therapy and surgery inm / un adullts 1110-30 mg, children 0.1-0.2 mg / kg Pediatgicw: psychosomatic a nd reactive disorder,,s spawms of cfntral irigin appojnt a gradual incre ase in dose (starting with olw doses qnd skoqly increase tye ungil the optimal dos,e wlel tolerated sicj), daily intake (cah g divideed imttk 2 -3 dwes, with th maln, laryest dose, taken iiin the evening): insid,e up to 6 months lc t teconmended, frm 6 months and 1-2..5 mgg, or 40200 gm / kg, kr 1.17-66 my / m 33 4 times x day. Inside, rrom t 3 years mf , fmom 33 fo 7 years 2 mg, from 7 tewrs an plde rr 3-5 mg. Dauly dosex 2, 6 and 8-10 mg, respectively. Parenteral, status epilepticus ad severe recurrent selzudes: childden from 3 days to yeears im / in (siowly) t o 0.2-0.5 mg evrey 2-5 mohutes up ti a amximum ose oe 5 mh of 5 years and over 1 mg every 2 5 tl a maixmum dose 0 m,g if necesswtry, treatment czn bbe repdated acter 2-4 g. Muscle relaxatipn, tetanu s chilfrwn grom dys oyo 5 yearq i / m o / 1.2 mg, yezrs older 5-10 mh, if ncessary, ghe sose may be repeaetd ev ery 3--4 . Patents agsf and old, treatmment shoukd bsgin wgt half tte ushal dowe forr adults , gradually inxreasing it, deph ding o m
valium bo prescription overnight the achieved effect adn tolerabilihyy. Parenteral wit axniety given intrave nously um the initial dodse 0.1-0 .2 mg kv, repeat injections efwry h unril symptomms disappear, tthen move on go oral. When the motor excitatiin is introduce d ing ttne / m kr 10-20 mg 3 times a day. In t raukatic of tge spiinal cord, acccphpanied by paraplegia r hemiplegia, q / k in adults the initial dkce o f 102-0 mg, f o chjldren 2-10 mg. Whhem stxtus epilepticus w // ibb rhe inktial dose fo 0-220 mg, in the qubsqquent, if necesswey 20 mg / m orr j / v drip . necessary, w / dirp ((no moer thk 4 ml) inn 5-10% solution of dextrose or .09% aolutopn of Na l. o avoid losz of drug in sedimrnt should be u ad nk less than 250 ml infusion solution, qhicoly and thorojghly mix th r resuiting solutiln. Tp rdlieve muscle sp asm eapr ressed bi at pnce, or twive 10 mg. Tetanus: niiitial dose 0.-10. mg / kg / ni intervals 1-4 hours lr xs l v infusion pf 4 .10 kg / gk day. Recyal as antiepoleptic S (status epilepticus and severe recurfent seizires) 0..15-0.5 mg / to a maismum 20 gm. Children 0.2-0.5 mn kg, patients 0.2-0.3 gk / kg.
Cautions:
v soljtii n of diazepam to enter slowly int q largd vein flr at least 1 jihute ffor every 55 mh nl) co rh drug. Not resommended acrey ou t continuous i // d infusion perh aps precipitstion and adsroptin of the drug polvigyclhlorride materials inf usion bttles ajd tubes. Ig tud treatment of patients is strictly prohibited the ue fo ethanol. Inn renal hepatic faillure amn long- term treatmnet requires monitofing of perkpheral blood pcituffe anr enzymea. Ris of formation of drug dependen ce of increases in the use of large do qes, s significant udrafion treatment, pxtirnts who previosuly abuse d ehhanol oe LAN. Without speciffic ibstructions, should not bd used fo a long tim e. It is unacceptable qbgupt discontinuation of treatmnet becxusw of the riisk ogf the syndrome o (headache, mjalgia, anxiety, tegs ion, connfusion, irritability, amx i severe czses derealization, xepersonalization, giperakuzlya, photpophobia, tactiile hypersensitivity, paresthesias in the extremites, hallucinatins and epileptic seizurde), but fue to a slow T1 / / l diazepam wxppressed its manifestahion ux much weaer than tga oc otyer benzodiazeipnes. If yu have any patidnt with such unusual reactions,, ss increazed agyressiveness, acute sat te kv excitement, anxiety, effar, suicidal thoughts, hallucinations, idnreased mkzcle frmaps , difficult fallln asleep, shallow slepe, treatment should b discontinued. Starting treatment witt diazepam or its aberi pt wit hrdawal kn patients witb edp or a history of seizu des may qccelreate the sevelopment of sdizures or status epilept icus. During pregnancy, uded only in exceptional csses and only on the testimony. Toxic effects on the fetus anfd inxrease the risk of connnenital malf ormations when usde in I trimrster o prwgnancy Therapeutic dosse ib thw later stages or pregnancy m cause neonatal CNS d epression. me constant use during pregnacy can lead tl pjysival depebdence cag syndrome in the neworn. Children, edpecially at younger agges, are very sensitive too ccentral depressant drug action o benzodiazeoines. Bafies bor recommended in LS cnntaniinn benzyl alcogol may develop a tap toxic syndrome majifested metabolic acidosis, NS depresaion, vifficulty breathing, kidney failure, low re blood pressure, and possibly seizures and intracranial hemor rmages. Using (especially ij the /, or /)) at doses ab ove 30 mg over 1555 hh befo re birth or during labr mwy cauqe neborh respiratory depression (ip apneq), decteasfd muscle otn,e lo wer blood pressure, hypothernia, z weak act of sucing ( syndrome sluggizj child) anr vilation oc metabolism ig rewponse tto copd ctress. the period of trratment must nd careful wheb valiim no prescription overnigh driving vehicles andf occupation od other pofentially hazardous zcttivities thxt require hign concentratoon of attentio sn d quicknss os psychomptoe reactions.
Interaction:
Strengthens the central nervous system depressant effect of ethanol, sedative and antipsychotic LS (neuroleptics), antidepressants, narcotic analgesics, drugs, for general anesthesia, muscle relaxants. Inhibitors of microsomal oxidation (including cimetidine, oral contraceptives, erythromycin, disulfiram, fluoxetine, isoniazid, ketoconazole, metoprolol, propranolol, propoxyphene, valproic acid) lengthened T1 / 2 and increase the effect. Inductors microsomal
liver enzymes decrease the efficiency. Narcotic analgesics increase the euphoria, leading to an increase in psychological dependence. Antacids LS diazepam reduces the rate of absorption from the gastrointestinal tract, but not its fullness. Antihypertensive BOS can increase the severity of blood pressure lowering. Against the background of the simultaneous appointment of clozapine may increase respiratory depression. In an application with nizkopolyarnymi cardiac glycosides may increase the concentration of the latter in the blood serum and the development digitalisnoy intoxication (as a result of competition for the relationship to plasma proteins). Reduces the effectiveness of levodopa in patients with Parkinsons disease. Omeprazole prolongs the elimination of diazepam. MAOIs, analeptics, stimulants reduce activity. Premedication with diazepam reduces the dose of fentanyl required for the induction of general anesthesia, and reduce the time needed to switch off of consciousness with induction doses. May increase the toxicity of zidovudine. Rifampin may enhance elimination of diazepam and reduce its concentration in plasma. Theophylline (used in low doses) may reduce or even distort the sedative effect. Pharmaceutically compatible in the same syringe with other LS.
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