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SIZE:
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GENERIC NAME:
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MANUFACTURER:
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UNIT:
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ADMINISTRATION ROUTE:
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FDA PREGNANCY GROUP:
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D
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INDICATIONS:
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Alcohol withdrawal |
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Anxiety disorder, generalized |
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Athetosis |
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Delirium tremens |
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Muscle spasm |
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Preanesthesia |
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Seizures, generalized tonic- clonic |
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Status epilepticus |
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Stiff- man syndrome |
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Tetanus |
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SIDE EFFECTS:
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anxiety |
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apnea |
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asthenia |
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ataxia |
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cardiac arrest |
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confusion |
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depression |
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dizziness |
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drowsiness |
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ejaculation dysfunction |
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euphoria |
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fatigue |
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headache |
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hypotension |
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impotence |
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insomnia |
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interstitial nephritis |
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libido decrease |
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mania |
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nightmares |
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orgasm dysfunction |
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respiratory depression |
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restlessness |
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syncope |
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teratogenesis |
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tolerance |
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tremor |
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vertigo |
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withdrawal |
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ABSOLUTE
CONTRAINDICATIONS :
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RELATIVE
CONTRAINDICATIONS : |
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asthma |
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benzodiazepine dependence |
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bipolar disorder |
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breast-feeding |
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children |
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chronic obstructive pulmonary disease (COPD) |
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CNS depression |
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dementia |
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depression |
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driving or operating machinery |
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elderly |
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extravasation |
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hepatic disease |
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infants |
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intraarterial administration |
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mania |
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myasthenia gravis |
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neonates |
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neuromuscular disease |
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obstetric delivery |
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Parkinson's disease |
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pregnancy |
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psychosis |
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pulmonary disease |
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renal failure |
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renal impairment |
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respiratory depression |
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seizure disorder |
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seizures |
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sleep apnea |
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status epilepticus |
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substance abuse |
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suicidal ideation |
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ADULT DOSE:
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Antianxiety agent-Preoperative medication: Dosage must be individualized; however, as a general guideline-Intramuscular or intravenous, 5 to 10 mg prior to surgery .
Anxiety disorders or symptoms of anxiety: Intramuscular or intravenous, 2 to 10 mg (2 to 5 mg for moderate symptoms; 5 to 10 mg for severe symptoms), the dose being repeated in three or four hours, if necessary .
Sedative-hypnotic-Alcohol withdrawal: Intramuscular or intravenous, initially 10 mg, followed by 5 to 10 mg in three or four hours, if necessary .
Amnestic-Cardioversion: Intravenous, 5 to 15 mg five to ten minutes prior to the procedure .
Endoscopic procedures: Intravenous (preferred route), up to 20 mg, the dosage being titrated to give the desired sedative response and administered immediately prior to the procedure .
Intramuscular, 5 to 10 mg approximately thirty minutes prior to the procedure .
Anticonvulsant-Status epilepticus and severe recurrent convulsive seizures: Intravenous, initially 5 to 10 mg, the dose being repeated, if necessary, at ten- to fifteen-minute intervals up to a cumulative dose of 30 mg. If necessary, regimen may be repeated in two to four hours.
Note: The intravenous route of administration is preferred; however, if intravenous administration is impossible, the intramuscular route of administration may be used .
Some clinicians have used continuous intravenous infusions of diazepam in the treatment of selected patients with status epilepticus refractory to initial treatment .
However, this method of administration is problematic due to inherent adsorption problems with plastic infusion bags and tubing .
Skeletal muscle relaxant adjunct-Muscle spasm: Intramuscular or intravenous, initially 5 to 10 mg, the dose being repeated in three or four hours, if necessary. For tetanus, larger doses may be required.
Note: Debilitated patients-Intramuscular or intravenous, initially 2 to 5 mg per dose, the dosage being increased gradually as needed and tolerated . |
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MAXIMUM ADULT DOSE:
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PEDIATRIC DOSE:
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Neonates 30 days of age and younger-Safety and efficacy have not been established .
Anticonvulsant-Status epilepticus and severe recurrent convulsive seizures: Infants older than 30 days of age and children younger than 5 years of age-Intravenous (slow), 200 to 500 mcg (0.2 to 0.5 mg) every two to five minutes up to a cumulative dose of 5 mg. If necessary, regimen may be repeated in two to four hours. Children 5 years of age and older-Intravenous (slow), 1 mg every two to five minutes up to a cumulative dose of 10 mg. If necessary, regimen may be repeated in two to four hours.
Note: The intravenous route of administration is preferred; however, if intravenous administration is impossible, the intramuscular route of administration may be used .
Skeletal muscle relaxant adjunct-Tetanus: Infants older than 30 days of age and children younger than 5 years of age-Intramuscular or intravenous, 1 to 2 mg, the dose being repeated every three or four hours as needed .
Children 5 years of age and older-Intramuscular or intravenous, 5 to 10 mg, the dose being repeated every three or four hours as needed .
Note: In general, when the intravenous route is used in infants and children, it is recommended that the medication be administered slowly over a three-minute period in a dose not to exceed 250 mcg (0.25 mg) per kg of body weight. After an interval of fifteen to thirty minutes, a second dose may be administered. After an additional interval of fifteen to thirty minutes, a third dose may be administered. If the third administration does not provide relief of symptoms, adjunctive treatment appropriate to the condition being treated should be considered. |
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MAXIMUM PEDIATRIC
DOSE:
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ELDERLY DOSE:
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Antianxiety agent or
Sedative-hypnotic or
Amnestic or
Anticonvulsant or
Skeletal muscle relaxant adjunct-Intramuscular or intravenous, initially 2 to 5 mg per dose, the dosage being increased gradually as needed and tolerated . |
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