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Instruction for use: Diazepam

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The Latin name of the substance Diazepam

Diazepamum (genus. Diazepami)

Chemical name

7-Chloro-1,3-dihydro-1-methyl-5-phenyl-2H-1,4-benzodiazepin-2-one

Gross formula

C16H13ClN2O

Pharmacological groups:

Means that affect neuromuscular transmission

Anxiolytics

Antiepileptic drugs

The nosological classification (ICD-10)

F05 Delirium not caused by alcohol or other psychoactive substances: Delirious condition

F06 Other mental disorders due to brain damage or dysfunction or somatic disease: Somatogenic depressions; Somatogenic psychosis

F06.4 Organic Anxiety Disorder

F10.2 Syndrome of alcohol dependence: Alcoholism; Alcohol addiction; posiomania; Dependence on alcohol; dipsomania; drunken state; alcohol abuse; Ideatornoy violations in alcoholism; Quarterly booze; Obsessive craving for alcohol; Neurotic symptoms of alcoholism; Craving for alcohol; Psychoorganic syndrome in chronic alcoholism; Reduced craving for alcohol; chronic alcoholism

F10.3 Abstinence: Alcohol withdrawal syndrome; Abstinence syndrome; Abstinence syndrome with alcoholism; Abstinence; Alcohol abstinence; Alcohol withdrawal status; Alcohol withdrawal syndrome; Postabstinctive disorder; Post-abstinence condition; Hangover syndrome; Abstinence syndrome; Alcohol abstinence syndrome; Alcohol withdrawal syndrome; Abstinence condition

F10.4 Abstinent state with delirium: Alcoholic delirium; White fever alcoholic; Delirium; Delirious condition with alcoholism and drug addiction

F10.5 Alcoholic alcohol: Alcoholic hallucinations; Psycho-organic syndrome in chronic alcoholism; Alcoholic psychosis; White fever alcoholic; Delirium; Delirium with alcoholism; Acute alcoholic psychosis; Delirious condition with alcoholism and drug addiction; Acute alcoholic psychosis with autonomic disorders

F11 Mental and behavioral disorders due to use of opioids: heroin addiction; heroin addiction; Diagnosis of opioid dependence; Dependence on opioids; morphine withdrawal; Opiate withdrawal; opium addiction; Opioid dependence; Opioid addiction; Behavioral disorder and postabstinentnom for drug dependence

F20 Schizophrenia: Schizophrenic conditions; Exacerbation of schizophrenia; Schizophrenia; Chronic schizophrenia; Dementia praecox; Bleuler's disease; Psychotic discordant; Dementia early; The febrile form of schizophrenia; Chronic schizophrenic disorder; Psychosis of the schizophrenic type; Acute form of schizophrenia; Acute schizophrenic disorder; Cerebral Organic Insufficiency in Schizophrenia; Acute attack of schizophrenia; Schizophrenic psychosis; Acute schizophrenia; Sluggish schizophrenia; Sluggish schizophrenia with apathoabulic disorders; Acute stage of schizophrenia with excitation

F29 Inorganic psychosis, unspecified: Childhood psychoses; Psychomotor agitation in psychoses; Hallucinatory-delusional disorders; Hallucinatory-delusional syndrome; Intoxication psychosis; Manic-delusional disorders; Manic chronic psychosis; Manic psychosis; Acute psychosis; paranoid psychosis; Paranoid psychosis; Subacute psychosis; Presenile psychosis; Psychosis; Intoxicating psychosis; Psychosis is paranoid; Psychosis in children; Reactive psychosis; Chronic psychosis; Chronic hallucinatory psychosis; Chronic psychosis; Chronic psychotic disorder; Schizophrenic psychosis

F32 Depressive episode: Adynamic subdepression; Astheno-adynamic subdepressive states; Asthenodepressive disorder; Astheno-depressive disorder; Asthenodepressive state; Astheno-depressive state; Major Depressive Disorder; Vyaloapatichesky depression with retardation; Double depression; Depressive pseudodement; Depressive illness; Depressive mood disorder; Depressive disorder; Depressive mood disorder; Depressive state; Depressive disorders; Depressive syndrome; Depressive syndrome larviated; Depressive syndrome with psychoses; Depressed masks; Depression; Depression Depletion; Depression with the phenomena of inhibition within the framework of cyclothymia; Depression is smiling; Involutional depression; Involutionary melancholy; Involutional depression; Manic-depressive disorder; Masked Depression; Melancholic Attack; Neurotic depression; Neurotic depression; Shallow Depression; Organic depression; Organic depressive syndrome; Simple depression; Simple melancholic syndrome; Psychogenic depression; Reactive depression; Reactive depression with moderate psychopathological symptoms; Reactive depressive states; Reactive depression; Recurrent depression; Seasonal depressive syndrome; Severostatic depression; Senile Depression; Senile Depression; Symptomatic Depression; Somatogenic depression; Cyclotymic depression; Exogenous Depression; Endogenous depression; Endogenous Depressive Conditions; Endogenous Depression; Endogenous depressive syndrome

