Journal ArticleDOI
Effects of intranasal midazolam and rectal diazepam on acute convulsions in children: prospective randomized study.
Tunc Fisgin,Y. K. Yavuz Gürer,Tahsin Teziç,Nesrin Şenbil,Pelin Zorlu,Çetin Okuyaz,Deniz Akgün +6 more
TLDR
In this study, the effects and side effects of rectal diazepam and intranasal midazolam were compared in the treatment of acute convulsions in children to develop a practical and safe treatment protocol and it is concluded that as an antiepileptic agent, intran asal midrazolam is more effective than rectaldiazepam.Abstract:
In this study, the effects and side effects of rectal diazepam and intranasal midazolam were compared in the treatment of acute convulsions in children to develop a practical and safe treatment protocol. In the diazepam group, the seizures of 13 (60%) patients terminated in 10 minutes; however, 9 (40%) patients did not respond. In the midazolam group, 20 (87%) patients responded in 10 minutes, but 3 (13%) patients did not respond. Regarding the anticonvulsant effect, midazolam was found to be more effective than diazepam, and the difference was statistically significant (P < .05). The necessity of a second drug for the seizures that did not stop with the first drug was higher in the diazepam group than the midazolam group, and the difference was statistically significant (P < .05). We conclude that as an antiepileptic agent, intranasal midazolam is more effective than rectal diazepam. After administration, we did not observe any serious complications. Further investigations are necessary; however, intranasal administration is easy, so if the nasal drop and spray forms used in some European countries and the United States are available worldwide, it will be very useful for physicians in the emergency room.read more
Citations
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Journal ArticleDOI
Evidence-Based Guideline: Treatment of Convulsive Status Epilepticus in Children and Adults: Report of the Guideline Committee of the American Epilepsy Society
Tracy A. Glauser,Shlomo Shinnar,David Gloss,Brian K. Alldredge,Ravindra Arya,Jacquelyn L. Bainbridge,Mary A Bare,Thomas P. Bleck,W. Edwin Dodson,Lisa Garrity,Andy Jagoda,Daniel H. Lowenstein,John M. Pellock,James Riviello,Edward P. Sloan,David M. Treiman +15 more
TL;DR: Despite the paucity of well-designed randomized controlled trials, practical conclusions and an integrated treatment algorithm for the treatment of convulsive status epilepticus across the age spectrum (infants through adults) can be constructed.
Journal ArticleDOI
Intranasal delivery: physicochemical and therapeutic aspects.
TL;DR: The present review provides an in-depth discussion of therapeutic aspects of IN delivery including consideration of the intended indication, regimen, and patient population, as well as physicochemical properties of the drug itself.
Journal ArticleDOI
Benzodiazepines in epilepsy: pharmacology and pharmacokinetics.
TL;DR: Among these BZDs, clorazepate has a unique profile that includes a long half‐life of its active metabolite and slow onset of tolerance, which could theoretically help minimize adverse events.
Journal ArticleDOI
Evaluation of intranasal delivery route of drug administration for brain targeting
TL;DR: This review presents some possibilities to enhance the drug penetration through the nasal barrier and summarizes some in vitro, ex vivo and in vivo technologies to test the drug delivery across the nasal epithelium into the brain.
Journal ArticleDOI
Safety and efficacy of buccal midazolam versus rectal diazepam for emergency treatment of seizures in children: a randomised controlled trial.
John McIntyre,Sue Robertson,Elizabeth Norris,Richard Appleton,William P Whitehouse,Barbara Phillips,Tim Martland,Kathleen Berry,Jacqueline Collier,Stephanie L. Smith,Imti Choonara +10 more
TL;DR: Buccal midazolam was more effective than rectal diazepam for children presenting to hospital with acute seizures and was not associated with an increased incidence of respiratory depression.
References
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Journal ArticleDOI
Preanesthetic Sedation of Preschool Children Using Intranasal Midazolam
Journal ArticleDOI
Comparison of intranasal midazolam with intravenous diazepam for treating febrile seizures in children: prospective randomised study
TL;DR: The overall time to cessation of seizures after arrival at hospital was faster with intranasal midazolam than with intravenous diazepam, although midAZolam was as safe and effective as diazepAM.
Journal ArticleDOI
A comparison of rectal diazepam gel and placebo for acute repetitive seizures.
Fritz E. Dreifuss,N P Rosman,James C. Cloyd,John M. Pellock,Ruben Kuzniecky,W D Lo,Fumisuke Matsuo,G B Sharp,J A Conry,Donna Bergen,W E Bell +10 more
TL;DR: Rectal diazepam gel, administered at home by trained care givers, is an effective and well-tolerated treatment for acute repetitive seizures.
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