Diazepam

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Diazepam is a drug that is used as a sedative and muscle relaxant, and to treat anxiety and epileptic seizures.

Information about Diazepam

Diazepam is a benzodiazepine that is available for both oral and intravenous administration; oral diazepam is used predominantly as an anxiolytic agent, while the intravenous form is used as an anticonvulsant. 

Liver safety of Diazepam

Use of intravenous diazepam has not been linked to serum enzyme elevations during therapy or to clinically apparent liver injury. In contrast, use of the oral form of diazepam has been linked to rare instances of cholestatic liver injury.

Mechanism of action of Diazepam

Diazepam (dye az' e pam) is a benzodiazepine with particularly potent activity against spread of seizure activity in several animal models.  The antiseizure activity of the benzodiazepines is mediated by their ability to enhance gamma-aminobutryic acid (GABA) mediated inhibition of synaptic transmission through binding to the GABA A receptor.  The use of diazepam as an anticonvulsant is limited largely to intravenous therapy of status epilepticus.  Oral diazepam is not as effective or well tolerated as a therapy for epilepsy as are other benzodiazepines such as clobazam, clonazepam and clorazepate. 

{{fda} Diazepam was approved in the United States in 1963 and it is currently widely used to treat acute seizures and status epilepticus.  Indications also include premedication before surgical operations and as conscious sedation for minor invasive procedures.  Several generic forms of parenteral diazepam are available in ampules of 5 mg/mL. 

Dosage and administration for Diazepam

The typical recommended dose for status epilepticus is 5 to 10 mg given intravenously, which can be repeated at 10 to 15 minute intervals until control of seizure activity or to a maximum of 30 mg.  Intramuscular administration can be used for premedication before general anesthesia. 

Side effects of Diazepam

Common effects of the use of parenteral diazepam include somnolence, confusion, dysarthria, diplopia and coma. Acute overdose of diazepam can cause respiratory arrest and death. Anticonvulsants

Generic Name / Brand Name Liver Toxicity Score Approval Year Major Indications
Brivaracetam / Briviact E 2016 Partial seizures
Carbamazepine / Tegretol A 1968 Partial, mixed and generalized seizures, trigeminal neuralgia
Clobazam / Onfi E 2011 Seizures assocated with Lennox-Gastaut syndrome
Clonazepam / Klonopin D 1975 Absence and myoclonic seizures, anxiety and panic disorders
Clorazepate / Tranxene E 1972 Partial seizures, anxiety disorders, and alcohol withdrawal
Diazepam / Valium E 1963 Convulsions, anxiety disorders, muscle spasms
Eslicarbazepine / Aptiom D 2013 Partial seizures
Ethosuximide / Zarontin E 1960 Absence seizures
Ezogabine / Potiga E 2011 Partial seizures
Felbamate / Febatol B 1993 Refractory or severe epilepsy
Fosphenytoin / Cerebyx A 1996 Tonic-clonic seizures, status epilepticus
Gabapentin / Neurontin C 1993 Partial seizures, post-herpetic neuralgia
Lacosamide / Vimpat D 2008 Partial seizures
Lamotrigine / Lamictal B 1994 Partial and generalized tonic-clonic seizures, bipolar disorder
Levetiracetam / Keppra C 1999 Partial, generalized tonic-clonic, and myoclonic seizures
Methsuximide / Celontin E 1957 Absence seizures
Oxcarbazepine / Trileptal D 2000 Partial seziures
Perampanel / Fycompa E 2012 Partial and generalized tonic-clonic seizures
Phenobarbital / Luminal A 1916 Partial and generalized seizures, anxiety, and irritable bowel syndrome
Phenytoin / Dilantin A 1938 Generalized tonic-clonic and partial onset seizures, status epilepticus
Pregabalin / Lyrica C 2004 Partial seizures, fibromyalgia, and neuropathic pain
Primidone / Mysoline E 1954 Partial and generalized tonic-clonic seizures
Rufinamide / Banzel E 2008 Seizures associated with Lennox-Gastaut syndrome
Tiagabine / Gabitril E 1997 Partial seizures
Topiramate / Topamax C 1996 Partial and generalized tonic-clonic seizures, migraine headaches
Valproate / Depakene A 1978 Absence and complex partial seizures
Vigabatrin / Sabril D 2009 Refractory, complex partial seizures, and infantile spasms
Zonisamide / Zonegran D 2000 Partial seizures

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