The drug "Diazepam": Do I need a prescription? "Diazepam": instructions for use, composition, analogs, release form
Diazepam is a special pharmacological substance that has the widest spectrum of action. It has anxiolytic, hypnotic and muscle relaxant effect, has anticonvulsant and sedative properties. If to carry out chemical classification of drugs based on it, then it would be more correct to attribute them to the category of benzodiazepine derivatives. Diazepam is present in a variety of medicines that have different trade names. This component can act as the only active substance, but can also be used in combination with chemical compounds of similar action.
What is this medicine
Speaking about the pharmacological form of the drug "Diazepam", it is worth noting that it is produced in the form of solutions for injections,suppositories and tablets for oral use. According to a single formula, the medicine is made by Russian and foreign manufacturers. To date, in the sale of retail pharmacy chain, you can find several names of drugs, which include diazepam:
- "Reladorm" (cyclobarbital is also a part of this drug).
Immediately, it is worth noting that Diazepam is not for sale without a prescription, as it is considered a psychotropic drug. His anxiolytic action is expressed by the immediate dulling of fear, anxiety, deep anxiety and nervous shock, anxiety. The process of muscle relaxation after taking the medication occurs as a result of centralized action, manifested by the inhibition of spinal reflexes. With regular use of Diazepam, the patient will experience increased drowsiness, as he has a strong hypnotic effect over the next 24 hours after taking, regardless of the time of day.
The undoubted advantage of this active substance is its powerful anticonvulsant properties.In addition, "Diazepam" is used to quickly neutralize epileptic seizures.
What is the difference from other drugs
A feature of this drug is its widespread use in drug abuse practice. With the help of "Diazepam" in ampoules, doctors can quickly arrest the withdrawal syndrome. This condition is manifested by increased fear, panic, severe anxiety and anxiety for no apparent reason. Due to the complex effects of the drug can reduce the risk of the so-called alcoholic neurosis. In addition, "Diazepam" minimizes the severity of symptoms of an existing mental disorder that occurs with impaired consciousness (from dizziness to coma). This condition is called delirium.
Often, "Diazepam" is used by anesthetists for premedication - a preliminary drug preparation of the patient for general anesthesia and surgery. The event helps to reduce the level of anxiety of the patient, reduce the activity of secretion of glands, strengthen the effects of drugs for anesthesia, in particular, "Fentanyl".Diazepam partially eliminates the effect of this anesthetic, which provides an easy and favorable introductory effect.
Drugs based on this substance increase the patient's pain threshold, stabilize the heartbeat rhythm. With a sharp parenteral administration of "Diazepam" in ampoules hypotension may develop and intraocular pressure will increase. The drug effectively reduces the production of gastric juice at night, while almost instantly absorbed in the gastrointestinal tract. With intramuscular injection of "Diazepam" this period is longer.
Absorption and excretion
As is known, the predominant part of metabolic processes associated with the action of the main component takes place in the liver. On its basis, active metabolites are formed that easily overcome the blood-brain barrier. They are able to instantly penetrate the placenta. There are active metabolites of "Diazepam" and in breast milk. Patients with severe renal insufficiency are not allowed to take this drug, since the active substance is primarily eliminated through the excretory system. Partially metabolites leave the body with feces.With the systematic use of the components for a long time accumulated in the blood plasma.
In what cases is assigned
Referring to the instructions for use of "Diazepam", it is easy to see that this medicine is used to treat a variety of diseases and pathological conditions that require the provision of hypnotic and sedative effects. These include:
- neurosis, including anxiety disorders;
- irritability on the background of psychopathy;
- feeling of inexplicable fear and stable emotional stress;
- anxiety syndrome resulting from an endogenous disease of the nature (CNS disorders and schizophrenia);
- arousal of the psychomotor or somatic type;
- alcohol withdrawal syndrome;
- phobias and obsessive depressive states;
In the reviews of "Diazepam" it is repeatedly noted that this drug is also suitable for the treatment of children older than six months. In pediatrics, this group of medicines has been used for a long time, as their use shows good results in the treatment of the following diseases:
- neurosis and neurosis-like states;
- cephalgia of unknown etiology;
- alarm conditions;
- convulsive and epileptic seizures;
- spastic attacks with cerebral palsy;
- spasms of skeletal muscles;
- Angina attacks.
