Anticonvulsants diazepam

Benzodiazepines, ie, the hiU BZR agonists, are prescribed for anxiety, insomnia, sedation, myorelaxation, and as anticonvulsants (97). Those benzodiazepines most commonly prescribed for the treatment of anxiety disorders are lorazepam (19), alprazolam (20), diazepam (21), bromazepam (22), chlorazepate (23), and oxazepam (24). These dmgs together represent about 70% of total... 

Diphenylhydantoin (23), diazepam (24), phenacemide (25), and ethylphenacemide (26) are all potent anticonvulsants 41 . The first two drugs, though chemically unrelated, have similarities in their three-dimensional structures 42). The other two open-chain acetylurea derivatives 25 and 26 in the crystalline state bear striking stereochemical... 

Occasionally, status epilepticus (an emergency situation characterized by continual seizure activity with no interruptions) can occur. Diazepam (Valium) is most often the initial drug prescribed for this condition. However, because the effects of diazepam last less than 1 hour, a longer-lasting anticonvulsant, such as phenytoin or phenobarbital, also must be given to control the seizure activity. 

Some of these drugp may have additional uses as sedatives, muscle relaxants, anticonvulsants, and in the treatment of alcohol withdrawal. For example, clo-razepate (Tranxene) and diazepam (Valium) are used as anticonvulsants (see Chap. 28). Additional uses of the individual antianxiety drugp are given in the Summary Drug Table Antianxiety Drugp. 

Anticonvulsant drugs such as carbamazepine, diazepam, valproic acid, and phenobarbital also slightly increased the duration of the initial AD. However, the effects of these drugs on the other associated seizure events were quite different from PCP and ketamine. The effects of carbamazepine and diazepam, typical of the four compounds, are illustrated in figure 4. These compounds either suppressed the rebound spiking (diazepam, valproic acid, and phenobarbital) or lengthened the total seizure duration with no rebound suppression (carbamazepine). 

Benzodiazepines are the evidence-based treatment of choice for uncomplicated alcohol withdrawal.17 Barbiturates are not recommended because of their low therapeutic index due to respiratory depression. Some of the anticonvulsants have also been used to treat uncomplicated withdrawal (particularly car-bamazepine and sodium valproate). Although anticonvulsants provide an alternative to benzodiazepines, they are not as well studied and are less commonly used. The most commonly employed benzodiazepines are chlordiazepoxide, diazepam, lorazepam, and oxazepam. They differ in three major ways (1) their pharmacokinetic properties, (2) the available routes for their administration, and (3) the rapidity of their onset of action due to the rate of gastrointestinal absorption and rate of crossing the blood-brain barrier. 

I with seizures and require anticonvulsant therapy. Phenytoin is the most frequently used agent, with a loading dose of 15 mg/kg followed by 300 mg by mouth daily (titrated to therapeutic levels between 10 and 20 mcg/mL). Diazepam 5 mg intravenously may be used for rapid control of persistent seizures. Prophylactic anticonvulsants have been used frequently, but a recent meta-analysis did not support their use.23 Thus, because adverse effects and drug interactions are common, the routine use of prophylactic anticonvulsants is not recommended. 

Benzodiazepine The family name for a group of drugs with anticonvulsant, muscle relaxant and sedative-hypnotic properties. Examples include chlorodiazepoxide (Librium), diazepam (Valium), flunitrazepam and temazepam. These drugs have largely superseded the barbiturates. 

Acute management of toxaphene-induced seizures in humans with anticonvulsants, especially diazepam, phenobarbital, and phenytoin (USPHS 1994). 

A benzodiazepine (BZ) should be administered as soon as possible if the patient is actively seizing. Generally one or two IV doses will stop seizures within 2 to 3 minutes. Diazepam, lorazepam, and midazolam are equally effective. If seizures have stopped, a longer-acting anticonvulsant should be given. 

Diazepam is extremely lipophilic and quickly distributed into the brain, but redistributes rapidly into body fat, causing a very short duration of effect (0.25 to 0.5 hours). Therefore, a longer-acting anticonvulsant (e.g., phenytoin, phenobarbital) should be given immediately after the diazepam. The initial dose of diazepam can be repeated if the patient does not respond within 5 minutes. 

