Diazepam is more likely to cause respiratory depression when it is administered how?

• A. Slowly
• B. Rapidly or with other CNS depressants
• C. Orally
• D. Intramuscularly

Answer: (B)

Diazepam is a benzodiazepine that enhances GABAergic inhibition, producing sedation and anxiolysis. Respiratory depression is not typical at therapeutic oral doses, but the risk rises when it is given rapidly by injection or when it is used with other central nervous system depressants (such as opioids, alcohol, or other sedatives). A rapid administration causes a quick surge in brain concentration, leading to stronger CNS depression, including suppression of the respiratory centers in the brainstem and a blunted ventilatory response to carbon dioxide. With other depressants, their effects compound, increasing the chance of significant respiratory compromise. That’s why the combination or rapid IV administration is the scenario most associated with respiratory depression.