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35 Cards in this Set

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Diazepam (Valium)
Class
Benzodiazepine, sedative-hypnotic, anticonvulsant
Diazepam (Valium)
Mechanism of Action
Potentiates effects of inhibitory neurotransmitters. Raises seizure threshold. Induces amnesia and sedation
Diazepam (Valium)
Indications
Acute anxiety states, acute alcohol withdrawal, musce relaxant, seizure activity, agitation, analgesia for medical procedures
Diazepam (Valium)
Contraindications
Hyppersensitivity, glaucoma, coma, shock, substance abuse, head injury
Diazepam (Valium)
Advers reactions
Respiratory Distress, hypotension, drowsiness, ataxia, reflex tachicardia, confusion, thrombosis, phebitis
Diazepam (Valium)
Drug interactions
Incompatible with most drugs, fluids
Diazepam (Valium)
Route and dose
Seizure: 5-10mg IV q 10-15 min prn. (Max 30mg)
Sedation for Cardioversion: 5-15mg IV over 5-10minutes prior to cardioversion
Rectally: 0.5mg/kg via 2" rectal cath and flush with 2-3ml air after administration.
Diazepam (Valium)
Duration of action
Onset 1-5 min
Peak: minutes
duration 20-50 min
Diazepam (Valium)
Special considerations
Pregnancy Safety: Category D. Short duration of Anticonvulsant effect. Reduce dose 50%in elderly pt
Lorazepam (Ativan)
Class
Benzodiazepine, sedative, anticonvulsant
Lorazepam (Ativan)
Mechanism of Action
Anxiolitic, anticonvulsant, ans sedative effects, suppresses propagation of seizure activity, produced by foci in cortex, thalamus, and limbic areas
Lorazepam (Ativan)
Indications
Initial control of status epilepticus or severe recurrent seizures, severe anxiety, sedation
Lorazepam (Ativan)
Contraindications
Acute narrow-angle glaucoma, coma, shock, or suspected drug abuse.
Lorazepam (Ativan)
adverse reactions
Repiratory depression, apnea, drowsiness, sedation, ataxia, phycomotor impairment, confusion, restlessness, delirium, hypotension, bradycardia
Lorazepam (Ativan)
Drug interactions
May precipitate CNS depression, if pt is already taking CNS depressant medications
Lorazepam (Ativan)
Route and Dose
IV or IO (dilute 1-1 with water!)
2-4 mg slow IV at 2mg/min or IM. May repeat 15-20 min to max dose of 8mg.
Sedation: 0.05 mg/kg up to 4 mg IM
Lorazepam (Ativan)
Duration of Action
Onset: 1-5 min
Peak effect: Variable
Duration6-8 hours
Lorazepam (Ativan)
Special Considerations
Pregnancy Safety: Category D
Monitor BP and Resp rate during admin
Have advanced airway equipment available
Refrigerate or expires in 6 weeks.
Midazolam (Versed)
Class
Short acting benzodiazepine CNS depressant
Midazolam (Versed)
Mechanism of Action
Anxiolitic and sedative properties similar to other benzodiazepines, memory impairment
Midazolam (Versed)
Indications
Sedation, anxiolitic prior to endotracheal or nasotracheal intubation; administer for conscious sedation.
Midazolam (Versed)
Contraindications
Glaucoma, shock, Coma, Alcohol Intoxication, Overdose, Depressed vital signs, concomitant use with other CNS depression, barbituates, alcohol, narcotics
Midazolam (Versed)
Adverse Reactions
Hiccough, cough, oversedation, injection site pain, headache, blurred vision, hypotension, respiratory depression, and arrest
Midazolam (Versed)
Drug interations
should not be used in pts who have taken a CNS depressant
Midazolam (Versed)
Dosage and Route
2.0-2.5 mg slow IV over 2-3 min; may be repeated to total maximun: 0.1 mg/kg.
Midazolam (Versed)
Duration of Action
Onset: 1-3 min, IV and dose dependant.
Peak effect: Variable
Duration: 2-6 hours, dose dependant.
Midazolam (Versed)
Special Considerations
Pregnancy Safety: Category D
Administer imediately prior to intubation procedure.
Requires continous monitoring of respiratory and cardiac function. Never administer as IV bolus.
Flumazenil (Romazicon)
Class
Benzodiazepine receptor antagonist
Flumazenil (Romazicon)
Mechanism or action
Antagonizes the actions of benzodiazepines on the CNS
Flumazenil (Romazicon)
Indications
Reversal of respiratory depression and sedative effects from pure benzodiazepine overdose
Flumazenil (Romazicon)
Contraindications
Hypersensitivity, tricyclic antidepressant overdose, seizure-prone pts, coma of unknown etiology
Flumazenil (Romazicon)
Adverse Reactions
n/v, agitation, injection site pain, visual distubances, seizure, cutaneous vasodilation.
Flumazenil (Romazicon)
Drug Interactions
Toxic efffects of mixed-dose overdose (especially tricyclics)
Flumazenil (Romazicon)
Dose and Route
First Dose: 0.2 mg IV/IO over 15 seconds.
Second Dose: 0.3 mg IV/IO over 30 Seconds. If no response, give a third dose: 0.5 mg IV/IO. If no response repeat once every minute until adequate response or a total of 3mg is given.
Flumazenil (Romazicon)
Special Considerations
Pregnancy Safety: Category C. Be prepared to manage seizures in pts dependant on benzodiazepines or who have ingested large doses of other drugs.
May precipitate withdraw symptoms on those dependant on bezodiazepines.
Monitor pts for re-sedation and respiratory depression. Be prepared to assist in ventilations.