F34.1 Dysthymia: Dysthymic state within the framework of psychopathic disorders in children and adolescents

F40.0 Agoraphobia: Fear of open space; Fear of being in a crowd

F40.2 Specific (isolated) phobias: Claustrophobia

F41.0 Panic disorder [episodic paroxysmal anxiety]: Panic state; Panic attack; Panic; Panic disorder

F43.0 Acute stress reaction

F43.1 Post-traumatic stress disorder: Combat fatigue; Catastrophe Syndrome; The survivor's syndrome; Traumatic isolation; Traumatic neurosis; Traumatic syndrome; Post-traumatic stress disorder

F43.2 Adverse Reactions Disorder: Mental Adjustment Disorder

F44 Dissociative [conversion] disorders: Psychogenic psychosis; Conversion disorder; Dissociative phenomena; Pseudodegmentation; Conversion symptoms

F45 Somatoform disorders: Psychosomatic disorder; Psychosomatic disorders; Psychosomatic diseases; The state of excitement in somatic diseases; Functional psychosomatic disorders of the cardiovascular system

F51.0 Insomnia of inorganic etiology: Situational insomnia; Situational sleep disorders

F60 Specific personality disorders

F63 Disorders of habits and drives: Impulsive drives and actions

F95 Teaki: Teak child; Children's teak; Nerve Teacks in Children; Nervous teack; Teak

G40 Epilepsy: Atypical convulsive seizures; Atonic seizures; Great seizures; Large convulsive seizures; Generalized Absences; Jackson epilepsy; Diffuse large seizure; Diencephalic epilepsy; Cortical and non-convulsive forms of epilepsy; Primary-generalized seizures; Primary-generalized tonic-clonic seizure; Pycnoleptic absence; Repeated epileptic seizures; Attack generalized; Seizure fit; Refractory epilepsy in children; Complicated convulsive seizures; Mixed seizures; Mixed forms of epilepsy; Convulsive condition; Convulsive seizures; Convulsions; Convulsive forms of epilepsy; Epilepsy grand mal; Epileptic seizures; Great seizures in children

G41 Epilepticus: Convulsive Syndrome; Convulsive status in children

G47.0 Disorders of falling asleep and maintaining sleep [insomnia]: Insomnia; Insomnia, especially difficulty falling asleep; desynchronosis; Prolonged sleep disturbance; Difficulty falling asleep; Short-term and transient insomnia; Short-term and chronic sleep disorders; Short or shallow sleep; Violation of sleep; Disturbed sleep, especially in the phase of falling asleep; Infringements sleep; sleep disturbances; Neurotic sleep disturbance; Shallow superficial sleep; shallow sleep; Poor quality of sleep; Night awakening; sleep Pathology; Postsomnic violation; transient insomnia; Trouble falling asleep; Early awakening; Early morning awakening; Early awakening; sleep disorder; somnipathy; persistent insomnia; difficult to fall asleep; difficulty falling asleep; Difficulty falling asleep in children; persistent insomnia; Worsening sleep; Chronic insomnia; Frequent night and / or early morning awakening; Frequent nocturnal awakening and a sense of the depth of the non-sleep; Night waking

G83.9 Paralytic syndrome, unspecified: Bulbar paresis; Bulbar Parez

L29 Itching: Itching with partial obstruction of the biliary tract; Dermatitis itchy; Dermatosis with persistent itching; Other itching dermatoses; Itching dermatoses; Itching allergic dermatosis; Itching dermatitis; Itching dermatosis; Itching itch; Excruciating itching; Severe itching; Endogenous itching; Skin itching with dermatosis; Restricted itchy dermatitis; Itching of the skin; Itchy scalp; Itching eczema

