Diazepam

Diazepam - available formulated in either propylene glycol or a lipid emulsion (diazemuls), which causes minimal thrombophlebitis.Also available in a rectal solution (Stesolid) which takes up to 10 min to work.

Uses:
Termination of epileptic fit

Contraindications:
Airway obstruction

Administration:
• IV: Diazemuls 5–10mg over 2 min, repeated if necessary after
  15 min, up to total 30mg
• PR: Stesolid up to 20mg

How not to use diazepam:
IM injection – painful and unpredictable absorption

Adverse effects:
Respiratory depression and apnoea
Drowsiness
Hypotension and bradycardia

Cautions:
Airway obstruction with further neurological damage
Enhanced and prolonged sedative effect in the elderly
Additive effects with other CNS depressants

Organ failure:
CNS: enhanced and prolonged sedative effect
Respiratory: respiratory depression
Hepatic: enhanced and prolonged sedative effect. Can precipitate coma
Renal: enhanced and prolonged sedative effect

Renal replacement therapy:
No further dose modification is required during renal replacement therapy