MASSACHUSETTS GENERAL HOSPITAL

Department of Pharmacy

Department of Nursing

Critical Care

Generic Name:

Diazepam

Trade Name:

Valium

Action:

Sedative/Hypnotic

Anxiolytic

Indications:

Restlessness / Anxiety /Agitation

Alcohol Withdrawal

Conscious Sedation

Status Epilepticus

Administration Guidelines:

Usual Dosage Range and Route:

Anxiety / Agitation: 2.5mg to 10 mg IVP not to exceed 5 mg / minute

Status Epilepticus: 10mg to 30 mg IVP not to exceed 5 mg / minute

Special Considerations:

·         Diazepam IV contains a vesicant; vesicants cause blisters, severe tissue injury, or necrosis when they infiltrate (Refer to Nursing Policy for management 08-02-01 VESICANTS: TREATMENT FOR EXTRAVASATION)

·         Whenever possible administer doses orally

·         For IV administration central line is preferred

·         May be administered peripherally in a secure vein

·         IVP should not exceed 5mg/minute

·         Burning sensation may result at site of injection if administered through peripheral access

·        Flush with 0.9% sodium chloride before and after administration

 

·         Dosage adjustments may be required in:

-          Geriatric patients

-          Renal failure

-          Hepatic failure

- Cumulative effect may be observed, dosage adjustment may be required

- Caution: will potentiate actions and side effects of narcotics and other CNS depressants

-Refer to general care Alcohol Withdrawal Pathway when patients are transitioning from levels of care

Precautions and Side Effects:

- Hypotension

- Bradycardia

- Respiratory depression/arrest

 rev: 3/07