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DIAZEPAM
- (Valium) Antianxiety, Hypnotic, Anticonvulsant, Sedative
- Des: benzodiazepine sedative and skeletal muscle relaxant 1) reduces tremors 2) induces amnesia 3) reduces the incidence and recurrence of seizures 4) relaxes muscle spasms in orthopedic injuries 5) produces amnesia for painful procedures (cardioversion).
- Ind: 1) major motor seizures 2) status epilepticus 3) premedication before cardioversion 4) muscle tremors due to injury 5) acute anxiety
- CI: 1) shock 2) coma 3) acute alcoholism 4) depressed vital signs 5) obstetric patients 6) neonates
- PC: 1) psychoses 2) depression 3) myasthenia gravis 4) COPD. (Due to a short half-life of the drug, seizure activity may recur.)
- Dos: (seizures) 5 to 10 mg IV/IM Ped: 0.5 to 2 mg IV/IM.
- (acute anxiety) 2 to 5 mg IV/IM. Ped: 0.5 to 2 mg IM
- (premed for cardioversion) 5 to 15 mg IV Ped: 0.2 to 0.5 mg/kg IV
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ETOMIDATE
- (Amidate) Hypnotic
- Des: 1) ultra–short-acting nonbarbiturate hypnotic 2) no analgesic effects 3) limited cardiovascular and respiratory effects.
- Ind: Induce sedation for rapid sequence intubation.
- CI:
- PC: 1) marked hypotension 2) severe asthma 3) severe cardiovascular disease
- Dos: 0.1 to 0.3 mg/kg IV over 15 to 30 sec. Ped: children > 10 years, same as for adults
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FLUMAZENIL
- (Romazicon) Benzodiazepine Antagonist
- Des: used to reverse the sedative, recall, and psychomotor effects of diazepam, midazolam, and the other benzodiazepines.
- Ind: respiratory depression secondary to the benzodiazepines.
- CI: 1) hypersensitivity to flumazenil or benzodiazepines 2) patients who take medication for status epilepticus or seizures 3) seizure-prone patients during labor and delivery 4) tricyclic antidepressant overdose
- PI: 1) hepatic impairment 2) elderly 3) pregnancy 4) nursing mothers 5) head injury 6) alcohol and drug dependency 7) physical dependence on benzodiazepines
- Dose: 0.2 mg IV over 30 sec/min, up to 1 mg
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MIDAZOLAM
- (Versed) Sedative
- Des: short-acting benzodiazepine with CNS depressant 1) muscle relaxant 2) anticonvulsant 3) anterograde amnestic effects
- Ind: to induce sedation before cardioversion or intubation
- CI: 1) hypersensitivity to benzodiazepines 2) narrow-angle glaucoma 3) shock 4) coma 5) acute alcohol intoxication
- PI: 1) COPD 2) renal impairment 3) CHF 4) elderly
- Dose: 1 to 2.5 mg slow IV; 0.07 to 0.08 mg/kg IM (usually 5 mg). Ped: 0.05 to 0.2 mg/kg IV: 0.1 to 0.15 mg/kg IM; 3 mg intranasal.
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SUCCINYLCHOLINE
- (Anectine) Depolarizing Neuromuscular Blocker
- Des: ultra–short-acting depolarizing neuromuscular blocker
- Ind: facilitated endotracheal intubation
- CI: 1) family history of malignant hyperthermia 2) penetrating eye injury 3) narrow-angle glaucoma 4) hyperkalemia
- PI: 1) severe burn 2) crush injury 3) spinal cord injury
- Dose: 1 to 1.5 mg/kg IV/IM. Ped: 1 to 2 mg/kg IV/IM.
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