Of particular importance is the "diazepam" for women. The drug is used to facilitate labor, as well as to stop convulsive seizures with eclampsia. During menopause, Diazepam helps to overcome psychosomatic disorders caused by hormonal disruptions against the background of menopausal age-related changes.
Young children prescribed the drug in an injectable form of release. "Diazepam" has been used for a long time and is recommended for use in various indications. At the moment, "Diazepam" gave way to the popularity of counterparts and, accordingly, has become less popular. The reason for this was the acquisition by the drug of the legal status of a psychotropic drug. For a better understanding, we will dwell on this point in more detail.
Registration and legal details of the sale of "Diazepam"
There are many classifications of drugs. One of them is the division of all those who have undergone the registration procedure in Russia for drugs into pharmacological groups.According to this classification principle, all drugs with a psychoactive effect acquire the status of narcotic and psychotropic drugs. Meanwhile, not all drugs of this type are subject to quantitative accounting and are sold according to prescriptions written by a doctor on the letterhead of a medical institution.
Difficulties in the purchase and sale of Diazepam are caused by another factor. In addition to the drug belonging to a specific pharmaceutical group, there is a mandatory legal status of the drug. This concept explains the presence of the drug in separate lists and lists that are approved at the legislative level. These documents determine the conditions for the sale and provision of the medicinal fund for industrial and civilian circulation. In particular, the drug "Diazepam" is considered psychotropic in accordance with the established pharmacological classification, and therefore is present in the lists of narcotic and psychotropic drugs.Medicines of this group are under strict accounting and control, therefore, they are dispensed from pharmacies only by prescription. "Diazepam" is no exception.The patient will be able to purchase it only if the attending physician makes an appointment on a special form. This document must be kept in a pharmacy for at least five years from the date of sale. The difficulty is that not every pharmacy has the right to dispense such drugs. To include this drug in the shopping assortment, an entrepreneur will need to obtain an additional license.
Comparison with the analogue: "Phenazepam"
In an attempt to avoid the foregoing legal nuances, doctors are trying to find a “simplified” counterpart of Diazepam. Many experts see an alternative to this drug in such a tranquilizer as Fenazepam. Despite the fact that both drugs belong to the group of benzodiazepines, the analogue of "Diazepam" has fewer restrictions. So, "Phenazepam" is available on prescription, which can be written out on a regular form. The turnover of this tranquilizer is not subject to strict subject-quantitative accounting. However, this does not always solve the problem, which lies in the differences in the indications for use of both drugs. Referred to the same pharmacological group, they are used in different clinical situations.
"Phenazepam" is prescribed only to patients who have been diagnosed with neurosis or neurotic condition, accompanied by:
- panic attacks of fear and anxiety;
- emotional impermanence;
- disorders of the autonomic nervous system;
- insomnia and other sleep disorders;
- neuralgia accompanied by tics and muscle rigidity.
Different and their mechanisms of action. “Diazepam”, unlike “Fenazepam”, is capable of stopping generalized convulsive seizures and is often used for sedation before general anesthesia. Judging by the indications given above for the purpose, the field of application of the analog is very limited.
Who is not suitable for the drug
Both drugs are characterized by absolute and relative contraindications. "Diazepam" is forbidden to take in a number of cases. For comparison, Phenazepam has a much more limited list of restrictions. Treatment with "Diazepam" is unacceptable for such diseases:
- severe myasthenia;
- individual intolerance to benzodiazepine derivatives;
- angle-closure glaucoma;
- state of shock;
- comatose disorders of consciousness;
- drug or alcohol addiction (with the exception of alcohol withdrawal syndrome and psychosis);
- overdose with drugs that suppress the activity of the central nervous system;
- bronchospasm and acute pulmonary insufficiency;
- chronic obstructive diseases of the respiratory system.
