ACETS OF INHALATIONAL MIDAZOLAM IN STATUS EPILEPTICUS
Abstract
Status epilepticus (SE) is a medical emergency associated with significant morbidity and mortality. SE is defined as a continuous seizure lasting more
than 30 minutes, or two or more seizures without full recovery of consciousness between any of them. Early treatment of SE with benzodiazepines,
followed if necessary by fosphenytoin administration, is the most widely followed strategy. In developing countries where facilities for assisted
ventilation are not readily available, it may be helpful to use inhalational midazolam in such settings. It is important to recognize SE and institute
treatment as early as possible to avoid a refractory state. It is equally important to attend to the general condition of the patient and to ensure that the
patient is hemodynamically stable.
Keywords: Epilepsy, Nasal route, Midazolam, Inhalational route, Facets.
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References
Lowenstein DH, Bleck T, Macdonald RL. It’s time to revise the
definition of status epilepticus. Epilepsia 1999;40(1):120-2.
Shinnar S, Berg AT, Moshe SL, Shinnar R. How long do new-onset
seizures in children last? Ann Neurol 2001;49(5):659-64.
Rogawski MA, Löscher W. The neurobiology of antiepileptic drugs.
Nat Rev Neurosci 2004;5(7):553-64.
Naritoku DK, Sinha S. Prolongation of midazolam half-life after
sustained infusion for status epilepticus. Neurology 2000;54(6):1366-8.
Available from: http://www.drugs.com/ppa/midazolam-hydrochloride.
html.
Proctor DF, Andersen I. The Nose Upper Airway Physiology and the
Atmospheric Environment. Amsterdam: Elsevier Biomedical Press;
Chien YW, Su KS, Chang SF. Nasal systemic drug delivery. New York:
Marcel Dekker Inc.; 1989.
Available from: http://www.diva-portal.org/diva/getDocument?urn_
nbn_se_uu_diva-9292__fulltext.pdf.
Available from: http://www.publications.uu.se/theses/abstract.
xsql?lang=en&dbid=9292.
Vidgren MT, Kublik H. Nasal delivery systems and their effect on
deposition and absorption. Adv Drug Deliv Rev 1998;29(1-2):157-77.
Coda BA, Rudy AC, Archer SM, Wermeling DP. Pharmacokinetics and
bioavailability of single-dose intranasal hydromorphone hydrochloride
in healthy volunteers. Anesth Analg 2003;97:117-23.
Studd J, Pornel B, Marton I, Bringer J, Varin C, Tsouderos Y, et al.
Efficacy and acceptability of intranasal 17 beta-oestradiol for
menopausal symptoms: Randomised dose-response study. Aerodiol
Study Group. Lancet 1999;353(9164):1574-8.
Available from: http://publications.uu.se/abstract.xsql?dbid=3905.
Available from: http://publications.uu.se/abstract.xsql?dbid=7829.
Mathison S, Nagilla R, Kompella UB. Nasal route for direct delivery
of solutes to the central nervous system: Fact or fiction? J Drug Target
;5:415-41.
Illum L. Is nose-to-brain transport of drugs in man a reality? J Pharm
Pharmacol 2004;56:3-17.
Ramachandrannair R, Corden TE. Pediatric Status Epilepticus
Treatment & Management.
Humphries LK, Eiland L0053. Treatment of acute seizures: Is intranasal
midazolam a viable option? J Pediatr Pharmacol Ther 2013;18(2):79-8
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