Valium spasms

The exact mode of action of diazepam (Valium), an antianxiety drug (see Chap. 30), in die relief of painful musculoskeletal conditions is unknown. The drug does have a sedative action, which may account for some of its ability to relieve muscle spasm and pain. 

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. 

Benzodiazepines also possess muscle relaxant activity. Their pharmacology is discussed in Chapter 30. Diazepam Valium) has been used for control of flexor and extensor spasms, spinal spasticity, and multiple sclerosis. The muscle relaxant effect of the benzodiazepines may be mediated by an action on the primary afferents in the spinal cord, resulting in an increased level of presynaptic inhibition of muscle tone. Polysynaptic reflexes are inhibited. The most troublesome side effect is drowsiness, which is dose dependent. Tolerance to both the therapeutic effects and the side effects develops. 

The depressant effect of barbiturates is often sought by persons who are self-medicating for amdety-related problems or insomnia. Drugs of the benzodiazepine family (Librium, Valium, and Xanax) are also legitimately prescribed for the treatment of anxiety as well as muscle spasms or convulsions. However, doctors and patients must be careful because prolonged or excessive use can lead to dependence. Illegal use often involves forged prescriptions or the cooperation of illicit doctors. 

Uses. Diazepam is one of the oldest medications for treating muscle spasms, and has been used extensively in treating spasms associated with musculoskeletal injuries such as acute low-back strains. Diazepam has also been used to control muscle spasms associated with tetanus toxin the use of valium in this situation can be life-saving as well by inhibiting spasms of the larynx and other muscles.51,65... 

It turned out that the nearly discarded substance had a novel structure, 5, a chlordiazepoxide. It was developed further and became known under the trade name Librium , which was the first antianxiety agent. Librium became the lead compound for the development of many other compounds with related structures. The best known is the diazepam Vh/ium , 6, a tranquilizer used to treat anxiety, muscle spasm, and symptoms of epilepsy. Today, about 40 diazepines are in the market. Nearly forgotten on the laboratory shelf, Librium and Valium became blockbuster drugs that fueled the growth of the Roche company. (Drugs are called blockbusters when sales are much higher than US 1 billion per year.)... 

The CNS contains a wide variety of neurotransmitters and high concentrations of receptors. Mechanisms of action of many drugs are often complex combinations of receptor-based actions. Some of the most widely used (and abused) drugs are hypnotics/sedatives, for treatment of insonmia. Barbiturates such as amylo-barbitone have been used for many years, but suffer from side-effects and are addictive. Thiopentone sodium salt (sodium pentothal), however, is very useful as a short-acting intravenous anaesthetic. The benzodiazepines, such as diazepam (Valium) and alprazolam (Xanax), are safer drags for insomnia and also can be used for treatment of anxiety and muscle spasms. Zolpidem (Ambien) is a newer and more selective hypnotic. 

Diazepam (Valium), a benzodiazepine, to a client with muscle spasms. 

THE DRUG SHOWN HERE IS DIAZEPAM, better known as Valium. It is commonly prescribed for a wide range of disorders, including anxiety, insomnia, seizures, muscle spasms, restless legs syndrome, and obsessive-compulsive disorder. Valium was invented by Leo Sternbach at Hoffmann-LaRoche Pharmaceuticals and first licensed for use in 1960. 

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