Kensche Maria, Sander Josemir W, Sisodiya Sanjay M
Institute of Neurology, University College London, London, UK.
BMJ Case Rep. 2010 Dec 15;2010:bcr0920103371. doi: 10.1136/bcr.09.2010.3371.
Buccal midazolam is a rescue medication to reduce the duration of or stop an epileptic seizure, and is used to prevent status epilepticus. It is available in various forms, including a buccal preparation with a strength of 10 mg/1 ml. Midazolam is a licensed medication, but the buccal formulation is currently used off-licence. The prescriber takes ultimate responsibility for its use in this way. Administered by a trained person, it is receiving widespread acceptance as an alternative and effective treatment to rectally-administered diazepam in the community. The commonest side effects of midazolam are drowsiness and somnolence, although respiratory depression and paradoxical reactions, for example, agitation, restlessness and disorientation, may also occur. Hypotension is said to be a rare side effect, but with no reported cases in people administered buccal midazolam. The authors report a case of significant hypotension associated with administration of buccal midazolam for seizure management.
口腔咪达唑仑是一种用于缩短癫痫发作持续时间或终止癫痫发作的急救药物，用于预防癫痫持续状态。它有多种剂型，包括一种浓度为10毫克/1毫升的口腔制剂。咪达唑仑是一种有许可证的药物，但目前口腔制剂的使用属于超适应症用药。开处方者需对这种用药方式承担最终责任。由经过培训的人员给药时，它作为社区中直肠给药地西泮的替代有效治疗方法而被广泛接受。咪达唑仑最常见的副作用是嗜睡和昏睡，不过也可能出现呼吸抑制和反常反应，例如激动、烦躁不安和定向障碍。据说低血压是一种罕见的副作用，但在使用口腔咪达唑仑的人群中尚无相关病例报告。作者报告了一例与使用口腔咪达唑仑治疗癫痫发作相关的严重低血压病例。
