Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS: Diazepam is an anti-anxiety medication in the benzodiazepine
family, the same family that includes alprazolam (Xanax), clonazepam (Klonopin),
lorazepam (Ativan), flurazepam (Dalmane), and others. Diazepam and other
benzodiazepines act by enhancing the effects of gamma-aminobutyric acid (GABA)
in the brain. GABA is a neurotransmitter (a chemical that nerve cells use to
communicate with each other) that inhibits activity in the brain. It is believed
that excessive activity in the brain may lead to anxiety or other psychiatric
disorders.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 2, 5, and 10 mg. Solution: 5 mg/ml. Injection: 5
mg/ml. Rectal Gel: 2.5, 10, and 20 mg.
STORAGE: Diazepam should be stored at room temperature, 15-30°C (59-86°F).
PRESCRIBED FOR: Diazepam is used for the treatment of anxiety disorders.
Diazepam also is used for the treatment of agitation,
tremors, delirium,
seizures, and hallucinations resulting from
alcohol withdrawal. It is used for
the treatment of seizures and relief of muscle spasms in some neurological
diseases.
DOSING: Diazepam may be taken with or without food. Diazepam is metabolized
by the liver and excreted mainly by the kidney. Dosages of diazepam may need to
be lowered in patients with abnormal kidney function. The usual oral diazepam
dose is 2-10 mg given 2-4 times daily. The usual rectal dose is 0.2-0.5 mg/kg
and depends on the age of the patient.
DRUG INTERACTIONS: Alcohol or medications that cause sedation may add to the
sedative effects of diazepam. Patients taking benzodiazepines should avoid such
combinations.
Cimetidine (Tagamet), ketoconazole
(Nizoral), omeprazole
(Prilosec, Rapinex), fluvoxamine
(Luvox), and fluoxetine
(Prozac) may prolong
the effects of diazepam by inhibiting liver enzymes that break down diazepam.
Dosages may need to be decreased when these drugs are used with diazepam.
PREGNANCY: Benzodiazepines, such as diazepam, can cause fetal abnormalities
and should not be used during pregnancy.
NURSING MOTHERS: Diazepam is excreted in
breast milk and can affect nursing
infants. Therefore, diazepam should not be used by women who are nursing.
SIDE EFFECTS: The most frequent side effects of diazepam are drowsiness,
fatigue, and ataxia (loss of balance). Rarely, diazepam causes a paradoxical
reaction with excitability, muscle spasm, lack of sleep, and rage.
Confusion,
depression, speech problems, and double vision are also rare side effects of
diazepam.
Diazepam can lead to addiction (dependency), especially when higher dosages
are used over prolonged periods of time. In patients addicted to diazepam or
after prolonged use, abrupt discontinuation of the medicine may cause symptoms
of withdrawal (insomnia,
headaches,
nausea,
vomiting, lightheadedness, sweating,
anxiety, and fatigue). Seizures can occur in more severe cases of withdrawal.
Therefore, after extended use, diazepam should be slowly tapered under a
doctor's supervision rather than abruptly stopping the medication.
Muscle cramps are involuntarily and forcibly contracted muscles that do not relax. Extremely common, any muscles that have voluntary control, including some organs, are subject to cramp. Since there is such variety in the types of muscle cramps that can occur, many causes and preventative medications are known. Stretching is the most common way to stop or prevent most muscle cramps.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Dizziness is a symptom that is often applies to a variety of sensations including lightheadedness and vertigo. Causes of dizziness include low blood pressure, heart problems, anemia, dehydration, and more. Treatment of dizziness depends on the cause.
Muscle spasms are involuntary muscle contractions that come on suddenly and are usually quite painful. Dehydration, doing strenuous exercise in a hot environment, prolonged muscle use, and certain diseases of the nervous system may cause muscle spasms. Symptoms and signs of a muscle spasm include an acute onset of pain and a possible bulge seen or felt beneath the skin where the muscle is located. Gently stretching the muscle usually resolves a muscle spasm.
Stress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
Temporomandibular joint disorder, or TMJ, is a disorder of the temporomandibular joint(s) that causes signs and symptoms including ear pain, bite problems, headaches, dizziness, clicking sounds in the jaw, tinnitus and/or locked jaws. Behaviors or conditions that can lead to TMJ include teeth grinding or clenching, fingernail biting, habitual gum chewing, trauma to the jaw, stress, and occupational hazards. Treatment for TMJ may include heat, ice, a soft diet, antiinflammatory medications, physical therapy, stress management, occlusal therapy, correction of bite abnormalities, and surgery.
