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Warnings
Pregnancy:
Several studies have suggested an increased risk of congenital malformations associated with the use of diazepam, chlordiazepoxide and meprobamate during the first trimester of pregnancy. Therefore, the administration of diazepam is rarely justified in women of childbearing potential. If the drug is prescribed for a woman of childbearing potential, she should be warned to contact her physician regarding discontinuation of the drug if she intends to become or suspects that she is pregnant.
Precautions
Geriatrics:
Elderly and debilitated patients or those with organic brain disorders have been found to be prone to CNS depression following even low doses. For these patients it is recommended that the dosage be limited to the smallest effective amount to preclude development of ataxia, oversedation or other possible adverse effects.

Use in emotional disorders:
Diazepam is not recommended in the treatment of psychotic or severely depressed patients. Precautions are indicated for severely depressed patients or those who show evidence of impending depression, particularly the recognition that suicidal tendencies may be present and protective measures may be necessary. Since excitement and other paradoxical reactions may result from the use of the drug in psychotic patients, it should not be used in ambulatory patients suspected of having psychotic tendencies.

Use in epileptic patients:
Since diazepam may exacerbate grand mal seizures in some patients, caution is required when it is used in epileptic patients. An adjustment may be necessary in their anticonvulsive medication. Abrupt withdrawal of diazepam in these patients should also be avoided.

Potentiation of drug effects:
Patients should be advised to abstain from alcohol and other CNS depressant drugs during treatment with diazepam. Phenothiazines, barbiturates, MAO inhibitors and other psychoactive drugs may potentiate the action of the drug and should not usually be given concurrently.

Drug dependence:
Abrupt cessation of large doses of diazepam after prolonged periods may precipitate acute withdrawal symptoms and, in these cases, the drug should be discontinued gradually. Caution should be exercised when it is considered necessary to administer diazepam to addiction prone individuals.

Occupational Hazards:
Patients receiving diazepam should be advised to proceed cautiously whenever mental alertness and physical coordination are required.

The usual precautions in treating patients with impaired renal and hepatic functions should be observed. If diazepam is administered for protracted periods, periodic blood counts and liver function tests would be highly advisable.
Adverse Effects
The most common adverse effects reported are drowsiness and ataxia. Other reactions noted less frequently are fatigue, dizziness, nausea, blurred vision, diplopia, vertigo, headache, slurred speech, tremors, hypoactivity, dysarthria, euphoria, impairment of memory, confusion, depression, incontinence or urinary retention, constipation, skin rash, generalized exfoliative dermatitis, hypotension, changes in libido.

The more serious adverse reactions occasionally reported are leukopenia, jaundice, hypersensitivity and paradoxical reactions.

Paradoxical reactions such as hyperexcited states, anxiety, excitement, hallucinations, increased muscle spasticity, insomnia, rage, as well as sleep disturbances and stimulation, have been reported; should these occur, the drug should be discontinued.

Minor changes in EEG patterns have been observed in patients on diazepam therapy. These changes consist of low to moderate voltage fast activity, 20 to 30 cycles/second and are of no known significance.
Overdose
Symptoms:
Drowsiness, oversedation and ataxia. When the effects of drug overdosage begin to wear off, the patient exhibits some jitteriness and overstimulation. The cardinal manifestations of overdosage are drowsiness and confusion, reduced reflexes and coma. There are minimum effects on respiration, pulse and blood pressure unless the overdosage is extreme.

Treatment:
Gastric lavage may be beneficial if performed soon after oral ingestion of diazepam. If necessary, a CNS stimulant such as caffeine or methylphenidate may be administered with caution. Supportive measures should be instituted as indicated, such as, maintenance of an adequate airway, levarterenol for hypotension. Dialysis appears to be of little value.

Viagra is the most popular brand name for the drug sildenafil citrate.  It is marketed today by the pharmaceutical company Pfizer, and is also sold under the name Ravatio and Caverta in certain parts of the world.  Viagra is designed to treat erectile dysfunction, or ED.  It comes in the form of a blue pill in 25mg, 50mg, and 100mg dosages.  Although it is available only by way of a doctor’s prescription, there are numerous websites on the internet that sell Viagra after filling out a short questionnaire. 

The drug Viagra was designed in the 1990s with the intention of treating a form of cardiovascular disease known as angina pectoris.  Though it was not found effective for its original intention, researches of the drug remarked on its ability to induce erections in male study participants.  It was then patented in 1996 with the intention of development as a treatment for ED.  By 1998 it had passed the necessary tests for FDA approval, and hit the market with immediate and large-scale success.

Erectile dysfunction is a very common disorder in men, and can develop for a number of reasons.  Some of the most common causes behind ED are psychological in origin, and are not based on any physical irregularities.  Most men experience some difficulty getting or maintaining an erection at some point in their lives, even though they are otherwise healthy.  For these cases, drugs like Viagra are extremely effective.   Some cases of ED can be caused by damage to the nervous system, diabetes, or hypogonadism, and in these cases Viagra may not be effective.

Viagra is classified as a PDE5 inhibitor.  PDE5 causes a compound called cyclic GMP or cGMP to degrade.  Since cGMP causes the arterial smooth muscles in the penis to relax, allowing the penis to fill with blood and become erect, inhibiting the action of PDE5 will lead to penile erections so long as the individual is otherwise healthy.  Some other PDE5 inhibitors available today include Levitra, and Cialis.

The most common side effects of Viagra include headache, stomach upset, flushing, and sweating.  Occasionally, users of Viagra experience blurred vision, and in some rare cases have reported temporary lose of sight in one or both eyes.  Viagra should not be taken in conjunction with drugs designed for angina pectoris, as together they can induce a dangerous drop in blood pressure.  Even though it is available on the internet, it is not recommended you take Viagra without prior consultation with a physician.