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Doctors are faced with life or death decisions on a daily basis. Lives can be lost or saved in a matter of seconds. Thus the invention of the emergency drug kit permits rapid access to the four most critical medications in emergency situations. The following text will explain the importance of every individual medication in the kit. DIAZEPAM WHAT IT IS Benzodiazepine Antianxiety agent Antiepileptic agent Skeletal muscle relaxant, centrally acting USES Management of anxiety disorders or for short-term relief of symptoms of anxiety Acute alcohol withdrawal; may be useful in symptomatic relief of acute agitation, tremor, delirium tremens, hallucinosis Muscle relaxant: adjunct for relief of reflex skeletal muscle spasm due to local pathology (inflammation of muscles or joints) or secondary to trauma; spasticity caused by upper motoneuron disorders (cerebral palsy and paraplegia); athetosis, stiff-man syndrome Treatment of tetanus (parenteral) Antiepileptic: adjunct in status epilepticus and severe recurrent convulsive seizures (parenteral); adjunct in convulsive disorders (oral) Preoperative: relief of anxiety and tension and to lessen recall in patients prior to surgical procedures, cardioversion, and endoscopic procedures (parenteral) Management of selected, refractory patients with epilepsy who require intermittent use to control bouts of increased seizure activity (rectal) Unlabeled use: treatment of panic attacks HOW IT WORKS Exact mechanisms of action not understood; acts mainly at the limbic system and reticular formation; may act in spinal cord and at supraspinal sites to produce skeletal muscle relaxation; potentiates the effects of GABA, an inhibitory neurotransmitter; anxiolytic effects occur at doses well below those necessary to cause sedation, ataxia; has little effect on cortical function. CONTRAINDICATION Contraindications: hypersensitivity to benzodiazepines; psychoses, acute narrowangle glaucoma, shock, coma, acute alcoholic intoxication; pregnancy (cleft lip or palate, inguinal hernia, cardiac defects, microcephaly, pyloric stenosis when used in first trimester; neonatal withdrawal syndrome reported in babies); lactation. Use cautiously with elderly or debilitated patients; impaired liver or kidney function. PRECAUTIONS Geriatrics: Elderly and debilitated patients or those with organic brain disorders have been found to be prone to CNS depression following even low doses. For these patients it is recommended that the dosage be limited to the smallest effective amount to preclude development of ataxia, oversedation or other possible adverse effects. Use in emotional disorders: Diazepam is not recommended in the treatment of psychotic or severely depressed patients. Precautions are indicated for severely depressed patients or those who show evidence of impending depression, particularly the recognition that suicidal tendencies may be present and protective measures may be necessary. Since excitement and other paradoxical reactions may result from the use of the drug in psychotic patients, it should not be used in ambulatory patients suspected of having psychotic tendencies. Use in epileptic patients: Since diazepam may exacerbate grand mal seizures in some patients, caution is required when it is used in epileptic patients. An adjustment may be necessary in their anticonvulsive medication. Abrupt withdrawal of diazepam in these patients should also be avoided. Potentiation of drug effects: Patients should be advised to abstain from alcohol and other CNS depressant drugs during treatment with diazepam. Phenothiazines, barbiturates, MAO inhibitors and other psychoactive drugs may potentiate the action of the drug and should not usually be given concurrently. Drug dependence: Abrupt cessation of large doses of diazepam after prolonged periods may precipitate acute withdrawal symptoms and, in these cases, the drug should be discontinued gradually. Caution should be exercised when it is considered necessary to administer diazepam to addiction prone individuals. Occupational Hazards: Patients receiving diazepam should be advised to proceed cautiously whenever mental alertness and physical coordination are required. The usual precautions in treating patients with impaired renal and hepatic functions should be observed. If diazepam is administered for protracted periods, periodic blood counts and liver function tests would be highly advisable. OVERDOSE Symptoms: Drowsiness, oversedation and ataxia. When the effects of drug overdosage begin to wear off, the patient exhibits some jitteriness and overstimulation. The cardinal manifestations of overdosage are drowsiness and confusion, reduced reflexes and coma. There are minimum effects on respiration, pulse and blood pressure unless the overdosage is extreme.
Approximate Word count = 2712
Approximate Pages = 10.8
(250 words per page double spaced)
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