L30.9 Unspecified Dermatitis: Allergic dermatoses complicated by a secondary bacterial infection; Anal eczema; Bacterial maturation; Varicose Eczema; Venous dermatitis; Inflammation of the skin; Inflammation of the skin upon contact with plants; Inflammatory Skin Disease; Inflammatory Skin Diseases; Inflammatory Skin Diseases; Inflammatory skin reactions; Inflammatory processes of the skin; Hypostatic dermatitis; Fungal Eczema; Fungal dermatosis; Dermatitis; Dermatitis is stagnant; Dermatitis and eczema in the anal area; Dermatitis acute contact; Perianal dermatitis; Dermatosis; Dermatosis of the scalp; Dermatosis of psoriasis; Dermatosis with persistent itching; Dermatoses; Dermatoses itchy; Other itching dermatoses; Significant eczematous manifestations; Itching with dermatoses; Itching eczema; Itching dermatoses; Itching dermatitis; Itching dermatosis; True eczema; Skin reaction to insect bites; Skin itching with dermatosis; Constitutional eczema; Weeping eczema; Drowsing inflammatory skin disease; Dying Infectious-Inflammatory Skin Disease; Non-allergic dermatitis; Nummular eczema; Acute contact eczema; Acute inflammatory skin disease; Acute dermatosis; Acute severe dermatosis; Perianal dermatitis; Superficial dermatosis; Subacute Contact Eczema; Simple dermatitis; Occupational dermatitis; Psychogenic dermatosis; Bubble dermatitis of newborns; Pustular eruptions; Irritation and redness of the skin; Low-flammable eczema; Dry atrophic eczema; Dry eczema; Toxic dermatitis; Ear eczema like dermatitis; Chronic eczema; Chronic dermatosis; Chronic dermatosis; Chronic common dermatosis; Scaly papular dermatosis; Eczema; Eczema anal region; Eczema of the hands; Eczema Contact; Eczema lichenized; Eczema Nummular; Eczema acute; Eczema acute contact; Eczema subacute; Eczematous dermatitis; Eczema-like rashes; Ecome exogenous; Endogenous eczema; Gluteal dermatitis; Limited itching dermatitis

M13.0 Unspecified polyarthritis: Polyarthritis; Inflammatory diseases of joints; Nonspecific polyarthritis; Exchange polyarthritis; Polyarthritis; Polyarthropathy; Subchronic polyarthritis; Chronic polyarthritis; Pain with osteoarthritis; Polyarthritis of unclear etiology

M13.9 Arthritis, unspecified: Arthritis; Non-infectious arthritis (non-infectious); Arthritis acute; Pain syndrome in acute inflammatory diseases of the musculoskeletal system; Pain syndrome in chronic inflammatory diseases of the musculoskeletal system; Pain with osteoarthritis; Inflammation in osteoarthritis; Inflammatory arthropathy; Inflammatory-degenerative joint disease; Inflammatory disease of the musculoskeletal system; Inflammatory joint disease; Inflammatory diseases of the musculoskeletal system; Destructive arthritis; Diseases of the musculoskeletal system; Diseases of the musculoskeletal system and connective tissue; Infections of the musculoskeletal system; Monoarthritis; Non-rheumatic arthritis; Osteoarthritis; Acute inflammation of the musculoskeletal system; Acute inflammatory disease of the musculoskeletal system; Acute inflammatory condition of the musculoskeletal system; Acute arthritis; Acute osteoarthritis; Post-traumatic osteoarthritis; Reactive arthritis; Chronic inflammatory diseases of the joints; Chronic arthritis; Chronic inflammatory arthritis; Chronic inflammation of the inner layer of the joint capsule; Chronic inflammation of the joint bag; Chronic inflammatory joint disease; Exudative Arthritis

M60 Myositis: Myositis; Fibrositis; Fibromyositis; Inflammatory disease of soft tissues

M62.4 Contracture of muscle: Neurological contractures with spasms; Muscular contracture

M71 Other bursopathies: Bursitis; Bursopathy; Diseases of soft tissues; Osteoarthritis in musculo-articular diseases; Inflammatory disease of soft tissues; Subacute bursitis

N94.3 Premenstrual tension syndrome: Pronounced premenstrual syndrome; Menstrual psychosomatic disorder; Menstrual syndrome; Premenstrual tension; Premenstrual status; Premenstrual period; Premenstrual syndrome; Menstruation syndrome

