Diazepam overdosage

Diazepam can cause central nervous system depression. It may cause respiratory depression in overdosage but, at hypnotic doses, the risk of hyperventilation in patients with severe chronic obstructive pulmonary disease is minimal. 

Given intravenously, both diazepam and midazolam are effective first-line treatments for status epilepticus. It is essential to be aware that the large doses that may be necessary to control convulsions are likely to cause respiratory depression and obtund protective reflexes. Oxygen and equipment suitable for its administration should be available. For intractable status epilepticus, clonazepam is a longer-acting alternative which can also be given by intravenous infusion. Overdosage... 

An overdosage of local anesthetics can produce dose-dependent central nervous system (CNS) side effects such as insomnia, visual and auditory disturbances, nystagmus, shivering, tonic-clonic convulsions, and finally fatal CNS depression. The initial CNS excitation and convulsions may be brought under control by diazepam or thiopental. 

The following postmortem concentrations were reported in a fatality attributed to oral overdosage of anileridine blood 0.9 pg/ml, bile 2.4 ig/ ml, urine 11.4pg/ml, vitreous humour 0.07pg/ml diazepam was also detected (M. A. Peat and L. Kopjak, Bull. int. Ass.forens. Toxicol., 1979, 14 3), 19). 

Severe anaphylactic reactions following intravenous administration of diazepam have been reported. Meprobamate causes toxicity similar to that of a barbiturate overdosage. Death may result from respiratory failure or hypotension. Limited information is available about the acute toxicity of Buspirone. Effects are merely extensions of pharmacological effects. Nausea, vomiting, dizziness, drowsiness, miosis, and gastric distention may be seen. 

Overdosage toxidty Poisoning with antipsychotics other than thioridazine is not usually fatal. Hypotension often responds to fluid replacement. Neuroleptics lower the convulsive threshold and may cause seizures, which are usually managed with diazepam or phenytoin. Thioridazine overdose, because of cardiotoxicity, is more difficult to treat. 

Another withdrawal symptom reported was that of persistent vomiting in the absence of an increase in blood pressure. Nausea and vomiting were stopped by a small dose of clonidine (97 ). Sometimes no effect is seen from clonidine administration, whilst in rare cases a paradoxical effect occurs (98). Gross overdosage was in 2 cases followed by high blood pressures, in its turn followed by hypotension, the latter apparently constituting an exaggerated response to treatment with diazepam, diazoxide and frusemide. No subsequent rebound hypertension was noted (99 ). 

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