【藥品庫存】 公告日期：2024/2/7。 即將停用品項：Dianlin 針 管四 10 mg/2 mL/Amp。 停用原因：用量極低，藥品近效期。 替代藥品：院內有同類品 。 配套措施：藥品用罄關檔停用，建請改以院內同類藥品 AnxiCAM 針 管四 2 mg/1 mL/Amp、Midatin 針 管四 5 mg/1 mL/Amp 等替代。 【藥品性質提示】 根據 2019 AGS Beers Criteria，本藥品為【潛在不適當用藥 (PIM)】，不建議用於老年人。 #高警訊藥品

焦慮、失眠、肌肉痙攣、癲癇重積狀態
Acute alcohol withdrawal syndrome; Anxiety; Muscle spasm; Status epilepticus

Anticonvulsant, Benzodiazepine
Binds to stereospecific benzodiazepine receptors on the postsynaptic GABA neuron at several sites within the central nervous system. Enhancement of the inhibitory effect of GABA on neuronal excitability results by increased neuronal membrane permeability to chloride ions. This shift in chloride ions results in hyperpolarization (a less excitable state) and stabilization. Benzodiazepine receptors and effects appear to be linked to the GABA-A receptors. Benzodiazepines do not bind to GABA-B receptors.

Onset of action:
1. Sedation: (Pediatric) 4-5 minutes
2. Status epilepticus: 1-3 minutesz
Duration of action:
1. Sedation: (Pediatric) 60-120 minutes
2. Status epilepticus: 15-30 minutes
Distribution:
Vd: 1.2 L/kg (range: 0.6 to 2 L/kg)
Metabolism:
Hepatic; diazepam is N-demethylated by CYP3A4 and 2C19 to the active metabolite N-desmethyldiazepam, and is hydroxylated by CYP3A4 to the active metabolite temazepam. N-desmethyldiazepam and temazepam are both further metabolized to oxazepam.
Excretion:
Urine (predominantly as glucuronide conjugates)

Hypersensitive to diazepam, acute narrow angle glaucoma, psychosis, shock, coma, alcohol intoxication.

D; Clip lip/palate, inguinal hernia, cardiac defects, and pyloric stenosis have been reported when use the drug during first trimester.

Diazepam and its metabolites are present in breast milk.

Drowsiness, depression, confusion, fatigue, ataxia, hypoactivity, bradycardia, cardiovascular collapse

Anxiety:
1. Anxiety, acute/severe: 2-10 mg every 3-6 hours as needed up to 40 mg/day
2. Anxiety disorders: Initial 2-5 mg once or twice daily; increase gradually up to 40 mg/day in 2-4 divided doses
Seizure:
Initial 5-10 mg every 10-15 minutes; increase gradually up to a total dose of 30mg
Muscle spasm:
Initial 5-10 mg every 3-4 hours (if necessary)

1. Kidney Impairment: There are no dosage adjustments provided in the manufacturer's labeling; use with caution.
2. Hemodialysis: Not dialyzable (0% to 5%); supplemental dose is not necessary.

There are no dosage adjustments provided in the manufacturer's labeling; use with caution because distribution and half-life may increase, and clearance may decrease significantly.

Do not mix IV product with other medications. To administer directly IV, inject slowly through infusion tubing as close as possible to the vein insertion.