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Inclusion of Valium on Code Cart and Guidelines: Q&A With Sheldon Sones of Sheldon S. Sones and Associates

Sheldon S. Sones, RPh, FASCP, is president of Sheldon S. Sones and Associates, a pharmacy and accreditation consulting firm based in Newington, Conn.


Q: Should we have Valium (diazepam) on the code cart and if so, what are the key guidelines?


Sheldon Sones: While most of my facilities have agreed that having diazepam on the code cart is a wise formulary addition, about one-third of the facilities do not maintain it as such.


While lorazepam is regarded as a drug of choice (due to its longer action) for status epilepticus, diazepam remains a wise choice (lorazepam has to be refrigerated and is usually not available in most facilities). We have seen two recent events calling for diazepam. I recommend it for review for inclusion at your medical staff meeting.


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Note: As with midazolam, last month this product was experiencing extremely short supply.


Some guidelines:

  • Do not add a second drug to the same syringe
  • Diazepam: Push at about 5 mg/ minute; Lorazepam: 2 mg/min
  • Too rapid administration may lead to hypotension and respiratory depression
  • Dose: Diazepam = 0.2 mg/kg
  • Dose: Lorazepam = 0.1 mg/kg



Learn more about Sheldon S. Sones and Associates at


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