DIAZAPAM
(VALIUM)
LORAZEPAM
(ATIVAN)
MIDAZOLAM HYDROCHLORIDE
(VERSED)
Flumazenil
(Romazicon)
Potpurri
100
DIAZEPAM (valium) is a Benzodiazepine, long-acting; sedative-hypnotic; anticonvulsant;schedule IV drug. What is the mechanism of action for diazapam (valium)? (3)
What is Diazapam(valium) 1. Potentiates effects of inhibitory neurotransmitters 2.Raises the seizure threshold. 3. Induces amnesia and sedation
100
LORAZEPAM (ATIVAN) is a Benzodiazepine, short/intermediate acting; sedative, anticonvulsant, schedule IV drug. WHat is the Mechanism of Action for this DRUG.
What is LORAZEPAM (ATIVAN)1. is an Anxiolytic, 2. anticonvulsant, and 3. sedative effect; 4. suppresses propagation of seizure activity produced by foci in cortex, thalamus, and limbic areas
100
MIDAZOLAM (versed) is a Class: Benzodiazepine, short/intermediate acting; schedule IV drug. 1. What is the Mechanism of action for MIDAZALAM (versed)?
MIDAZALAM (versed) reversibly interacts with gamma-amino butyric acid (GABA) receptors in the central nervous system causing sedative, anxiolytic, amnesic, and hypnotic effects.
100
FLUMAZENIL (Romazicon) is Class: Benzodiazepine antagonist, antidote. What is the Mechanism of Action for FLUMAZENIL (Romazicon)
Mechanism of action: FLUMAZENIL (Romazican)Antagonizes the action of benzodiazepines on the central nervous system, reversing the sedative effects.
100
What Are/Is the Onset Duration, Peak Effectand 2 Special consierations for the Use of DIAZAPAM (valium) Daily Double!
What is Duration of action: Onset: 1–5 minutes. Peak effect: 15 minutes. Duration: 20–50 minutes. Special considerations: Pregnancy safety: Category D. Short duration for anticonvulsant effect. Reduce dose by 50% in elderly patients.
200
Diazapam (valium) is indicated in what situations? (6)
What is 1. Acute anxiety states and agitation 2. acute alcohol withdrawal 3. muscle relaxant 4. seizure activity, 5. sedation for medical procedures (eg, intubation, ventilated patients, cardioversion), may 6. be helpful in acute symptomatic cocaine overdose.
200
Name two indications for the use of Larazepam (ATIVAN)
What is 1. Initial control of status epilepticus or severe recurrent seizures, 2. severe anxiety, sedation.
200
Name 3 indications and 5 contraindications for the use of MIDAZALAM (versed)
What is Indications: 1. Sedation for medical procedures (eg, intubation,2. ventilated patients, 3.cardioversion Contraindications:1. Acute narrow-angle glaucoma, 2.shock, 3. coma, 4. alcohol intoxication, 5. overdose, 6.depressed vital signs.
200
For FLUMAZENIL (Romazicon) Name 1. 1-indications 2. 3-contraindications
Indications: 1. Reversal of respiratory depression and sedative effects from pure benzodiazepine overdose. Contraindications: 1. Hypersensitivity, 2. tricyclic antidepressant overdose, 3. seizure-prone patients,4. coma of unknown etiology
200
Name 4 special considerations for the use of LORAZEPAM (ATIVAN)
What is LORAZEPAM (ATIVAN) Pregnancy safety: Category D. 1. Monitor respiratory rate and blood pressure during administration. 2. Have advanced airway equipment readily available.3. Inadvertent arterial injection may result in vasospasm and gangrene. 4. Lorazepam expires in 6 weeks when not refrigerated.
300
Name 6 contraindications for the administration of valium.
What is 1. Hypersensitivity, 2. narrow-angle glaucoma 3. myasthenia gravis,4. respiratory insufficiency, 5.coma, 6.head injury.
300
Name 2 contraindications and 6 adverse reactions for the use of LORAZAPM (ativan)
What is Contra Inications 1. Acute narrow-angle glaucoma, coma, 2. shock, 3. suspected drug abuse. Adverse reactions/side effects:1. Dizziness, 2. drowsiness, 3. CNS depression, 4. headache, 5. sedation, 6. respiratory depression, 7. apnea, 8. hypotension,9. bradycardia.
300
For MIDAZALAM (versed) 6 adverse reactions/side effects 1 drug interaction
What is Adverse reactions/side effects: 1. Headache, 2. somnolence 3. respiratory depression 4. respiratory arrest 5.apnea 6. hypotension 7. cardiac arrest 8. nausea, 9.vomiting 10. pain at the injection site. Drug interactions: 1. Should not be used in patients who have taken central nervous system depressants.
