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midazolam seizure

Debbie Terry, Anup D Patel, Daniel M Cohen, Daniel Scherzer, Jennifer Kline
The purpose of this study was to assess school nurses' perceptions of barriers to optimal management of seizures in schools. Eighty-three school nurses completed an electronic survey. Most agreed they felt confident they could identify a seizure (97.6%), give rectal diazepam (83.8%), and handle cluster seizures (67.1%), but fewer were confident they could give intranasal midazolam (63.3%), had specific information about a student's seizures (56.6%), or could swipe a vagus nerve stimulator magnet (47.4%). Nurses were more likely to be available at the time of a seizure in rural (17/20) (85%) versus suburban (21/34) (62%) or urban (8/25) (32%) schools (P = ...
September 12, 2016: Journal of Child Neurology
Daniel Crawford
Currently, evidence supports the use of intranasal midazolam as an effective, and in many cases, preferable treatment option for prolonged seizures in children. Despite this knowledge, intranasal midazolam is not routinely found as a standard of care. The goal of this project was to implement the use of intranasal midazolam as a rescue medication for prolonged seizures within a child neurology practice and, in doing so, create a model for implementation that would be replicable for other practice sites. This project focused on the development of a process to make intranasal midazolam available as a treatment option and then the creation of an educational intervention for providers within a child neurology practice...
September 5, 2016: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
Jerome Niquet, Roger Baldwin, Keith Norman, Lucie Suchomelova, Lucille Lumley, Claude G Wasterlain
OBJECTIVE: Pharmacoresistance remains an unsolved therapeutic challenge in status epilepticus (SE) and in cholinergic SE induced by nerve agent intoxication. SE triggers a rapid internalization of synaptic γ-aminobutyric acid A (GABAA ) receptors and externalization of N-methyl-d-aspartate (NMDA) receptors that may explain the loss of potency of standard antiepileptic drugs (AEDs). We hypothesized that a drug combination aimed at correcting the consequences of receptor trafficking would reduce SE severity and its long-term consequences...
September 2016: Epilepsia
Robert C Tasker, Howard P Goodkin, Iván Sánchez Fernández, Kevin E Chapman, Nicholas S Abend, Ravindra Arya, James N Brenton, Jessica L Carpenter, William D Gaillard, Tracy A Glauser, Joshua Goldstein, Ashley R Helseth, Michele C Jackson, Kush Kapur, Mohamad A Mikati, Katrina Peariso, Mark S Wainwright, Angus A Wilfong, Korwyn Williams, Tobias Loddenkemper
OBJECTIVE: To describe pediatric patients with convulsive refractory status epilepticus in whom there is intention to use an IV anesthetic for seizure control. DESIGN: Two-year prospective observational study evaluating patients (age range, 1 mo to 21 yr) with refractory status epilepticus not responding to two antiepileptic drug classes and treated with continuous infusion of anesthetic agent. SETTING: Nine pediatric hospitals in the United States...
October 2016: Pediatric Critical Care Medicine
Rachelle Abouchedid, James H Ho, Simon Hudson, Alison Dines, John R H Archer, David M Wood, Paul I Dargan
INTRODUCTION: Synthetic Cannabinoid Receptor Agonists (SCRAs) are the largest group of new psychoactive substances reported to the European Warning System and the United Nations Office on Drugs and Crime to date. The heterogeneous nature and speed of diversification of these compounds make it challenging to accurately characterise and predict harms of these compounds in pre-clinical studies, ahead of their appearance. CASE REPORT: We report the case of a 19-year-old female who purchased three products from a headshop: two new psychoactive substances (sachets of "cannabis tea" and "mushroom tea") as well as two LSD blotters...
July 25, 2016: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
Michal Zelcer, Ran D Goldman
QUESTION: There are times when parents arrive to my clinic after their child has had a seizure and a second seizure takes place in the clinic. While waiting for transport to the hospital, are there ways to stop the seizures without the need to obtain intravenous access in the clinic? ANSWER: Intravenous diazepam has been a first-line therapy to stop seizures in children for many years. Other routes of drug administration such as intramuscular, rectal, and buccal are available but have several limitations...
