Diazepam

Aka: Diazepam, Valium

1. See Also
   1. Benzodiazepine
2. Indications
   1. Insomnia
   2. Anxiety Disorder
   3. Alcohol Withdrawal
   4. Seizure Disorder
   5. Musculoskeletal spasm
   6. Tetanus
3. Contraindications
   1. Acute Narrow Angle Glaucoma
   2. Untreated Open Angle Glaucoma
   3. Children under age 6 years
4. Pharmacokinetics
   1. Half Life: 20-90 hours
5. Precautions
   1. Avoid when requiring optimal mental status
      1. Driving
      2. Operating machinery
   2. Use caution if risk of cardiopulmonary depression
      1. Elderly
      2. Very ill patients
      3. Limited pulmonary reserve (e.g. COPD)
   3. Do not use with other cardiopulmonary depressants
      1. Alcohol
      2. Barbiturates
   4. Intravenous Injection
      1. Inject intravenously slowly (1 ml per minute)
      2. Reduce dose to 70% when administering with Narcotic
6. Adverse Reactions
   1. Common General affects
      1. Drowsiness
      2. Fatigue
      3. Ataxia
      4. Benzodiazepine Dependence with withdrawal symptoms
   2. Local injection side affects (inject slowly)
      1. Venous thrombosis
      2. Phlebitis
7. Dosing
   1. Anxiety Disorder
      1. Dose: 2 to 10 mg PO bid to qid
      2. Maximum Daily Dose: 40 mg
   2. Acute Alcohol Withdrawal
      1. First day: 10 mg PO tid to qid
      2. Next days: 5 mg PO tid to qid
   3. Musculoskeletal spasm
      1. Dose: 2 to 10 mg PO tid to qid
   4. Seizure disorder
      1. Dose: 2 to 10 mg PO qd
   5. Older patients or with comorbid condition
      1. Dose: 2 to 2.5 mg PO qd to bid
8. Equivalents to 60 mg Diazepam (for withdrawal protocol)
   1. Alprazolam (Xanax) 6 mg
   2. Chlordiazepoxide (Limbitrol) 150 mg
   3. Clonazepam (Klonopin) 24 mg
   4. Flurazepam (Dalmane) 90 mg
   5. Halazepam (Paxipam) 240 mg
   6. Lorazepam (Ativan) 12 mg
   7. Oxazepam (Serax) 60 mg
   8. Temazepam (Restoril) 60 mg