration of therapy or abruptly discontinue drug unless otherwise instructed by a clinician.
Risk of potentially fatal additive effects e. Potential for drug to impair mental alertness or physical coordination; use caution when operating machinery or performing hazardous tasks until effects on individual are known. Upon receiving Diastat AcuDial from the pharmacy and again prior to administering a dose, importance of verifying accuracy of prescription e.
Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, and alcohol consumption. Importance of informing clinicians about any concomitant illnesses, particularly depression. Importance of women informing their clinician if they are or plan to become pregnant or plan to breast-feed. Importance of informing patients of other important precautionary information. Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
Interaction of disulfiram with benzodiazepines. Klotz U, Reimann I.