Epilepsy is a brain disorder in which the person has seizures. There are two kinds of seizures, focal and generalized. There are many causes of epilepsy. Treatment of epilepsy (seizures) depends upon the cause and type of seizures experienced.
Wisdom teeth are the third set of molars that people get in their late teens or early twenties. Impacted wisdom teeth that only partially erupt allows for an opening for bacteria to enter around the tooth and cause an infection, which results in pain, swelling, jaw stiffness, and general illness. Before your wisdom teeth are pulled, the teeth and the surrounding tissue will be numbed with a local anesthetic. Recovery from wisdom tooth removal depends upon the difficulty of the extraction.
Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
The shoulder is the most often dislocated joint in the body due to its mobility. Dislocation occurs when the head of the humerus is dislocated from its socket. Symptoms and signs of a shoulder dislocation include nausea and vomiting, lightheadedness, weakness, and sweating. There are various methods of reducing a dislocation and returning the humeral head to its normal place. The method for reduction of a shoulder dislocation depends upon the type of dislocation, the patient, the situation, and the clinician's experience. Intravenous narcotics and muscle relaxants are often administered to relax the muscles and relieve pain.
Agoraphobia is a fear of being outside or of being in a situation from which escape would be impossible. Symptoms include anxiety, fear, disorientation, rapid heartbeat, diarrhea, or dizziness. Treatment may incorporate psychotherapy, self-exposure to the anxiety-causing situation, and medications such as SSRIs, benzodiazepines, and beta blockers.
Meniere disease (idiopathic endolymphatic hydrops) is an inner ear disorder with symptoms that include vertigo, tinnitus, hearing loss, and the sensation of ear fullness. Diuretics, anti-vertigo, anti-nausea and low salt diets are the primary treatment for Meniere disease. Surgery may be recommended if the vertigo cannot be controlled with medication.
Phobias are unrelenting fears of activities (social phobias), situations (agoraphobia), and specific items (arachnophobia). There is thought to be a hereditary component to phobias, though there may be a cultural influence or they may be triggered by life events. Symptoms and signs of phobias include having a panic attack, shaking, breathing troubles, rapid heart beat, and a strong desire to escape the situation. Treatment of phobias typically involves desensitization, cognitive behavioral therapy, and medications such as selective serotonin reuptake inhibitors and beta blockers.
Dystonia disorders cause involuntary movements and prolonged muscle contraction, resulting in twisting body motions, tremor, and abnormal posture. There are many forms of dystonia. Some types of dystonia respond to dopamine, or can be controlled with dedative-type medications, or surgery.
Brief psychotic disorder is a short-term mental illness that features psychotic symptoms. There are three forms of brief psychotic disorder. The first occurs shortly after a major stress, the second has no apparent trauma that triggers the illness, and the third is associated with postpartum onset. Symptoms include hallucinations, delusions, unusual behavior, disorientation, changes in eating and sleeping, and speech that doesn't make sense. Treatment typically involves medication and psychotherapy.
A nerve problem might affect your bladder control if the nerves that are supposed to carry messages between the brain and the bladder do not work properly. Such problems include urine retention, poor control of sphincter muscles, and overactive bladder. Treatment depends upon the cause of the nerve damage and resulting type of bladder control problem.
Stiff-Person syndrome is a neurological disorder associated with features of an autoimmune disease. Signs and symptoms of Stiff-Person syndrome include a heightened sensitivity to stimuli (noise, touch, emotional distress) and fluctuating muscle rigidity of the trunk and limbs. Conditions associated with Stiff-Person syndrome include thyroiditis, vitiligo, pernicious anemia, and diabetes. Treatment for Stiff-Person syndrome is generally medication to control symptoms.
What Are the Symptoms of Brief Psychotic Disorder?
The most obvious symptoms include:
Hallucinations: Hallucinations are sensory perceptions of things
that aren't actually present, such as hearing voices, seeing things that aren't
there or feeling sensations on your skin even though nothing is touching your
body.
Delusions: These are false beliefs that the person refuses to give
up, even in the face of contradictory facts.
Other symptoms of brief psychotic disorder include:
Disorganized thinking
Speech or language that doesn't make sense
Unusual behavior and dress
Problems with memory
Disorientation or confusion
Changes in eating or sleeping habits, energy level, or weight
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