As already mentioned, this drug is not prescribed to children under 6 months, despite the fact that the instructions for use of "Diazepam" indicate the infant age up to 1 month. Due to the high absorbability of the tool is not used in the treatment of pregnant and lactating women. The most dangerous period for the use of "Diazepam" (including prescription) is the first and third trimester.
Very carefully, doctors approach the prescription of a drug for patients with pathologies of the liver and kidneys, especially with signs of acute insufficiency. If a patient’s history of psychotropic drugs was noted earlier, he should take this tranquilizer only under medical supervision. A person with a diagnosed depressive disorder can be treated with Diazepam only in a hospital setting, since taking a tranquilizer can worsen his mental state.Persons with functional pathologies of the brain "Diazepam" tablets or ampoules are prescribed in the minimum dosage. The same applies to patients over 60 years old.
After getting acquainted with the description of this medicinal product and studying the impressive list of contraindications, its strict limitations become obvious and fully reasoned. The dosage of "Diazepam" individually determined by the doctor. Self-treatment and uncontrolled use of this tranquilizer is fraught with serious consequences for the health and life of the patient. One of the possible complications is the rapid formation of sustainable drug dependence.
The mechanism of action "Diazepam". Is the drug addictive?
In this regard, the drug is no different from other tranquilizers. The use of any medication from this group for a long time gradually and imperceptibly for the patient causes physiological and psychological addiction. Diazepam's craving for consumption, which appears in patients, can be explained by the ability of the main active ingredient to increase mood up to the euphoric state.If a person is prone to addiction, he may begin to abuse the medicine, neglecting the recommended dosage and frequency of administration with only one purpose: to get elated. It is important to understand that the effect of euphoria is not therapeutic, it is a kind of adverse reaction of the body.
With each subsequent time, the person will need more and more medication, which ultimately can lead to the establishment of persistent dependence. Psychotropic substances negatively affect the psyche and the emotional state of the patient, inhibiting the general well-being. Drug dependence is a serious complication, which can be eliminated in a drug treatment center or a specialized drug treatment clinic. Unfortunately, this syndrome is not always treated successfully, like other types of pathological addictions (drug addiction, alcoholism, gambling, etc.). Such patients require long-term rehabilitation.
The danger that threatens the health and life of the patient in case of an overdose, is another reason for selling "Diazepam" prescription.With inadequate use of this tranquilizer and incorrectly calculated dosage, serious poisoning is possible, for which such a clinical picture will be characteristic:
- increased sleepiness;
- incoherent and fuzzy speech;
- lowering blood pressure and body temperature;
- tremor of the limbs;
- disturbance of a rhythm of heartbeat;
- increased arousal;
- depression of respiratory function;
Doctors in their reviews about "Diazepam" pay special attention to the need for emergency medical care. With an overdose of this medication, the patient will need urgent medical intervention, which is a whole range of measures:
- Forced diuresis. The procedure will remove the substance and its active metabolites from the body through the kidneys. To do this, intravenously injected detoxification solutions with diuretics. Such a “flush” will help alleviate the patient’s condition and relieve acute symptoms.
- Symptomatic therapy. It is necessary to stabilize the heart and respiratory functions, during which they use stimulating and supporting medicines.
- Use of an antidote called Flumazenil. The more popular drug is Anexat. This is a specific drug that has antagonistic properties in relation to the benzodiazepine group.
The success of treatment of poisoning with "Diazepam" is largely determined by the dose taken, the individual characteristics of the body and the time that the patient spent waiting for medical care. Overdose "Diazepam" - the indication for hospitalization in inpatient treatment facilities, as acute intoxication often requires intensive care and intensive care.
What do the doctor's say
Reviews of specialists about this drug confirm its high efficacy in the practice of treatment of convulsive syndrome. The advantage of "Diazepam" in comparison with analogues is its quick action, because most often the tool is used in emergency cases. When taking a single dose of the drug in the minimum dose, the effect of the aftereffect is weak.