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D-pam

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Indications:

Severe anxiety,Insomnia associated with anxiety,Premedication before anaesthesia,Adjunct in seizures,Muscle spasms,Alcohol withdrawal syndrome,Sedation in minor surgical and medical procedures.

Contraindications:

Hypersensitivity; myasthenia gravis, preexisting CNS depression or coma, respiratory depression; acute pulmonary insufficiency or sleep apnoea syndrome; severe hepatic impairment; acute narrow angle glaucoma; children <6 mth (oral); pregnancy and lactation.

Adverse reactions:

Psychological and physical dependence with withdrawal syndrome, fatigue, drowsiness, sedation, ataxia, vertigo, confusion, depression, GI disturbances, changes in salivation, amnesia, jaundice, paradoxical excitation, elevated liver enzyme values; muscle weakness, visual disturbances, headache, slurring of speech and dysarthria, mental changes, incontinence, constipation, hypotension, tachycardia, changes in libido, pain and thrombophlebitis at inj site (IV). Potentially Fatal: Respiratory and CNS depression, coma.

Interactions:

Increased clearance of diazepam when used with phenytoin, carbamazepine and phenobarbital. Reversible deterioration of parkinsonism may occur when given together with levodopa. Combination with lithium may produce hypothermia. May need to reduce dose of narcotics when used concurrently. Potentially Fatal: Phenothiazines, barbiturates, MAOIs potentiate action of diazepam. Additive CNS depressant effects with alcohol and CNS depressants or psychoactive medications. Mutual potentiation of action with analgesics, anaesthetics and some anticonvulsants. Food Interaction Grapefruit juice may increase serum levels and toxicity of diazepam. Levels may be reduced by St John’s wort. Avoid valerian, kava kava, gotu kola and St John’s wort. Lab Interference: False-positive urinary glucose determinations.

Warnings:

Impaired renal and hepatic function, respiratory disease, organic cerebral changes, elderly, psychotic patients, epileptics, history of alcohol or drug addiction, impaired gag reflux, obese patients. May cause CNS depression. Discontinue treatment if patient develops psychiatric and paradoxical reactions. Caution when used in patients with depression or anxiety associated with depression, especially if patient has suicidal risk. May increase risk of falls. Safety and efficacy of the inj have not been established in children <1 mth of age. Safety and efficacy of oral use have not been established in children <6 mth of age. Safety and efficacy of rectal gel have not been established in children <2 yr of age. Abrupt withdrawal or large dose reduction may cause rebound or withdrawal symptoms. pregnancy: Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).

Form:

INJECTION

Dosage and Administration

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