Drug encyclopedia

Valium (Diazepamum, Diazepam, Seduxenum, Relanium, Sibazonum) – the light tranquilizer, a recommended which dose compounds 5-10 mg for 2-3 times a day. It is on sale in white sheaths on 2 mg and in yellow tablets on 5 mg with an inscription “Roche”.

Valium renders sedatively-soporific, anticonvulsant and central running down action. The mechanism of action of Diazepamum is caused by stimulation of benzodiazepine receptors of the receptor complex, result ining to inhibiting effect intensifying on transfer of nervous impulses.

Stimulates the benzodiazepine receptors located in the allosteric centre a post of receptors of the ascending activating reticular formation of a brainstem and internuncial neurons of side horns of a spinal marrow; reduces excitability of subcortical frames of a brain (the limbic system, a thalamus, a hypothalamus), inhibits spinal jerks. Anksiolitichesky action is caused by influence on an amygdaloid complex of limbic system and shows in emotional pressure reduction, weakening of alarm, pavor, disturbing. The sedation is caused by influence on a reticular formation of a fulcrum of a brain and nonspecific kernels of a thalamus and shows reduction of semiology of a neurotic parentage (alarm, pavor).

The basic mechanism of soporific action consists in oppression of cells of a reticular formation of a fulcrum of a brain. Anticonvulsant action is realised by intensifying of presynaptic inhibition. Diffusion of epileptogenic activity is depressed, but excited state of the locus is not taken out. The central running down action is caused by inhibition of spinal eisodic inhibiting pathes. Probably and a direct inhibition of motor nerves and function of muscles. Possessing moderate sympatholytic activity, can invoke depression of a BP and dilating of coronary pots. Raises a threshold of pain sensitivity. Depresses parasympathetic (including vestibular) paroxysms. Reduces night secretion of a gastric juice. Drug action is observed by 2-7 day of treatment. Productive semiology of a psychotic genesis (acute crazy, hallucinative, affective distresses) practically does not influence, reduction of affective intensity, crazy distresses is seldom observed. At an abstinent syndrome at an alcoholism invokes weakening of agitation, a tremor, negativism, and also a tremens and hallucinations. The therapeutic effect at sick of cardialgias, arrhythmias and paresthesias is observed to the extremity of 1 week.

Indications:
Disturbing distresses. A dysphoria. A sleeplessness (difficulty of a backfilling). A spastic stricture of skeletal muscles at an aboriginal trauma; the spastic states bound to a lesion head or a spinal marrow (a cerebral paralysis, an athetosis, a tetanus); a miositis, a bursitis, an arthritis, a rheumatic progressing chronic polyarthritis; an arthrosis accompanied by a strain of skeletal muscles; a stenocardia, a strain headache. An abstinent alcoholic syndrome: uneasiness, intensity, agitation, a tremor, transitional reactive states. As a part of complex therapy: an arterial hypertensia, a peptic ulcer of a stomach and 12-perstnoj intestines; psychosomatic distresses in obstetrics and gynecology: climacteric and menstrual distresses; the epileptic status; an eczema, etc. the diseases accompanied by an itch, irritability. A premedication before operative measures and endoscopic manipulations, a general anaesthesia. For parenteral introduction: Premedication before a general anaesthesia; as a component of the combined general anaesthesia; a myocardial infarction (as a part of complex therapy); motorial excitation of a various aetiology in neurology and psychiatry; paranoidly-galljutsinatornye states; epileptic attacks (cupping); simplification of generic activity; premature birth (only in the end of III trimester of pregnancy); premature layer separation of a placenta.

Contraindications:
Hypersensitivity, a coma, a shock, an acute drunkenness with weakening of the vital functions, the acute intoxications, having oppressing an effect (including narcotic analgetics), a myasthenia, an angle-closure glaucoma (a bad attack or predisposition); serious danger of advance of degree of respiratory insufficiency, acute respiratory insufficiency, an absentia epileptica, pregnancy (especially I trimester), a milking period, children’s age till 6 months (at intake), till 30 days включительно.C guard. An epilepsy or epileptic attacks in the anamnesis (an initiation of treatment Diazepamum or its sharp cancellation development of attacks or the epileptic status can accelerate), hepatic and-or renal insufficiency, cerebral and spinal an ataxia, hyperkinesias, medicinal dependence in the anamnesis, predilection to abuse by psychoactive materials, organic diseases of a brain, a hypoproteinemia, advanced age.

Side effects:
From outside the excitatory system: in an initiation of treatment (especially at elderly patients) – drowsiness, giddiness, undue fatigability, depression of ability to concentration of attention, an ataxia, a disorientation, instability of a gait and bad coordination of movements, flabbiness, an obtusion of emotions, retardation mental and motor reactions, an ecmnesia (educes more often, than at method of other benzodiazepines); seldom – a headache, euphoria, depression, a tremor, depression of mood, a katalepsy, confusion of consciousness, dystonic extrapyramidal reactions (uncontrollable locomotions of a body, including eyes), delicacy, a myasthenia during the day, a hyporeflexia, a dysarthtia; extremely seldom – paradoxical reactions (aggressive flashes, psychomotor excitation, pavor, suicidal bent, a muscular spastic stricture, confusion of consciousness, hallucination, acute excitation, irritability, uneasiness, a sleeplessness).

From outside hemopoiesis members: a leukopenia, a neutropenia, an agranulocytosis (a fever, a hyperthermia, a pharyngalgia, excessive fatigability or delicacy), an anaemia, a thrombocytopenia.

From outside the alimentary system: dryness in a mouth or a hypersalivation, a heartburn, a hiccup, a gastralgia, a nausea, vomiting, appetite depression, constipations; disturbances of function of a liver, rising of activity of “hepatic” transaminases, an icterus.

From outside warmly vascular system: palpitation, a tachycardia, BP depression (at parenteral introduction).

From outside genitourinary system: an urine incontience, an ischuria, disturbance of function of nephroses, rising or libido depression, a dysmenorrhea.

Aboriginal reactions: in an introduction place – a phlebitis or venous clottage (a redness, a tumescence or a pain in an introduction place).

The other: habituation, medicinal dependence; seldom – respiratory centre oppression, disturbance of function of an external respiration, disturbance of sight (diplopia), a bulimia, depression of mass of a body. At falloff of a dose or the method termination – “a cancellation” syndrome (irritability, a headache, uneasiness, excitement, excitation, a sensation of fear, nervousness, sleep disturbances, a dysphoria, a spastic stricture of nonstriated muscles of an internal and a skeletal muscles, a depersonalisation, diaphoresis intensifying, depression, a nausea, vomiting, a tremor, perception distresses, including a hyperacusia, paresthesias, a photophobia, a tachycardia, cramps, hallucinations, it is rare – an acute psychosis). At application in obstetrics – at full-term and premature children – a muscular hypotension, a hypothermia.

Overdosage.
Symptoms: drowsiness, confusion of consciousness, paradoxical excitation, depression of jerks, an areflexia, the reduced reaction to pain stimulations, a deep sleep, a dysarthtia, an ataxia, disturbance of sight (nystagmus), a tremor, a bradycardia, an asthma or the complicated breath,  the expressed delicacy, BP depression, a collapse, oppression of warm and respiratory activity, a clod.

Treatment: a gastric lavage, an artificial diuresis, activated carbon method. Symptomatic therapy (maintenance of breath and a BP), the PULMONARY ventilation. The hemodialysis is ineffective. The antagonist of benzodiazepines is not shown sick of an epilepsy which received treatment by benzodiazepines. At such patients opposing action in relation to benzodiazepines can provoke development of epileptic attacks.