N95.1 menopausal and menopausal status of women: Atrophy of the mucosa of the lower genital tract, caused by estrogen deficiency; Vaginal dryness; Autonomic dysfunction in women; gipoestrogeniya state; Deficiency of estrogen in menopausal women; Degenerative changes of the mucous membrane in the menopause; Natural menopause; an intact uterus; climacteric; Menopause women; Menopause in women; menopausal depression; Climacteric ovarian dysfunction; Menopause; Climacteric neurosis; Menopause; Menopausal symptoms complicated psychovegetative; Climacteric syndrome; Climacteric vegetative disorders; Climacteric psychosomatic disorder; menopausal disorders; Menopausal disorders in women; menopausal condition; Climacteric vascular disorders; Menopause; Menopausal vasomotor symptoms; menopausal period; Lack of estrogen; Feeling the heat; Pathological menopause; perimenopause; menopause; postmenopausal; Premature menopause; premenopauznom period; tides; hot flashes; flushing in the Meno and postmenopausal; Hot flashes / hot flashes in menopause; Heart attack during menopause; Early menopause in women; Disorders of menopause; climacteric syndrome; Vascular complications of menopause; Physiological menopause; Estrogendefitsitnye state; premature Menopause

O15 Eclampsia

O62.9 Violation of labor activity, unspecified: Stimulation of labor; Stimulation of labor

R25.2 Cramp and spasm: Muscle spasms in tetanus; Pain syndrome with smooth muscle spasms; Pain syndrome with smooth muscle spasms (renal and biliary colic, intestinal spasm, dysmenorrhea); Pain syndrome with spasms of smooth muscles of internal organs; Pain syndrome with spasms of smooth muscles of internal organs (renal and biliary colic, intestinal spasm, dysmenorrhea); Painful muscular spasm; Mimic spasms; Muscular spasticity; Muscle spasms; Muscular spasms of central origin; Muscular spasticity; Muscle spasm; Neurological contractures with spasms; Night cramps in the extremities; Nocturnal cramps in the legs; Night cramps calf muscles; Symptomatic convulsive state; Vesta Syndrome; Spasm of smooth muscles; Spasm of smooth vascular musculature; Spasm of muscles; Spasm of striated muscle due to organic diseases of the central nervous system; Skeletal muscle spasms; Spasms of smooth muscles of internal organs; Skeletal Muscle Cramps; Spastic states of striated musculature; Spasmodic pain syndrome; The spastic condition of smooth muscles; Spasticity of skeletal musculature; Muscle cramp; Convulsions; Cramps of the calf muscles; Convulsions of central origin; Convulsive condition; Convulsive Syndrome; Convulsive status in children; Tonic convulsions; Cerebral spasmodic syndrome; clasp knife phenomenon

R25.8.0 * Hyperkinesis: Hyperkinesis of the Choreic; Hyperkinesis of central origin; Hyperkinesia rheumatic; Hyperkinesis; Floating tremor

R32 Urinary incontinence, unspecified: Daytime enuresis; Idiopathic instability of the bladder; Urinary incontinence; Nocturia; Disorder of the function of the sphincter of the bladder; Spontaneous urination; Mixed forms of urinary incontinence; Functional disorders of urination; Functional disorders of urination; Functional enuresis in children; Enuresis

R45.1 Anxiety and agitation: Agitation; Anxiety; Explosive excitability; Internal stimulation; Excitability; Excitation; Excitation acute; Psychomotor agitation; Hyperexcitability; Motor excitement; Cessation of psychomotor agitation; Nervous excitement; Restlessness; Night trouble; Acute stage of schizophrenia with excitation; Acute mental agitation; Paroxysm of excitation; Overexcitation; Increased excitability; Increased nervous excitability; Increased emotional and cardiac excitability; Increased agitation; Mental arousal; Psychomotor agitation; Psychomotor agitation in psychoses; Psychomotor agitation of an epileptic nature; Psychomotor paroxysm; Psychomotor fit; Symptoms of excitation; Symptoms of psychomotor agitation; The state of agitation; A state of anxiety; Excitation status; A state of heightened concern; The state of psychomotor agitation; Conditions of anxiety; Excitation conditions; The state of excitement in somatic diseases; Excitation level; Feelings of anxiety; Emotional arousal

R45.4 Irritability and anger: Neurosis with increased irritability; Outbursts of anger; Anger; Resentment; Increased irritability; Increased irritability of the nervous system; Irritability; Irritability in neuroses; Irritability in psychopathic disorders; Symptoms of irritability; Dysphoria

R45.7 Condition of emotional shock and stress, unspecified: Exposure to stress factors; Exposure to extreme situations; Neuropsychic stresses; Professional stress; Psychoemotional overload and stress; Psychoemotional stress; Stressful condition; Stress; Stress loading; Stressful condition; Stressful situations; Stress of everyday life; Chronic stress; Long-term emotional stress; Psychological stress in air flights; Psychoemotional stress in stressful situations

R51 Headache: pain in the head; cephalgia; Pain in sinusitis; Pain in the neck; Pain headache; Headache vasomotor origin; Headache vasomotor origin; Headache with vasomotor disturbances; Headache; Neurological Headache; Continuous headache

