Gastrointestinal System Disorders Q 21 - Gyan Darpan : Learning Portal
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Saturday, 16 April 2022

Gastrointestinal System Disorders Q 21

Elmer is scheduled for a proctoscopy and has an I.V. The doctor wrote an order for 5mg of I.V. diazepam(Valium). Which order is correct regarding diazepam?
    A. Give diazepam in the I.V. port closest to the vein.
    B. Mix diazepam with 50 ml of dextrose 5% in water and give it over 15 minutes.
    C. Give diazepam rapidly I.V. to prevent the bloodstream from diluting the drug mixture.
    D. Question the order because I.V. administration of diazepam is contraindicated.

Correct Answer: A. Give diazepam in the I.V. port closest to the vein.

Diazepam is absorbed by the plastic I.V. tubing and should be given in the port closest to the vein. Diazepam is a benzodiazepine medication that is FDA approved for the management of anxiety disorders, short-term relief of anxiety symptoms, spasticity associated with upper motor neuron disorders, adjunct therapy for muscle spasms, preoperative anxiety relief, management of certain refractory epilepsy patients and adjunct in severe recurrent convulsive seizures, and an adjunct in status epilepticus.

Option B: Diazepam is available in multiple formulations, including oral tablets, intramuscular injections (IM), intravenous injection (IV), or rectal gel. Of note, oral tablets have a more reliable absorption and controlled release when compared to IM.
Option C: Diazepam is highly lipophilic. While there is a moderately quick onset of action, the drug quickly redistributes. Once in the body, diazepam is mostly broken down by the CYP2C19 and CYP3A4 enzymes to several active metabolites, mainly desmethyldiazepam. Other minor active metabolites include oxazepam and temazepam. The average half-lives of oral diazepam and desmethyldiazepam are about 46 hours and 100 hours, respectively.
Option D: When administered intravenously, diazepam actS within 1 to 3 minutes, while oral dosing onset ranges between 15 to 60 minutes. Diazepam is long-lasting with a duration of action of more than 12 hours.

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