NAME OF DRUG
diazepam in emulsion

CLASSIFICATION

Anxiolytic-Sedative, Muscle Relaxant

ALTERNATE NAME

DIAZEMULS

INDICATIONS

• restricted for use as premedicant for anesthesia and endoscopy to decrease anxiety states and diminish recall of procedure
• induction of anesthesia

RECONSTITUTION AND STABILITY

• stable at room temperature

COMPATIBILITY

• compatible in D5W (maximum concentration 0.4 mg/mL)
• compatible with fat emulsion; use within 6 hours
• compatible via Y-site with NS
• compatible in the same syringe with atropine, fentanyl, meperidine, scopolamine hydrobromide; use within 30 minutes
• incompatible with potassium chloride and other drugs

ROUTES OF ADMINISTRATION

• IM - not recommended (absorption is delayed, unpredictable) exception: when oral or IV routes are not feasible, inject deeply into the muscle
• IV direct - rate not exceeding 5 mg/minute
• IV infusion - maximum concentration 0.4 mg/mL in D5W or use full strength in evacuated IV bags

VH & HSC ADMINISTRATION POLICY

RESTRICTED TO ANAESTHESIA, GE CLINIC, RADIOLOGY, ICU

E - Direct IV route can be administered by nurses provided a venous access has been established, and according to policies and recommendations stated in this manual.

H - The IV infusion administration rate MUST be controlled by an automated infusion control device.

DOSAGE

• - individualized according to indication, patient's requirements and response
• Adults:

  Premedication:  IV: - 5-10 mg (Elderly and debilitated patients - 2-5 mg)

  Infusion for relief of anxiety: initiate at 1-10mg/hour and titrate to response

POTENTIAL HAZARDS OF PARENTERAL ADMINISTRATION

• thrombophlebitis, pain at injection site - less frequent and less severe than with diazepam in propylene glycol base
• hypotension, bradycardia, respiratory depression and cardiac arrest may follow to IV administration
• avoid extravasation

IMPORTANT IMPLICATIONS

• notify physician if respiratory rate falls below 8 per minute
• adverse effects include: sedation, dizziness, vertigo (more pronounced in the elderly), anterograde anmesia, depression and mental confusion
• CNS depressant effects are additive with other concomitantly used CNS depressants
• use with caution in patients with hepatic failure

Rev. Jan 2007