|
Diazepam
Systematic (IUPAC) name
7-chloro-1-methyl- 5-phenyl-1,3-dihydro-2H- 1,4-benzodiazepin-2-one Identifiers CAS number 439-14-5 ATC code N05BA01 N05BA17 PubChem 3016 DrugBank APRD00642 Chemical data Formula C16H13ClN2O Mol. mass 284.7 g/mol Pharmacokinetic data Bioavailability 93% Metabolism Hepatic Half life 20-100 hours Excretion Renal Therapeutic considerations Pregnancy cat. C(AU) D(US) Legal statusPrescription Only (S4)(AU) Schedule IV(CA) Schedule IV(US) Schedule IV (International) Routes Oral, IM, IV, suppositoryDiazepam (IPA: /daɪˈæzɨpæm/), first marketed as Valium by Hoffmann-La Roche) is a benzodiazepine derivative drug. It possesses anxiolytic, anticonvulsant, sedative, skeletal muscle relaxant and amnestic properties. It is commonly used for treating anxiety, insomnia, seizures, alcohol withdrawal, and muscle spasms. It may also be used before certain medical procedures (such as endoscopies) to reduce tension and anxiety, and in some surgical procedures to induce amnesia.[1][2] Diazepam is a core medicine in the World Health Organization's "Essential Drugs List", which is a list of minimum medical needs for a basic health care system.[3] Diazepam is used to treat a wide range of conditions and has been one of the most frequently prescribed medications in the world for the past 40 years. It was invented by Dr. Leo Sternbach. Contents 1 History 2 Physical properties 3 Pharmacology 4 Mechanism of action 5 Pharmacokinetics 6 Indications 6.1 Veterinary uses 6.2 Judicial Executions 7 Dosage 7.1 Availability 8 Side effects 9 Interactions 10 Contraindications 10.1 Special caution needed 11 Dependence 11.1 Patients at a high risk for abuse and dependence 12 Pregnancy 13 Overdose 14 Misuse and abuse 15 Legal status 16 Toxicity 17 Further reading 18 References 19 External links // HistoryDiazepam was the second benzodiazepine to be invented by Sternbach of Hoffmann-La Roche, and was approved for use in 1963. It is two and a half times more potent than its predecessor, chlordiazepoxide, which it quickly surpassed in terms of sales. After this initial success, other pharmaceutical companies began to introduce other benzodiazepine derivatives.[4] The benzodiazepines gained popularity among medical professionals as an improvement upon barbiturates, which have a comparatively narrow therapeutic index, and are far more sedating at therapeutic doses. The benzodiazepines are also far less dangerous; death rarely results from diazepam overdose, except in cases where it is consumed with large amounts of other depressants (such as alcohol or other sedatives).[5] Diazepam was the top-selling pharmaceutical in the United States from 1969 to 1982, with peak sales in 1978 of 2.3 billion pills.[4] Diazepam along with oxazepam, nitrazepam and temazepam represent 82% of the benzodiazepine market in Australia.[6] While psychiatrists continue to prescribe diazepam for the short-term relief of anxiety, neurology has taken the lead in prescribing diazepam for the palliative treatment of certain types of epilepsy and spastic activity, e.g., forms of paresis. It is also the first line of defense for a rare disorder called stiff-person syndrome.[7] Diazepam is also found in nature. Several plants, such as potato and wheat, contain trace amounts of naturally occurring diazepam and other benzodiazepines.[8] Physical propertiesDiazepam occurs as solid white or yellow crystals and has a melting point of 131.5 to 134.5 °C. It is odorless, and has a slightly bitter taste. The British Pharmacopoeia lists diazepam as being very slightly soluble in water, soluble in alcohol and freely soluble in chloroform. The United States Pharmacopoeia lists diazepam as soluble 1 in 16 of ethyl alcohol, 1 in 2 of chloroform, 1 in 39 of ether, and practically insoluble in water. The pH |