Almohaish Sulaiman, Sandler Melissa, Brophy Gretchen M
Department of Pharmacotherapy and Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, VA 23298, USA.
College of Clinical Pharmacy, King Faisal University, Al-Ahsa 3198, Saudi Arabia.
J Clin Med. 2021 Apr 17;10(8):1754. doi: 10.3390/jcm10081754.
Time plays a major role in seizure evaluation and treatment. Acute repetitive seizures and status epilepticus are medical emergencies that require immediate assessment and treatment for optimal therapeutic response. Benzodiazepines are considered the first-line agent for rapid seizure control. Thus, various routes of administration of benzodiazepines have been studied to facilitate a quick, effective, and easy therapy administration. Choosing the right agent may vary based on the drug and route properties, patient's environment, caregiver's skills, and drug accessibility. The pharmacokinetic and pharmacodynamic aspects of benzodiazepines are essential in the decision-making process. Ultimately, agents and routes that give the highest bioavailability, fastest absorption, and a modest duration are preferred. In the outpatient setting, intranasal and buccal routes appear to be equally effective and more rapidly administered than rectal diazepam. On the other hand, in the inpatient setting, if available, the IV route is ideal for benzodiazepine administration to avoid any potential absorption delay. In this article, we will provide an overview and comparison of the various routes of benzodiazepine administration for acute control of repetitive seizures and status epilepticus.
时间在癫痫发作的评估和治疗中起着重要作用。急性重复性癫痫发作和癫痫持续状态是医疗急症，需要立即进行评估和治疗以获得最佳治疗效果。苯二氮䓬类药物被认为是快速控制癫痫发作的一线药物。因此，人们对苯二氮䓬类药物的各种给药途径进行了研究，以促进快速、有效且简便的治疗给药。根据药物和给药途径的特性、患者所处环境、护理人员的技能以及药物的可及性，选择合适的药物可能会有所不同。苯二氮䓬类药物的药代动力学和药效学方面在决策过程中至关重要。最终，具有最高生物利用度、最快吸收速度和适度作用持续时间的药物和给药途径是首选。在门诊环境中，鼻内和颊部给药途径似乎同样有效，且比直肠给予地西泮给药更快。另一方面，在住院环境中，如果可行，静脉给药途径是苯二氮䓬类药物给药的理想选择，以避免任何潜在的吸收延迟。在本文中，我们将概述和比较苯二氮䓬类药物用于急性控制重复性癫痫发作和癫痫持续状态的各种给药途径。
