Diazepam and Narcan

By. Katie Pepe, Ellen Ramos Rochedieu, and Joseph Johnson

PharmacologyDr. Alvarado

Medication (generic and trade name):

Diazepam also called

or

Classification: Benzodiazepine / hypnotic agents

Source of drug: Synthetic

Drug Form: Liquid (can also be tablets)

Drug dosage (adult): Dosage prior to endoscopic procedures is typically intravenous injection of up to 10mg. If given 30 minutes prior to the procedure typical dosage is 5-10mg. All other preoperative procedures normally require 10mg given intramuscularly.

Indications for use (with emphasis on surgery): Diazepam can be used for the management of anxiety. In the surgical setting it is administered prior to surgical procedure and endoscopic procedures to calm nerves. In a non-surgical setting it can be given to relieve short-term anxiety symptoms and acute alcohol withdrawal.

Administration route(s): In the surgical setting diazepam is administered intravenously, but can be administered Intramuscularly if needed.

Outside the surgical setting it can also be administered via tablets.

What are given: During administration, extreme caution must be taken to inject IV slowly. It is also advised that diazepam not be mixed or diluted with any other products. Patients must be monitored to ensure blood counts remain within natural limits and that dependency does not occur.

List drug interactions: Possible drug interactions include the use of narcotics, barbiturates, MAOIs and other antidepressants, as they may make diazepam more powerful. The use of alcohol and other central nervous system depressants is not recommended as they may cause apnea. Diazepam should also not be used during pregnancy.

What are the contraindications: Not to be given to those who are in shock, coma or experiencing alcohol intoxication, have kidney or hepatic dysfunction. And not recommended to control seizures.What is the drug’s action on two different body systems: Diazepam produces a calming effect on patients by affecting the thalamus, hypothalamus and parts of the limbic system.

How is the drug absorbed: Diazepam is rapidly absorbed from the gastrointestinal tract. Peaking occurs 30-90 minutes after administration, but may be further delayed in elderly patients. Diazepam has a half-life of 1-2 days. This is extended in patients withkidney or liver disease. How is it distributed: Diazepam is widely distributed in the body and accumulates in lipid rich areas such as the CNS and adipose tissue. Diazepam and its metabolites are highly bound to plasma proteins.

How is the drug metabolized: Diazepam is metabolized in the liver and the following metabolites are produced: desmethyldiazepam, methyloxazepam, oxazepam and temazepam.

How is the drug excreted: The metabolites are eliminated by the kidneys in either their free form or conjugated form.

MEDICATION (GENERIC AND TRADE NAME):

ALSO CALLED

Source of drug: Synthetic

Classification: Narcotic antagonist during surgery or to treat pain non-surgically

Drug Form: Liquid

Drug dosage (adult): Initial dose is 0.1 – 0.2 mg administered intravenously at 2-3 minute intervals until desired degree of reversal has been achieved.

Indications for use (with emphasis on surgery):

Narcan is used in the surgical setting for reversal of narcotic or opioid depression.

Administration route(s): Administration is traditionally intravenous, but can be intramuscularly or subcutaneous if intravenous access is not available.

List two side effects: Side effects may include body aches, dizziness, diarrhea, nausea, fever, chills, sneezing and runny nose.

List an adverse effect: Traditional adverse reactions may include hypotension, vertricular tachycardia, dyspnea, pulmonary edema, sweating, and seizures.

What precautions are given: Care must be given to those patients what have opiate dependency and elderly patients that have pre-existing cardiac, renal or hepatic diseases.List drug interactions: Drug interactions may arise in medications that produce adverse cardiovascular effects.

What are the contraindications: Narcan is contraindicated in patients who have a known hypersensitivity to naloxone hydrochloride.