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Emergency Management of Seizures: An Overview
Author(s) -
Uthman Basim M.,
Wilder B. J.
Publication year - 1989
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1157.1989.tb05823.x
Subject(s) - phenytoin , lorazepam , medicine , diazepam , status epilepticus , phenobarbital , anesthesia , drug , route of administration , anticonvulsant , onset of action , epilepsy , prodrug , pharmacology , psychiatry
Summary: The drugs currently used in the emergency management of seizures are chiefly phenytoin, phenobarbital, diazepam, lorazepam, and paraldehyde. The combination of intravenous phenytoin and lorazepam has the advantages of rapid onset of action, sustained efficacy, and freedom from drug interactions. The intermittent oral or rectal administration of diazepam is especially useful for acute home treatment of recurrent seizures. Phenytoin prodrug (ACC‐9653), an investigational new drug, is promptly absorbed after intramuscular injection. Unlike phenytoin, it does not require propylene glycol and high alkalinity for solubility and therefore does not produce soft‐tissue injury after parenteral administration. It appears to be close to an ideal drug for the emergency management of seizures.