Valium for vertigo?

[firedoc5]

Thorazine is what we used most for people being combative or freaking out due to an OD or someone who just couldn't handle what ever drug they took. For a while we had some bad cut coke and for some reason had a sharp increase on acid/PCP.

We had used Valium for just such incidences, but never helped. So 75-100mg. of Thorazine IM worked very well. A few times they would be fighting us so bad that we couldn't find the usual areas used for IM injections, so you improvise. One night I had a nurse trying to get around the seven guys holding the patient down to give him the injection. Finally I just took the syringe and popped him in his upper thigh, right through his clothes. Not the best way to do it, so I just improvised.

[Ridryder 911]

Hey Doc, although Valium may not be your first line, I have seen it as the prefferred choice with those of dx. of Meniere's Disease.

R/r 911

[Doczilla]

Their dizziness would have to be pretty freakin' bad for me to okay some valium over the radio, particularly if the patient was old. I'm not saying I wouldn't do it, but it wouldn't be a standing order.

Benzos like valium are the drug of choice for treatment of excited delirium from stimulants like cocaine and meth. Because of the hyperadrenergic state, very very high doses are sometimes required. Versed is a fine drug for this, though you have to be prepared to re-dose the patient, since it won't last very long.

The only time I've used thorazine is for refractory hiccups. I haven't seen it used much anymore in psychotic patients, largely because of several other good choices (haldol, geodon, zyprexa, +/- a benzo like valium or ativan). This drug is pretty old school.

Thorazine's use is limited by its main side effect of orthostatic hypotension. You can sock the patient with 100mg of thorazine and leave him alone for a while. If you walk past the room, he remembers that he was mad at you and gets up to come after you, but gets all orthostatic and dizzy and has to sit back down. This hypotension can be severe. There's also the EPS to worry about.

'zilla