The administration of rectal diazepam for acute management of seizures

Seigler, Robert S.

doi:10.1016/0736-4679(90)90225-k

Cited by 44 publications

(10 citation statements)

References 19 publications

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“…3 Felter and Asch, -"' Valman, 15 administered as a bolus through a 1-cm 3 disposable insulin or tuberculin syringe insened 4 to 5 em into the rectum. Seigler 16 reponed a low incidence of systemic side effects with rectal use of diazepam, as well as absorption and maintenance of therapeutic drug serum levels comparable to those achieved with intravenously administered diazepam. Knudsen 9 proposed that if the seizure does not stop within 5 minutes, an additional dose of0.5 mg/kg be given rectally, followed by intravenous diazepam, to a maximum total dose of2 to 3 mg/kg by both routes.…”

Section: Acute Managementmentioning

confidence: 92%

Febrile seizure

Monsen

Graham²,

Snell³

1991

Postgraduate Medicine

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Section: Acute Managementmentioning

confidence: 92%

Febrile seizure

Monsen

Graham²,

Snell³

1991

Postgraduate Medicine

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“…Continuous therapy is associated with long-term adverse effects, ineffective in preventing recurrences [19,20]. Intermittent therapy with diazepam and antipyretics has had higher recurrence rate besides risk of excessive sedation [21][22][23][24][25][26]. Intermittent diazepam has shown conflicting results against placebo controlled trial and effective only in comparison to continuous phenobarbital in preventing FS recurrence [24].…”

Section: Parametersmentioning

confidence: 99%

Intermittent clobazam in febrile seizures: an Indian experience

Bajaj

Puri

et al. 2015

J Pediatr Neurol

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The aim of this study is to find the efficacy and safety of intermittent clobazam in febrile seizures (FS). The study was a double blind placebo control trial. Sixty patients of age group 6 months to five years presenting with febrile seizures were finally randomized to clobazam (group A; n = 30; male/female: 14:16) and placebo (group B; n = 30; male/female: 17:13) groups after exclusion of mental retardation, congenital malformations, intracranial infections, renal or hepatic dysfunction or history of intake of antiepileptic drugs and afebrile seizures. The patients in group A were given intermittent prophylactic clobazam @0.75 mg/kg body weight twice daily and group B were given placebo, during the course of fever. Antipyretic (paracetamol) and cold sponging was advised to the guardian, if the fever exceeded 38?C. The patients were assessed primarily on the basis of recurrence of seizure per febrile episodes, pattern of seizures and safety from the adverse effects reported during the course of study and from the investigation done on the patient. The two groups had comparable clinical profile. Mean ages of patients in group A and B were 25.5 ? 13.38 and 18.43 ? 13.95 months, respectively. Thirteen cases in group A and 12 cases in group B had abnormal electroencephalogram at baseline. Five patients in group A and eight cases in group B had a family history of FS. Twenty seven patients in group A and 24 patients belonging to group B had generalized seizures at presentation whereas three and six patients presented with partial seizures at the time of enrolment in group A and B respectively. After treatment with clobazam seven and two patients had generalized and partial seizures respectively while the figures were 23 and 2 for group B patients. Thus, recurrence of FS was observed in 30% (nine) patients in group A and 83.3% (25) in group B, this difference was statistically significant. There were 151 and 161 febrile episodes during the course of study in group A and B, respectively, 0.139 seizures per febrile episodes were observed in group A after treatment with clobazam and 0.820 seizures per febrile episodes in the placebo group. There was a significant reduction in the frequency of seizures per febrile episode with clobazam as compared to placebo. The average number of seizures preceding six months was 4.33 ? 2.78 in the clobazam and, this declined significantly to 0.7 ? 1.37 (P < 0.001), while in the placebo group no decline in seizure frequency was observed. There was a significant prolongation of seizure free interval in group A treated with clobazam on comparison to placebo group. No significant adverse effect except irritability was observed in four patients on clobazam. Clobazam is efficacious and well tolerated as intermittent therapy for FS and is superior to the use of intermittent antipyretics alone.

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“…Parenteral preparations of diazepam given by rectum are rapidly and completely absorbed [9,26,33,145,155,173]. Peak concentrations occur within 20 min, and parenteral diazepam thus has a distinct advantage for treatment of uncontrolled seizures over standard antiseizure medications given by rectum, which require several hours to peak concentrations [26,33,67,145,155].…”

Section: Lamotriginementioning

confidence: 99%

Symptom control in cancer patients: the clinical pharmacology and therapeutic role of suppositories and rectal suspensions

Davis¹,

Walsh²,

LeGrand

et al. 2002

Support Care Cancer

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Rectally administered medications are essential in palliative medicine, particularly in the last days of life. They are underutilized. The pharmacology of rectally administered medications relates not only to the medication but also to the suppository base, additives, drug ionization, p K(a), absorptive surface of the rectum, and rectal health. The pharmacokinetics may differ from those of orally administered medications owing to reduced hepatic first-pass clearance. In this review the pharmacology of rectally administered palliative medications is reviewed and the use of individual drugs is outlined.

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The administration of rectal diazepam for acute management of seizures

Cited by 44 publications

References 19 publications

Febrile seizure

Febrile seizure

Intermittent clobazam in febrile seizures: an Indian experience

Symptom control in cancer patients: the clinical pharmacology and therapeutic role of suppositories and rectal suspensions

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