July 2016: Canadian Family Physician Médecin de Famille Canadien
Devashish Dhiren Vyas, Gopal Krishna Dash
A 28-year old female was admitted with recurrent seizures following 2 days of febrile illness, after which she developed status epilepticus. Midazolam and later thiopentone infusions were started after failure of regular intravenous antiepileptics. Burst suppression was achieved at doses of 3 mg/kg/hr for midazolam and 6 mg/kg/hr of thiopentone. Adjunctive medications included methylprednisolone, intravenous immunoglobulin and acyclovir. Imaging and biochemical parameters were normal. She required 3 cycles of midazolam and 2 cycles of thiopentone for complete cessation of seizures...
June 2016: Journal of Epilepsy Research
Mamta Kapoor, Narsihmulu Cheryala, Davin Rautiola, Gunda I Georg, James C Cloyd, Ronald A Siegel
Water-soluble prodrugs can be rapidly converted by enzymes to hydrophobic drugs, whose aqueous thermodynamic solubilities are low, but are maintained in aqueous solution at supersaturated concentrations due to slow precipitation kinetics. Recently, we investigated avizafone (AVF) in combination with Aspergillus oryzae protease as a prodrug/enzyme system intended to produce supersaturated diazepam (DZP). Several fold enhancement of permeation of supersaturated DZP across Madin-Darby canine kidney II-wild type (MDCKII-wt) monolayers was observed, compared to saturated DZP solutions...
August 2016: Journal of Pharmaceutical Sciences
Cindy Acon-Chen, Jeffrey A Koenig, Garrett R Smith, Amber R Truitt, Thaddeus P Thomas, Tsung-Ming Shih
Organophosphorus nerve agents such as soman (GD) inhibit acetylcholinesterase, producing an excess of acetylcholine (ACh), which results in respiratory distress, convulsions and status epilepticus that leads to neuropathology. Several drugs (topiramate, clobazam, pregnanolone, allopregnanolone, UBP 302, cyclopentyladenosine [CPA], ketamine, midazolam and scopolamine) have been identified as potential neuroprotectants that may terminate seizures and reduce brain damage. To systematically evaluate their efficacy, this study employed in vivo striatal microdialysis and liquid chromatography to respectively collect and analyze extracellular ACh in freely moving rats treated with these drugs 20 min after seizure onset induced by a high dose of GD...
June 2016: Toxicology Mechanisms and Methods
Zhiqiang Meng, James K Rowlett
BACKGROUND: Progesterone-derived neuroactive steroids have shown promise clinically (e.g., anti-seizure medications) but, as with other GABAA receptor modulators (e.g., benzodiazepines), may have the potential for abuse. METHODS: We evaluated the reinforcing effects of progesterone, a steroid precursor of endogenous neuroactive steroids, with and without pretreatments with the neuroactive steroid synthesis inhibitor, finasteride, in rhesus monkeys trained under a progressive-ratio (PR) schedule of i...
August 1, 2016: Drug and Alcohol Dependence
Sandeep B Patil, Arun Grace Roy, Kollencheri Puthenveettil Vinayan
PURPOSE: To describe the clinical features and outcome of febrile infection-related epilepsy syndrome (FIRES), a catastrophic epileptic encephalopathy, in a cohort of South Indian children. MATERIALS AND METHODS: We performed a retrospective chart review of a cohort of children with previously normal development who presented with status epilepticus or encephalopathy with recurrent seizures following a nonspecific febrile illness during the period between January 2007 and January 2012...
April 2016: Annals of Indian Academy of Neurology
D Lee, A Batty, D Gladwell, N J Brereton, E Tate
No abstract text is available yet for this article.
November 2012: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
D Gladwell, M Aneli, A Batty, D Lee
No abstract text is available yet for this article.
November 2012: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
D Lee, D Gladwell, A Batty, N J Brereton
No abstract text is available yet for this article.
