Diazepam is a drug that facilitates the binding of gamma-aminobutyric acid (GABA) to its receptor. GABA is an inhibitory neurotransmitter found in the brain. Diazepam 2mg increases GABA activity by reducing the functioning of certain areas of the brain. It acts on the limbic system, the thalamus and the hypothalamus. It does not produce blocking action of the autonomic peripheral nervous system nor extrapyramidal side effects . It has an extended action. It produces drowsiness, a decrease in anxiety and relaxation of muscles.
The duration of treatment should be as short as possible and re-evaluated at regular intervals, including the need to continue. Maximum 8-12 weeks, including gradual withdrawal.
The indications for diazepam 2mg are as follows:
Symptomatic suppression of anxiety, agitation and psychic tension by psychoneurotic states and transient situational disorders.
Induction to anesthesia.
Sedation prior to diagnostic, surgical and endoscopic interventions.
Coadjuvant in the treatment of musculoskeletal pain due to spasms or local pathology. Spasticity due to cerebral palsy and paraplegia, athetosis and generalized stiffness syndrome.
Coadjuvant in anticonvulsive therapy, febrile convulsions in children older than one year, seizures epilepticus, status epilepticus, tetanus, peeclampsia and eclampsia.
Drowsiness, affective dullness, reduced alertness, confusion, fatigue, headache, dizziness, muscle weakness, ataxia or diplopia.
Psychiatric and paradoxical reactions. Diazepam high is often reported by users and this is the reason that the drug becomes addictive for many users.
In case of hypersensitivity or overdose to benzodiazepines.
In patients with myasthenia gravis, sleep apnea syndrome, severe respiratory failure, severe hepatic impairment.
In the case of drug dependence and alcoholism (except the treatment of acute withdrawal reactions).
In patients with angle-closure (rectal, parenteral) glaucoma, severe chronic hypercapnia.
Mild or moderate, children, insuff. Chronic respiratory disease, porphyria, epilepsy, alcohol or drug dependence, or history. In patients with CNS lesions and with epileptic seizures, extreme caution as it can decrease cerebral circulation and blood oxygenation, which can lead to irreversible brain damage. Risk of anterograde amnesia, psychiatric and paradoxical reactions. After continued use there is risk of tolerance, dependence (physical and psychic). Abrupt discontinuation after continued use causes abstinence syndrome. Do not use in anxiety associated with depression or tto. Primary of enf. Psychotic IV: risk of apnea and / or cardiac arrest in the elderly, very debilitated or with limited cardiac or pulmonary reserve. Extreme precautions to avoid IA administration or extravasation.
Hepatic impairment of DIAZEPAM
Contraindicated in I.H. Severe risk of encephalopathy. Caution in I.H. Mild-moderate: reduce dosage.
Renal insufficiency of DIAZEPAM
Caution. Reduce doses.
Interactions of DIAZEPAM
Potentiation of the depressant effect on CNS with: neuroleptics, hypnotics, anxiolytics / sedatives, antidepressants, narcotic analgesics, antiepileptics, anesthetics, sedative antihistamines. Increased sedative effect with: alcohol, cisapride, cimetidine, propofol, ethanol. Action augmented by: cytochrome P450 inhibitors, protease inhibitors, azoles antifungals, isoniazid. Additive effect of CNS and respiratory with barbiturates, central acting muscle relaxants. Toxicity increased by: ethinylestradiol and mestranol, fluoxetine, omeprazole, ketoconazole, fluvoxamine, aq. Valproic acid. Anticonvulsive effect decreased by: ginkgo. Effectiveness decreased by: H. perforatum. Effect decreased by: phenobarbital, carbamazepine, phenytoin, rifampicin. Increases the action of: digoxin.
Symptoms and treatment of overdose
Diazepam overdose causes severe drowsiness, loss of coordination, agitation, continual confusion, decreased reflexes, slow heartbeat, shortness of breath or difficulty breathing, continuous babbling, wobbling, severe weakness.
Parenteral overdose treatment is supportive and consists of: Breathing, pulse and blood pressure should be monitored. If breathing is depressed, oxygen should be given. Intravenous fluids may be given to increase diuresis. Adequate ventilation should be maintained. If necessary, hypotension can be controlled by the intravenous administration of vasopressors such as Dopamine, Norepinephrine, or Metaraminol. If excitation occurs, barbiturates should not be used as they may exacerbate excitation and / or prolong CNS depression. Dialysis is of limited value in the treatment of overdose.