T14.9 Injury unspecified: Pain syndrome after trauma; Pain syndrome with injuries; Pain syndrome with injuries and after surgery; Pain in case of injury; Pain of a traumatic nature; Joint pain with injuries; Postoperative and post-traumatic pain; Pain in case of injury; Pain of traumatic origin; Severe pain syndrome of traumatic origin; Deep tissue damage; Deep scratches on the trunk; Closed injury; Minor Household Injuries; Minor skin damage; Violations of the integrity of soft tissues; Uncomplicated trauma; Extensive traumatic injury; Acute pain syndrome of traumatic origin; Edema with trauma; Postponed sports injuries; Post-traumatic pain; Soft tissue injuries; Joint wounds; Sports injuries; Injury; Traumatic pain; Traumatic pains; Traumatic infiltrate; Injuries to sports

Z100 * CLASS XXII Surgical practice: Abdominal surgery; adenomectomy; Amputation; Coronary angioplasty; Angioplasty of the carotid arteries; Antiseptic skin treatment for wounds; Antiseptic Hand; Appendectomy; atherectomy; Balloon coronary angioplasty; Vaginal hysterectomy; The coronary bypass; Interventions in the vagina and cervix; Interventions on the bladder; Intervention in the mouth; Restoration and reconstructive surgery; Hand hygiene of medical personnel; Gynecologic surgery; Gynecological intervention; Gynecological surgery; Hypovolemic shock during operations; Disinfection of purulent wounds; Disinfection of wounds edges; Diagnostic intervention; Diagnostic procedures; Cervical Diathermocoagulation; Long-surgery; Replacing the fistula catheters; Infection in orthopedic surgery; Artificial heart valve; cystectomy; Short-term outpatient surgery; Short-term operation; Short surgical procedures; Krikotireotomiya; Blood loss during surgery; Bleeding during surgery and in the postoperative period; Kuldotsentez; laser photocoagulation; laser coagulation; retinal laser coagulation; Laparoscopy; Laparoscopy in Gynecology; CSF fistula; Small gynecological operations; Small surgical procedures; Mastectomy and subsequent plastic; mediastinotomy; Microsurgical operations on the ear; Mukogingivalnye operation; suturing; Minor surgery; neurosurgical operation; Immobilization of the eyeball in ophthalmic surgery; testectomy; pancreatectomy; Perikardektomiya; The period of rehabilitation after surgery; The period of convalescence after surgery; Percutaneous transluminal coronary angioplasty; Pleural thoracentesis; Pneumonia postoperative and posttraumatic; Preparation for surgical procedures; Preparation for surgery; Preparation of the surgeon's hands before surgery; Preparation of the colon for surgical procedures; Postoperative aspiration pneumonia in neurosurgical and thoracic surgery; Postoperative nausea; Postoperative bleeding; postoperative granuloma; postoperative shock; The early postoperative period; myocardial revascularization; Radiectomy; gastric Resection; bowel resection; uterine Resection; liver Resection; enterectomy; Resection of part of the stomach; Reocclusion of the operated vessel; Bonding tissues during surgical procedures; Removal of sutures; Condition after eye surgery; Condition after surgery; Condition after surgery in the nasal cavity; Condition after gastrectomy; Status after resection of the small intestine; Condition after tonsillectomy; Condition after removal of the duodenum; Condition after phlebectomy; Vascular surgery; Splenectomy; Sterilization of surgical instruments; Sterilization of surgical instruments; sternotomy; Dental surgery; Dental intervention in periodontal tissues; strumectomy; Tonsillectomy; Thoracic surgery; Thoracic surgery; total gastrectomy; Transdermal intravascular coronary angioplasty; Transurethral resection; Turbinektomiya; Removal of a tooth; cataract surgery; Removal of cysts; tonsillectomy; Removal of fibroids; Removing the mobile primary teeth; Removing polyps; Removing broken tooth; Removal of the uterus body; Removal of sutures; Fistula likvoroprovodyaschih ways; Frontoetmoidogaymorotomiya; Surgical infection; Surgical treatment of chronic limb ulcers; Surgery; The surgery in the anal area; The surgery on the colon; Surgical practice; The surgical procedure; Surgical interventions; Surgery on the gastrointestinal tract; Surgical procedures on the urinary tract; Surgical procedures on the urinary system; Surgical intervention of the genitourinary system; Surgical procedures on the heart; Surgical manipulation; surgery; Surgery on the veins; Surgical intervention; Vascular surgery; Surgical treatment of thrombosis; Surgery; cholecystectomy; Partial gastric resection; hysterectomy; Percutaneous transluminal coronary angioplasty; Percutaneous transluminal angioplasty; Coronary artery bypass; tooth Extirpation; Extirpation of milk teeth; pulpectomy; pulsative cardiopulmonary bypass; tooth Extraction; teeth Extraction; cataract extraction; Electrocoagulation; endourological intervention; episiotomy; Etmoidotomiya; Complications after tooth extraction

CAS Code

439-14-5

Characteristics of the substance Diazepam

Anxiolytic, benzodiazepine derivative.