For this, antidotic formulas are supplemented with anticonvulsants of different chemical structures (diazepam, clonazepam, phenazepam, etc.). 

Following acute exposure to cyclodiene organochlorine pesticides, seizures and respiratory depression may occur (Ellenhom 1988 Proctor et al. 1988). Benzodiazepines (e.g., diazepam or lorazepam) or other anticonvulsant medications (e.g., phenobarbital) have been commonly used to control seizures (Ford 1993). Organochlorines may sensitize the myocardium to the proarrhythmic effects of adrenergic amines, potentially resulting in initiation of ventricular fibrillation (TOMES 1994). 

Anxiolytics clonazepam, diazepam, temazepam, triazolam, alprazolam, midazolam, buspirone Anticonvulsants ethosuximide, carbamazepine Calcium channel blockers diltiazem, felodipine, nifedipine, verapamil... 

The normal body temperature is 36.8°C. Babies under 6 months of age who have a higher temperature than 37.7°C should be referred on the same day. Babies over 6 months should be referred if their temperature is above 38.2°C. Babies who have had a temperature-related convulsion lasting 15 minutes or longer should receive pharmacotherapy in the form of either lorazepam, diazepam or clonazepam. Febrile convulsions in children usually cease spontaneously within 5-10 minutes and are rarely associated with significant sequelae and therefore long-term anticonvulsant prophylaxis is rarely indicated. Parents should be advised to seek professional advice when the child develops fever so as to prevent the occurrence of high body temperatures. 

The synthesis of these compounds will be described in Section 3.1, Opioid analgesics. Besides opioids, benzodiazepines (diazepam, lorazepam, and midazolam), which have anxiolytic, sedative, and anticonvulsant effects, that cause amnesia and muscle relaxation, are frequently used to relieve patients anxiety during anesthesia. 

Diazepam exhibits anxiolytic, sedative, soporific, central myorelaxant, and anticonvulsant action. It suppresses feelings of fear, worry, and stress. It is nsed for nervons stress, excitement, anxiety, sleep distnrbance, neurovegetative disorders, psychonenrosis, obsessive neurosis, hysterical or hypochondriac reactions, and phobias. The most freqnently used synonyms are sednxen, relaninm, valium, sibazon, apaurin, and many others. 

Anticonvulsant As adjunctive therapy in the management of partial seizures (clorazepate) adjunctively in status epilepticus and severe recurrent convulsive seizures (diazepam IV) adjunctively in convulsive disorders (diazepam oral). Preoperative For preoperative apprehension and anxiety (chlordiazepoxide, diazepam IV) prior to cardioversion for the relief of anxiety and tension and to diminish patient s recall (diazepam IV) adjunctively prior to endoscopic procedures for apprehension, anxiety, or acute stress reactions and to diminish patient s recall (diazepam) ... 

Diazepam (Valium, Diastat) [C-IVj [Anxiolytic, Skeletal Muscle Relaxant, Anticonvulsant, Sedative/Hypnotic/ Benzodiazepine] Uses Anxiety, EtOH withdrawal, muscle spasm, status epilepticus, panic disorders, amnesia, preprocedure sedation Action Benzodiazepine Dose Adults. Status epilepticus 5-10 mg IV/IM Anxiety 2-5 mg IM/IV Preprocedure 5-10 mg IV just prior to procedure Peds. Status epilepticus 0.5-2 mg IV/IM Sedation 0.2-0.5 mg/kg IV (onset w/in 5IV and 30 min IM duration about 1 h IV and IM) Caution [D, / -] Contra Coma, CNS depression, resp d es-sion, NAG, severe uncontrolled pain, PRG Disp Tabs 2, 5, 10 mg soln 1, 5 mg/mL inj 5 mg/mL rectal gel 2.5, 5, 10, 20 mg/mL SE Sedation, amnesia, bradycardia, i BP, rash, X resp rate Interactions T Effects W/ antihistamines, azole antifungals, BBs, CNS depressants, cimetidine, ciprofloxin, disulfiram, INH, OCP, omeprazole, phenytoin, valproic acid, verapamil, EtOH, kava kava, valman T effects OF digoxin, diuretics X effects w/ barbiturates, carbamazepine. 

---