医学
癫痫持续状态
咪唑安定
安定
鼻腔给药
耐受性
劳拉西泮
麻醉
直肠给药
癫痫
苯二氮卓
鼻喷雾剂
药理学
不利影响
镇静
精神科
内科学
受体
作者
Robert J. Kotloski,Barry E. Gidal
标识
DOI:10.1016/j.ncl.2022.03.016
摘要
Treatment of seizure clusters endeavors to prevent additional seizures and avoid progression to conditions such as prolonged seizures and status epilepticus. Rescue therapies are key components of seizure action plans (SAPs) for individuals with seizure clusters. Three rescue therapies are approved in the United States for the treatment of seizure clusters: diazepam rectal gel, midazolam nasal spray, and diazepam nasal spray. Diazepam rectal gel is an effective rescue therapy for seizure clusters, though adults and adolescents may have social reservations regarding its administration. Intranasal delivery of midazolam or diazepam is a promising alternative to rectal administration because these formulations offer easy, socially acceptable administration exhibit a rapid onset, and allow for the possibility of self-administration. Off-label benzodiazepines, such as orally disintegrating lorazepam and intranasal use of an intravenous (IV) formulation of midazolam via nasal atomizer, are less well characterized regarding bioavailability and tolerability compared with approved agents.
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