Diazepam contraindications

The skeletal muscle relaxants are contraindicated in patients with known hypersensitivity. Baclofen is contraindicated in skeletal muscle spasms caused by rheumatic disorders. Carisoprodol is contraindicated in patients with a known hypersensitivity to meprobamate. Cyclobenzaprine is contraindicated in patients with a recent myocardial infarction, cardiac conduction disorders, and hyperthyroidism, hi addition, cyclobenzaprine is contraindicated within 14 days of the administration of a monoamine oxidase inhibitor. Oral dantrolene is contraindicated in patients with active hepatic disease and muscle spasm caused by rheumatic disorders and during lactation. See Chapter 30 for information on diazepam. 

Although b-blockers are considered the treatment of choice for akathisia, low doses of clonazepam, diazepam, or lorazepam may also reduce its severity ( 172, 389, 445, 447, 448, 449 and 450). These BZDs may be a useful alternative when a-blockers are contraindicated (e.g., in patients with asthma, insulin-dependent diabetes meilitus, cardiac conduction abnormalities) or as an adjunct when akathisia persists despite stepwise escalation of these agents ( 177). 

The cardiac arrhythmias are life-threatening, so the patient must be closely monitored, with facilities available for possible resuscitation. Drugs such as quinidine and procainamide are contraindicated, but lidocaine, propranolol, or phenytoin has been used safely and effectively. The arterial blood gas levels, pH, and electrolyte concentrations should be monitored so that metabolic acidosis or hypokalemia can be identified that would further aggravate the arrhythmias. Electrical pacing may be required if the antiarrhythmic drugs fail. Hyperpyrexia is treated by cooling. Seizures may be managed by intravenous doses of diazepam. 

Patients receiving intravenous benzodiazepines must be monitored for respiratory depression, which may demand artificial ventilation during intensive treatment. Diazepam may cause more respiratory depression than lorazepam at equieffective dosages (SEDA-20, 59) and is contraindicated in neonates for this reason and because it produces unacceptably prolonged sedation (9). 

Diazepam may be beneficial to control convulsions. Activated charcoal is administered as a slurry. Pheno-barbital is used if seizures recur after the use of diazepam. Gastric lavage may be of benefit if the patient has ingested a large amount of DDT and the procedure can be done within 1 h after ingestion. Emetics are contraindicated. 

The answer b 1 [IV HJ. Atropine would be contraindicated in methyixanthine toxicosis because it acts by blocking vagal activity, resulting in a rapid heart rate arxl ventricular arrhythmias. Diazepam may be useful to control severe hyperactivity and seizures during acute methyixanthine Icosis. Lidocalne... 

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