White or white with a weak yellowish tinge crystalline powder odorless with a molecular mass of 284.74. Almost nerastvorim in water, it is difficult soluble in alcohol, soluble in chloroform.

Pharmacology

Pharmacological action - anticonvulsant, anxiolytic, miorelaxing, central, sleeping, sedative.

Interacts with specific benzodiazepine receptors located in the postsynaptic GABA-receptor complex in the limbic system of the brain, thalamus, hypothalamus, ascending activating reticular formation of the brainstem and intercalary neurons of the lateral horns of the spinal cord. Increases the sensitivity of GABA receptors to the mediator (GABA), which causes an increase in the opening frequency in the cytoplasmic membrane of the neurons of the channels for the incoming currents of chloride ions. As a result, the inhibitory effect of GABA and the inhibition of interneuronal transmission in the relevant departments of the central nervous system increase.

Anxiolytic activity is manifested by the ability to stop internal anxiety, fear, anxiety, stress. Has antipanic and amnestic (mainly with parenteral application) action.

In the treatment of sleep disorders, the use of diazepam as a hypnotic is useful in cases where it is simultaneously desirable to get anxiolytic action throughout the day.

Central miorelaxing effect is associated with inhibition of polysynaptic spinal reflexes.

Has a pronounced anticonvulsant effect, is used in epilepsy for the treatment of convulsive paroxysms, mental equivalents, for the arrest of epileptic status.

In acute alcohol withdrawal, it alleviates symptoms such as agitation, nervous tension, anxiety, anxiety, tremor, and also reduces the likelihood of development or signs of acute delirium that has arisen, incl. Hallucinations.

Effective in conditions of parenteral administration in adults with acute conditions accompanied by psychomotor agitation, seizures, etc.

Sedation is observed a few minutes after IV introduction and 30-40 minutes after IM. After removal of acute manifestations of the disease, diazepam is administered orally.

In anesthesia practice is used to reduce fear, anxiety, stress and reduce acute stress reaction in the preoperative period and in difficult, including. Diagnostic, intervention in therapy and surgery. In the latter case, the patient's memories of the procedure can be weakened (electropulse therapy, cardiac catheterization, endoscopic procedures, dislocation reposition and reposition of bone fragments, biopsy, bandaging of burn wounds, etc.).

Diazepam improves the efficacy of induction anesthesia (premedication with diazepam can reduce the dose of fentanyl required to produce an effect during anesthesia, and shorten the time to turn off consciousness with induction doses).

Increases the threshold of pain sensitivity, has an antiarrhythmic effect, lowers blood pressure (with rapid on / in the introduction). Reduces night secretion of gastric juice. Has the ability to inhibit the outflow of intraocular fluid or increase its secretion and, thereby, increase the intraocular pressure.

In experimental studies, it was shown that LD50 of diazepam when administered is 720 mg / kg (mice) and 1240 mg / kg (rat).

A study of reproduction in rats when diazepam was administered at doses of 1, 10, 80 and 100 mg / kg orally for 60-228 days before crossing showed a reduction in the number of pregnancies and survival of offspring at doses of 100 mg / kg (possibly due to sedation Action, leading to a decrease in interest in crossing and rearing offspring). Doses less than 100 mg / kg had no effect on neonatal survival.

A study in rabbits taken diazepam at doses of 1, 2, 5 and 8 mg / kg from the 6th to the 18th day of pregnancy showed no adverse effects on reproduction and teratogenic effects.