300
For Flumazenil (Romazicon) name. 6 adverse reactions 1 drug interaction
Adverse reactions/side effects:1. Seizures, 2. dizziness, 3.agitation, 4.confusion, 5.headache, 6.visual disturbances,7. dysrhythmias, 8. chest pain, 9.hypertension,10. nausea, 11. vomiting, 12. hiccups, rigors, 13. shivering, 14. pain at the injection site. Drug interactions Toxic effects of mixed drug overdose (especially tricyclics).
300
Name 2 special considerations for the use of MIDAZALAM (versed)
Special considerations: Pregnancy safety: Category D. 1. Administer immediately prior to intubation procedure. Requires continuous monitoring of respiratory and cardiac function. 2. Decrease dose by 50% in patients with hepatic and renal dysfunction.
400
Name 6 Adverse reactions for DIAZAPAM (valium)
What is 1. Dizziness 2. drowsiness 3. confusion 4. headache 5. respiratory depression 6. hypotension 7.reflex 8. tachycardia 9. nausea, vomitin 10. muscle weakness, 11. tissue necrosis 12. ataxia 13. thrombosis 14. phlebitis.
400
What possible drug interactions are there when giving Lorazapam (ATIVAN)
What is Drug interactions: 1. May precipitate central nervous system depression if already taking central nervous system depressant medications..
400
For MIDAZALAM (versed) name the Dose for 1. Adult 2. Pediatrics
1. Adult: 2–2.5 mg slow IV (over 2–3 minutes). May be repeated to total maximum: 0.1 mg/kg. 2. Pediatric: 0.1–0.3 mg/kg IV/IO (maximum single dose:10 mg).
400
Name the Dose and Administration for FLUMAZENIL (Romazicon)
What is Adult: First dose 0.2 mg IV/IO over 15 seconds. Second dose: 0.3 mg may be given over 30 seconds; if no response, give third dose. Third dose: 0.5 mg IV/ IO over 30 seconds; if no response, repeat once every minute until adequate response or total of 3 mg is given. Pediatric: Not recommended.
400
NAME 5 Special considerations for the use of FLUMAZENIL (Romazicon)
What is Special considerations: Pregnancy safety: Category C. 1. Be prepared to manage seizures in patients who are physically dependent on benzodiazepines or 2.who have ingested larger doses of other drugs. 3.Flumazenil may precipitate withdrawal syndromes in patients dependent on benzodiazepines. 5.Monitor patients for re-sedation and respiratory depression; 6.be prepared to assist ventilations. 7. Not recommended in combined drug overdoses, especially with TCAs; may result in death. 8. Controversial use in unknown overdose or polysubstance overdose
500
Name Proper DIAZAPAM (Valium) Dosages for each indication listed below. 1. Adult Seizure Activity 2. Pre-medication for Cadioversion 3. Pediatric seizure activity 4. Rectal
What is 1. 5-10MG/IV Q10-15MIN/PRN 5MG OVER 5MIN MAX 30MG 2. 5–15 mg IV over 5–10 minutes prior to cardioversion. 3. Pediatric: Seizure activity: 0.2 mg/kg to 0.5 mg/kg slow IV q 2–5 minutes up to 5 mg (maximum dose 10 mg/kg 4. Rectal diazepam: 0.5 mg/kg via 2" rectal catheter and fl ush with 2–3 mL air after administration
500
When giving Lorazapam (ativan) IV/IO remember you must dilute with equal volumes of sterile water or saline. No dilution for I/M What are the drug doses for indicated below. for IM. 1. Adult Dose and rate 2.Dose for Sedation 3. Pediatric Dose
1. Adult dose and Rate: 2-4MG slow IV/IO (2MG/MIN) Repeat 15 to 20 MIN MAX dose 8MG 2. For sedation .05 MG/KG IM up to 4MG 3. Pediatric: 0.05– 0.20 mg/kg slow IV/IO/IM over 2 minutes. May be repeated once in 5–20 minutes. Maximum dose of 0.2 mg/kg
500
What is the duration of action for MIDAZALAM (versed) 1. Onset 2. Duration
Duration of action: Onset: 1–3 minutes, IV and dose dependent. Peak effect: Variable. Duration: 2–6 hours, dose dependent.
500
What is the Duration of action for FLUMAZENIL (Romazicon)
Duration of action: Onset: 1–2 minutes. Peak effect: Related to plasma concentration of benzodiazepines. Duration: Related to plasma concentration of benzodiazepines.
500
Daily Double: What BENZO can be used Intranasal.
What is MIDAZOLAM HYDROCHLORIDE (VERSED)
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