Diazepam antihistamines

There is an increased central nervous system (CNS) depressant effect when the skeletal muscle relaxants are administered with other CNS depressants, such as alcohol, antihistamines, opiates, and sedatives. There is an additive anticholinergic effect when cyclobenzaprine is administered with other drugs with anticholinergic effects (eg, antihistamines, antidepressants, atropine, haloperidol). See Chapter 30 for information on diazepam. 

Phenergan contains the antihistamine promethazine. Valium contains the benzodiazepine diazepam. Both the antihistamine and the benzodiazepine tend to reduce the blink rate, leading to dry eyes. Cilest is a combined oral contraceptive, which, like other oral contraceptives, may cause reduced tolerance because of corneal and eyelid oedema. 

Diazepam (Valium, Diastat) [C-IVj [Anxiolytic, Skeletal Muscle Relaxant, Anticonvulsant, Sedative/Hypnotic/ Benzodiazepine] Uses Anxiety, EtOH withdrawal, muscle spasm, status epilepticus, panic disorders, amnesia, preprocedure sedation Action Benzodiazepine Dose Adults. Status epilepticus 5-10 mg IV/IM Anxiety 2-5 mg IM/IV Preprocedure 5-10 mg IV just prior to procedure Peds. Status epilepticus 0.5-2 mg IV/IM Sedation 0.2-0.5 mg/kg IV (onset w/in 5IV and 30 min IM duration about 1 h IV and IM) Caution [D, / -] Contra Coma, CNS depression, resp d es-sion, NAG, severe uncontrolled pain, PRG Disp Tabs 2, 5, 10 mg soln 1, 5 mg/mL inj 5 mg/mL rectal gel 2.5, 5, 10, 20 mg/mL SE Sedation, amnesia, bradycardia, i BP, rash, X resp rate Interactions T Effects W/ antihistamines, azole antifungals, BBs, CNS depressants, cimetidine, ciprofloxin, disulfiram, INH, OCP, omeprazole, phenytoin, valproic acid, verapamil, EtOH, kava kava, valman T effects OF digoxin, diuretics X effects w/ barbiturates, carbamazepine. 

The tranquillizers like benzodiazepines (diazepam 5-10 mg oral, or lorazepam 2 to 4 mg IM, IV are now preferred for preanaesthetic medication because they produce tranquillity, have better muscle relaxant property and smoothen induction. Other tranquillizer compounds include phenothiazines which possess sedative, antiemetic and antihistaminic properties. They can be given orally as well as parenterally. 

The NovaScan has received substantial testing in a number of laboratory and applied settings. Performance on the NovaScan has been demonstrated to be sensitive to the effects of alcohol, marijuana, diazepam, amphetamine, scopolamine, and an over-the-counter antihistamine.6 59 60 In addition, epidemiological differences in performance associated with gender, age, and occupation have been considered. Variations of the testing paradigm have been used in a number of commercial settings. 

Anesthetics, antihistamines, barbiturates, benzodiazepines, chloral hydrate, meprobamate, narcotics, phenothiazines, tricyclic antidepressants Phenothiazines Diazepam... 

The potentiation of sedative effects from benzodiazepines when combined with centrally acting drugs with antihistamine properties (for example first-generation antihistamines, tricyclic antidepressants, and neuroleptic drugs) can pose problems (143). Antihistamines that do not have central actions do not interact with benzodiazepines as in the case of mizolastine and lorazepam (144), ebastine and diazepam (145), and terfenadine and diazepam (143). 

Mattila MJ, Aranko K, Kuitunen T. Diazepam effects on the performance of healthy subjects are not enhanced by treatment with the antihistamine ebastine. Br J Clin Pharmacol 1993 35(3) 272-7. 

Drugs that depress the CNS, such as the benzodiazepines, have their effects increased by interaction with the classic antihistamines. However, the second-generation antihistamines have not yet been proven to interact with CNS depressants such as alcohol or diazepam (34-37). 

Most side effects, such as transient yellowing of the skin and conjunctiva, a fluorescent cast to the mane, and the warm flush or early nausea occurring within 30 seconds of injection, can be explained to the patient before the procedure. Some practitioners advocate prophylaxis for nausea and vomiting, including administration of prochlorperazine, promethazine, or trimethoben-zamide, although there is no conclusive evidence for their benefit to patients. For patients likely to develop mticaria, premedication with systemic antihistamines is possible. Benzodiazepines, such as diazepam, may also be useful to control anxiety. 

This class of compounds includes the BZDs like diazepam (Valium) and oxazepam (Serax), chlordiaz-epoxide (Librium), meprobamate (carbamate derivative), and related compounds, and buspirone (aryl piperazine derivative), which is an anxioselective drug. A miscellaneous group of drugs includes certain antihistaminic and anticholinergic drugs that are difficult to classify (e.g., hydroxyzine and buclizine). 

Nephrotoxicity may be prevented or diminished by prehydration with 21 of normal saline administered over a 6-8 h period, followed by continued hydration during and after the cisplatin infusion. Nausea and vomiting may be managed with antiemetics. Electrolyte concentration should be monitored and supplemented as needed. Treatment for an anaphylactic reaction would include antihistamines, administered with or without epinephrine. If accidental exposure to the eyes or skin occurs, the affected skin area should be washed thoroughly with soap and water, and eyes should be flushed with copious amounts of tepid water for at least 15 min. Seizures should be treated with diazepam, lorazepan, phenobarbital, or phenytoin. 

Diazepam is used primarily in the treatment of mental anxiety. In addition, it acts as a muscle relaxant for a variety of medical conditions. It may also be used as a sedative-hypnotic and anticonvulsant (e.g., for status epilepticus and drug-induced seizures). Diazepam may also be used to alleviate some of the symptoms associated with the following cholinesterase poisoning, substance abuse withdrawal, antihistamine overdose. Black Widow spider envenomation, and chloroquine overdose. As an anesthetic, diazepam may be used alone or in combination with other drugs for conscious sedation. 

Clinically important, potentially hazardous interactions with antihistamines, azole antifungals, benzodiazepines, carbamazepine, cimetidine, delavirdine, diazepam, erythromycin, HIV protease inhibitors, ketorolac, macrolide antibiotics, neuroleptics, phenobarbital, phenytoin, rifampin, ritonavir... 

Some of this classification is not pure in that agents in some subcategories have multiple pharmacological properties that are frequently of clinical usefulness and not necessarily related to psychotropic effects. For example, some of the minor tranquilizers include members that have excellent skeletal muscle relaxant properties several are used as antiepileptics (e.g., diazepam). The diphenylmethane derivative hydroxyzine is a particularly good example of multiple pharmacology. In addition to its anxiolytic (antianxiety) property, it also exhibits the following clinically significant assets antihistaminic, adrenolytic, antiemetic, antispasmodic, hypothermic, and sedative effects. 

The acute poisoning that occurs with most antihistaminics does not cause severe CNS depression as would be expected based on their sedative properties, but is manifested by mydriasis, fever, flushing, CNS excitement, hallucinations, ataxia, athetosis, and convulsions. Some of these effects, which resemble those of atropine poisoning, may be due to their anticholinergic properties. Diazepam is an effective antidote to poisoning and should be used to reverse the CNS excitement and convulsions. 

Tranquilizers (e.g., meprobamate, chlorproraazine, reserpine, diazepam) Antihistamines (e.g., buclizine, meclizine, cyclizine)... 

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