November 2012: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Burnice Nalina Kumari Chellathurai, Ramakrishnan Thiagarajan, SelvaKumar Jayakumaran, Pradeep Devadoss, Elavazhagan
Epilepsy, characterized by the risk of recurrent seizures, is a chronic disease that afflicts about 5% of the world's population. The main dental problems associated with epileptic patients include gingival hyperplasia, minor oral injuries, tooth trauma, and prosthodontic problems, which require the dental treatment. Stress and fear are the most common triggering factors for the epilepsy in dental chair. Therefore, a more appropriate method of treating such epileptic patients may be warranted. Conscious sedation is a technique of providing good anesthesia and analgesia to patients, the main advantage of which is the patient's rapid return to presentation levels...
January 2016: Journal of Indian Society of Periodontology
Zi-Yu Zhao, Hong-Ying Wang, Bin Wen, Zhi-Bo Yang, Kang Feng, Jing-Chun Fan
Midazolam, lorazepam, and diazepam were recommended as emergent initial therapy for status epilepticus. However, there are no current studies to confirm the best agent for pediatric status epilepticus. We compared the efficacy of midazolam, lorazepam, and diazepam in treating pediatric status epilepticus using a network meta-analysis method. In total, 16 randomized controlled trials containing 1821 patients were included. Nonintravenous midazolam, intravenous lorazepam, and intravenous diazepam were more successful in achieving seizure cessation when compared with nonintravenous diazepam (odds ratio = 2...
August 2016: Journal of Child Neurology
Takashi Hitosugi, Masanori Tsukamoto, Kentaro Ishii, Masanori Kadowaki, Shigeki Fujiwara, Takeshi Yokoyama
Aicardi syndrome is a rare hereditary disorder that develops in only girls with the trilogy of nutatory epilepsy, callosal agenesis and chorioretinopathy. We experienced general anesthesia twice for a patient with Aicardi syndrome in addition to heavy mental retardation. She underwent surgical correction for cleft lip and palate at 6 months of age and at 2 years of age, respectively. Anesthesia was induced slowly with inhalation of nitrous oxide, oxygen and sevoflurare. After securing an intravenous route, midazolam, thiopental and vecuronium were administered and intubated orally...
January 2016: Masui. the Japanese Journal of Anesthesiology
Manish I Shah, John M Carey, Sarah E Rapp, Marina Masciale, Wendy B Alcanter, Juan A Mondragon, Elizabeth A Camp, Samuel J Prater, Cara B Doughty
BACKGROUND: A simulation-based course, Pediatric Simulation Training for Emergency Prehospital Providers (PediSTEPPs), was developed to optimize pediatric prehospital care. Seizures are common in Emergency Medical Services (EMS), and no studies have evaluated pediatric outcomes after EMS simulation training. OBJECTIVES: The primary objective was to determine if PediSTEPPs enhances seizure protocol adherence in blood glucose measurement and midazolam administration for seizing children...
July 2016: Prehospital Emergency Care
Maria D Donovan, Brendan T Griffin, Liudmila Kharoshankaya, John F Cryan, Geraldine B Boylan
Seizures are the most common neurological emergencies in the neonatal period and are associated with poor neurodevelopmental outcomes. Seizures affect up to five per 1000 term births and population-based studies suggest that they occur even more frequently in premature infants. Seizures are a sign of an underlying cerebral pathology, the most common of which is hypoxic-ischaemic encephalopathy in term infants. Due to a growing body of evidence that seizures exacerbate cerebral injury, effective diagnosis and treatment of neonatal seizures is of paramount importance to reduce long-term adverse outcomes...
April 2016: Drugs
Juan G Ochoa, William A Kilgo
Benzodiazepines are commonly prescribed as anxiolytics, sedatives, and anticonvulsants. They act on the GABAA receptor by increasing the conductance chloride through ionic channels, promoting a state of central nervous system depression. The clinical properties of benzodiazepines are dependent upon the composition of the different subunits of the GABAA receptor. Each subunit, in turn, has multiple subtypes that are present throughout the central nervous system, all of which impart different clinical responses...
April 2016: Current Treatment Options in Neurology
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