After ingestion quickly and well (about 75% of the dose) is absorbed from the digestive tract. After the / m administration is absorbed completely, but slower than when ingestion (the rate of absorption depends on the site of injection, the largest - when introduced into the deltoid muscle). With rectal administration, the diazepam solution is rapidly absorbed. Cmax in the blood is achieved after 0.5-2 h (with oral administration), 0.5-1.5 h (with the / m introduction). Equilibrium concentration in the blood with daily intake is achieved after 5 days - 2 weeks. It is biotransformation (98-99% diazepam) in the liver with the formation of pharmacologically active metabolites: desmethyldiazepam (nordiazepam), oxazepam and temazepam. Diazepam and its active metabolites bind to blood plasma proteins (diazepam 98%), pass through the BBB, placenta, enter the breast milk (in breast milk are found in concentrations of 1/10 of the concentrations in the mother's plasma). The volume of distribution of diazepam in the equilibrium state is 0.8-1.0 l / kg. Period poluraspredeleniya diazepam -. To 3.2 h T1 / 2 in adults is 20-70 hours (diazepam), 30-100 parts (nordiazepam) 9,5-12,4 (temazepam), 5-15 h (oxazepam) . T1 / 2 can be prolonged in newborns, patients of elderly and senile age, patients with liver diseases. T1 / 2 does not change with renal failure. The clearance of diazepam is 20-30 ml / min. It is excreted primarily by the kidneys (0.5-2% unchanged, about 70% in the form of glucuronide metabolites) and with feces (about 10%).

With repeated use, cumulation of diazepam and its active metabolites in blood plasma is noted.

Application of the Diazepam

As a sedative, anxiolytic and hypnotic.

Neurology and psychiatry. All kinds of anxiety disorders, incl. Neuroses, psychopathies, neurosis-like and psychopathic conditions, accompanied by anxiety, fear, increased irritability, emotional stress; Anxiety syndrome with endogenous mental illness, incl. At a schizophrenia (an auxiliary agent as a part of complex therapy), at organic defeats of a brain, incl. When cerebrovascular diseases (as part of combination therapy as an additional tool); Senesto-hypochondriacal, obsessive and phobic disorders, paranoid-hallucinatory states; Somatovegetative disorders, motor excitation of various etiologies in neurology and psychiatry; Tension headache; Sleep disorders; Vertebral syndrome; Abstinence syndrome (alcohol, drugs), incl. Alcoholic delirium (as part of complex therapy). In pediatric patients: neurotic and neurosis-like condition accompanied by emotional stress, anxiety, fear, increased irritability, headache, sleep disturbances, enuresis, mood disorders and behavior, etc. Cardiology.. Angina pectoris, myocardial infarction, arterial hypertension, etc. Anesthesiology and surgery. Premedication before and immediately before surgery and endoscopic procedures, induction of anesthesia, as a component of combined anesthesia (if ataralgezii in combination with analgesics). Obstetrics and gynecology. Eclampsia, facilitation of labor (for parenteral administration), premature labor, abruptio placenta (for parenteral administration); Menopausal and menstrual psychosomatic disorders. Dermatological practice. Eczema and other diseases, accompanied by itching, irritability (complex therapy).

As an anticonvulsant.

Epilepsy (an adjuvant, as part of a combination therapy), epileptic status or severe repeated epileptic seizures (for parenteral administration, auxiliaries); tetanus.

As a muscle relaxant.

Spastic conditions of the central genesis associated with the defeat of the brain or spinal cord (cerebral palsy, athetosis); Spasm of skeletal muscles with local trauma (ancillary); Spastic conditions in other diseases of the musculoskeletal system - myositis, bursitis, arthritis, rheumatic spondylitis, progressive chronic polyarthritis; Arthrosis, accompanied by a strain of skeletal muscles.

Contradictions

Hypersensitivity, acute liver disease and kidney disease, severe liver failure, myasthenia gravis, suicidal tendencies, drug or alcohol dependence (except for acute treatment of abstinence syndrome), severe respiratory insufficiency, severe hypercapnia, cerebral and spinal ataxia, acute glaucoma attack, angle-closure glaucoma, Pregnancy (I trimester), breast-feeding, age up to 30 days.

Restrictions on the use

Chronic respiratory insufficiency, sleep apnea syndrome, expressed renal dysfunction, open-angle glaucoma (on the background of adequate therapy), age to 6 months (only for vital indications in a hospital), pregnancy (II and III trimester).

Application in pregnancy and lactation

Contraindicated in the first trimester of pregnancy (increases the risk of congenital malformations). In the II and III trimester of pregnancy is possible, if the expected effect of therapy exceeds the potential risk to the fetus. At the time of treatment should stop breastfeeding.

Side effects of Diazepam

From the nervous system and sensory organs: lethargy, drowsiness, increased fatigue; Ataxia, dullness of emotions, blurred vision, diplopia, nystagmus, tremor, decreased reaction speed and concentration of attention, worsening of short-term memory, dysarthria, blurred speech; Confusion, depression, fainting, headache, dizziness; Paradoxical reactions (acute agitation, anxiety, hallucinations, nightmarish dreams, fits of rage, inadequate behavior); Anterograde amnesia.

