Sedative Hypnotics
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Contents
Section 8 - MEDICATION GUIDELINES
8.15 SEDATIVE / HYPNOTICS / ANTIPSYCHOTIC
Diazepam (VALIUM) / Sedative Hypnotic
DESCRIPTION
- It is a skeletal muscle relaxant that reduces tremors, induces amnesia, and reduces the incidence and recurrence of seizures.
INDICATIONS
- Seizures, Status Epilepticus, premedication prior to cardioversion, acute anxiety states, acute alcohol withdrawal.
CONTRAINDICATIONS
- Hypersensitivity to the medication.
PRECAUTIONS
- Due to a short half-life of the drug, seizure activity may recur.
DOSAGE
- 2 - 20 mg Slow IVP for adults titrated to effect. If no IV access, administer 10 - 20 mg IM up to a total of 2 ml per large muscle injection site or 1 ml per small muscle injection site. Refer to PRACTICE PARAMETER for specific dosages.
- Refer to Handtevy System for pediatric dosage.
Midazolam (VERSED) / Sedative / Hypnotic
DESCRIPTION
- It is a skeletal muscle relaxant that reduces tremors, induces amnesia, and reduces the incidence and recurrence of seizures.
- Depresses sub-cortical levels in CNS.
INDICATIONS
- Sedation for post resuscitation combativeness, combative head injury, intubations, pacing and cardioversion.
- Seizures, status epilepticus.
CONTRAINDICATIONS
- Pregnancy (relative contraindication), hypersensitivity to benzodiazepines, coma, acute narrow angle glaucoma, shock, alcohol intoxication.
PRECAUTIONS
- Hypotension, COPD, CHF, chronic renal failure, chills, elderly, debilitated.
DOSAGE
- INTUBATION: Initial dose, 2-5 mg IVP then 2-4 mg every 30 seconds to 1 minute.
- SEDATION, PACING, CARDIOVERSION: Initial dose 2-5 mg IVP then 2 mg every 30 second to 1 minute IVP. Max dose= 15 mg in the intubated patient. Can be given IM.07-.mg/kg with onset in approximately 15 minutes
- An IM injection requires immediate IV access upon sedation.
- HYPOTENSION responds well to Trendelenburg.
- Pediatrics refer to Handtevy System.
Lorazapam (ATIVAN) / Sedative Hypnotic
DESCRIPTION
- It is a skeletal muscle relaxant that reduces tremors, induces amnesia, and reduces the incidence and recurrence of seizures.
INDICATIONS
- Seizures, Status Epilepticus, premedication prior to cardioversion, acute anxiety states, acute alcohol withdrawal.
CONTRAINDICATIONS
- Hypersensitivity to the medication, pregnancy, severe respiratory failure, acute narrow-angle glaucoma.
PRECAUTIONS
- Risk for respiratory depression and bradycardia, and should be administered with ECG SpO2 EtCO2 monitoring.
DOSAGE
- 1-2 mg Slow IVP for adults titrated to effect. Max dose of 8mg. If no IV access or Agitated/Violent behavioral patient, administer 1-2 mg IM up to a total of 2 ml per large muscle injection site or 1 ml per small muscle injection site.
- Refer to Handtevy System for pediatric dosage.
