Diazepam drug overdose

Overdoses of cocaine are often rapidly fatal, victims dying within minutes from arrhythmias, seizures, or respiratory depression. Those who survive for 3 hours usually recover fully. Intravenous administration of diazepam, propranolol, or calcium channel-blocking drugs may be the best... 

If the user s bad trip is due to overdose of an antimuscarinic drug, natural or synthetic, then diazepam is specially preferred, or a neuroleptic with no or minimal antimuscarinic effects, e.g. haloperidol. A dose of an anticholinesterase that penetrates the central nervous system (physostig-... 

Acute overdose may be rapidly fatal without treatment and indeed has even been described as a means of suicide. (Chloroquine may now be bought from pharmacies in the UK without a prescription.) Puhnonciry oedema is followed by convulsions, cardiac arrh5dhmias and coma as little as 50 mg/kg can be fatal. These effects are principally due to the profound negative inotropic action of chloroquine. Diazepam was found fortuitously to protect the heart and adrenaline (epinephrine) reduces intraventricular conduction time this combination of drugs, given by separate i.v. infusions, improves survival. 

There have been three reports of chloroquine overdose, two from Oman (40) and one from the Netherlands (41). The two reports from Oman were similar to previously published reports of chloroquine overdose associated with cardiac dysfunction, confusion, and coma both patients had standard treatment with activated charcoal, diazepam infusions, and positive inotropic drugs, and both survived. The single case report from the Netherlands gave pharmacokinetic measurements performed before, during, and after hemoperfusion. This showed that hemoperfusion extracted very little chloroquine and was unlikely to be of any use in chloroquine overdose, as would be expected from the high protein binding and large volume of distribution of chloroquine. 

Management of hydroxychloroquine overdose is similar to that of chloroquine overdose, including the use of charcoal for drug adsorption, diazepam for seizures and sedation, early intubation and mechanical ventilation, and potassium replacement for severe hjrpokalemia. 

Of 149 patients, 10 received an overdose of rectal diazepam indicated for acute repetitive seizures (51 overdoses in total) (26). There were no untoward events in 40 cases, and the adverse events were most often not drug-related. No patient had bradypnea or apnea. 

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. 

Overdose of diazepam with oral and parenteral administration has the potential to cause impairment of consciousness and judgment, hypotension, bradycardia, coma, and respiratory failure. In addition, deaths have been reported when diazepam is used in combination with other CNS depressants. Sedation and somnolence are common adverse effects from the drug. 

HYPNOTICS are agents that induce sleep. They are used mainly to treat short-term insomnia, for instance in shiftwork, to cope with Jet-lag or in sleep disturbances due to emotional problems or in serious illness. The best-known and most-used hypnotics in current use are the benzodiazepines - and this class of drug is also used, at a lower dose, as ANXIOLYTICS. Examples from the class that are of relatively long-lasting action and may cause drowsiness the next day include diazepam, flunitrazepam, flurazepam and nitrazepam. Examples with a shorter duration include loprazolam, lormetazepam and temazepam. All can cause drug dependence on continued usage. Examples of hypnotics that are now much less used include chloral hydrate, chlormethiazole and triclofos. The barbiturates (e.g. amylobarbitone) are now very little used, as they are prone to cause serious dependence and are dangerous in overdose. 

Treatment of toxicity Severe toxicity is best treated symptomatically. Convulsions are often treated with intravenous diazepam or a short-acting barbiturate such as thiopental. Hyperventilation with oxygen is helpful. Occasionally, a neuromuscular blocking drug may be used to control violent convulsive activity. The cardiovascular toxicity of bupivacaine overdose is difficult to treat and has caused fatalities in healthy young adults. 

Cocaine intoxication has become a common problem in hospital emergency rooms. Which one of the following drugs is not likely to be of any value in the management of cocaine overdose (A) Dantrolene Diazepam Lidocaine Naltrexone Nitroprusside... 

II. Toxic dose. In general, the toxic therapeutic ratio for benzodiazepines is very high. For example, oral overdoses of diazepam have been reported in excess of 15-20 times the therapeutic dose without serious depression of consciousness. On the other hand, respiratory arrest has been report after ingestion of 5 mg of triazolam and after rapid Intravenous injection of diazepam, midazolam, and many other benzodiazepines. Also, ingestion of another drug with CNS-depres-sant properties (eg, ethanol, barbiturates, opioids, etc) will likely produce additive effects. 

A 32-year-old man taking moclobemide 20 mg twice daily and diazepam developed the serotonin syndrome 40 minutes after taking a single 150-mg dose of venlafaxine. Serotonin toxicity (the serotonin syndrome) occurred in 4 patients who took an overdose of moclobemide with venlafaxine (just 150 mg in one case and 750 mg in another). In this analysis of moclobemide overdoses, the risk of developing serotonin toxicity was increased 35 times in patients who also took another serotonergic drug. Venlafaxine was taken in 4 of the 11 cases mentioned." Another man very rapidly developed the serotonin syndrome after taking considerable overdoses of moclobemide (3 g) and venlafaxine (2.625 g). ... 

---