From the cardiovascular system and blood (hematopoiesis, hemostasis): bradycardia, neutropenia.

On the part of the digestive tract: a violation of salivation (dry mouth or hypersalivation), nausea, constipation.

Other: allergic reactions (urticaria, rash), urinary incontinence, urinary retention, changes in libido, increased activity of hepatic transaminases and alkaline phosphatase, jaundice.

With parenteral administration: reactions at the injection site (thrombosis, phlebitis, formation of infiltrates); With a rapid in / in the introduction - hypotension, cardiovascular collapse, impaired function of external respiration, hiccups.

Perhaps the development of addiction, drug dependence, withdrawal syndrome, postoperative syndrome (muscle weakness, decreased performance), rebound-syndrome (see "Precautions").

Interaction

Potentiates the effects of alcohol, anticonvulsant and hypotensive drugs, neuroleptics, tricyclic antidepressants, analgesics (including narcotic analgesics), hypnotic drugs, general anesthetics, muscle relaxants, antihistamines with sedative effect. Analeptics, psychostimulants - reduce activity. Antacids can slow down, but not the degree of absorption of diazepam.

Isoniazid slows the excretion of diazepam (and increases its concentration in the blood). Inhibitors of microsomal oxidation (including cimetidine, ketoconazole, fluvoxamine, fluoxetine, omeprazole) alter the pharmacokinetics and prolong the duration of the diazepam effect. Rifampicin reduces the concentration of diazepam in the blood. Erythromycin slows the metabolism of diazepam in the liver. Diazepam can alter the plasma concentrations of phenytoin.

Overdose

Symptoms: depression of the central nervous system of various degrees (from drowsiness to coma): pronounced drowsiness, lethargy, weakness, decreased muscle tone, ataxia, prolonged confusion, inhibition of reflexes, coma; Hypotension, respiratory depression are also possible.

Treatment: induction of vomiting and the appointment of activated carbon (if the patient is conscious), gastric lavage through the probe (if the patient is unconscious), symptomatic therapy, monitoring of vital functions, intravenous fluids (to enhance diuresis), if necessary. When developing excitation, barbiturates should not be used. As a specific antidote, a benzodiazepine receptor antagonist, flumazenil (in a hospital setting) is used. Hemodialysis is ineffective.

Routes of administration

Inside, IV, IM, rectally.

Precautions for the substance Diazepam

It is not recommended to conduct benzodiazepine monotherapy with anxiety and depression (suicide attempts are possible). In connection with the possibility of developing paradoxical reactions, incl. Aggressive behavior, with caution to prescribe to patients with personal and behavioral disorders. Paradoxical reactions are more often observed in children and elderly patients. If there are paradoxical reactions, diazepam should be discarded.

During the treatment with diazepam, the use of alcoholic beverages is unacceptable.

Do not use during work drivers of vehicles and people whose activities require a quick mental and physical reaction, and is associated with increased concentration of attention.

The use of diazepam in children under 14 years is permissible only in clearly justified cases, the duration of treatment should be minimal.

When taking diazepam (even in therapeutic doses) it is possible to develop addiction, the formation of physical and mental dependence. The risk of dependence is increased with the use of large doses and with an increase in the duration of admission, as well as in patients with drug and alcohol dependence in the anamnesis. The abolition of diazepam should be carried out gradually, by lowering the dose to reduce the risk of withdrawal and rebound syndrome. With severe cancellation after prolonged use or reception of high doses, withdrawal symptoms occur (headache and muscle pain, anxiety, anxiety, confusion, tremors, convulsions), in severe cases - depersonalization, hallucinations, epileptic seizures (abrupt withdrawal in epilepsy). Transient syndrome, in which the symptoms that led to the appointment of diazepam, resumed in a more pronounced form (rebound-syndrome), can also be accompanied by mood changes, anxiety, etc.

With prolonged use, it is necessary to periodically monitor the picture of peripheral blood and liver function.

Use in doses above 30 mg (especially IM or IV) for 15 hours before delivery can cause apnea in the newborn, hypotension, hypothermia, breast failure, etc.

Cases of benzodiazepine addiction are described.

Special instructions

It should be borne in mind that anxiety or stress associated with everyday stress usually do not require treatment with anxiolytics.

It is not allowed to mix diazepam with other drugs in one syringe (possibly settling the drug on the walls). When IV administration is introduced into large veins and slowly, controlling the function of respiration. It is necessary to avoid getting the solution into the artery and extravasal space.

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