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diazepam

diazepam

Summary

  • 99% prot. bound; enterohep. circ; metab. to nordazepam → oxazepam;
  • T½= 30-60hrs; Vd = 1.1L/kg; Clearance = 0.38ml/min/kg;
  • redistribution half-times: diazepam 1hr;

Clinical usage and dosages

Anticonvulsant

  • many prefer use of the water-soluble, shorter-acting midazolam
  • adults:
    • initially 5-10 mg IVI, may repeat every 10-15 min to max 30 mg; repeat in 2-4 hrs if necessary. (MIMS)
  • paediatric:
    • rectal:
      • 0.2-0.5mg/kg pr
      • solution is usually already made up in bottle diluted to 1mg/ml.
      • Give 0.2ml/kg pr stat and titrate to 0.8mg/kg pr as needed over 10min.
    • IV (repeat in 2-4 hrs if necessary):
      • 0.1-0.2mg/kg iv
      • 1 mth-5 yrs: 0.2-0.5 mg slow IVI every 2-5 min to max 5 mg; (MIMS)
      • greater than or equal to 5 yrs: 1 mg every 2-5 min to max 10 mg; (MIMS)
      • Draw up all of 2ml ampoule (ie. 10mg) of diazepam into 10ml syringe and dilute by adding 8ml N.Saline, thus making final concentration of 1mg/ml.
      • Give 0.1mg/kg IV over 1-2min, titrate to 0.4mg/kg (max. 10mg) as needed over 5-10min.

Anxiolytic

  • adults:
    • ambulatory patients: 2mg tds or 2mg 1-2 times during the day and 5mg nocte
    • elderly/debility: avoid if possible, but if you must, then 2mg bd
    • hospitalised patients being observed: up to 10-15mg tds (max. 40mg/day)

Ethanol (alcohol) withdrawal

  • adults:
    • may require 10 mg IV or IMI initially, then 5-10 mg in 3-4 hrs if necessary
    • regular 10-20mg o doses may be given under close supervision in hospital according to your hospital's alcohol withdrawal guidelines, which usually include regular specific documentation of alcohol withdrawal status.
    • WARNING: large, frequent doses of this long acting agent may result in death from respiratory depression if unmonitored!
diazepam.txt · Last modified: 2009/10/31 22:47 by 127.0.0.1

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