Rectal solutions diazepam

The intramuscular dosage of diazepam solution for injection is 5-10 mg, repeated if necessary after 4 hours. A rectal solution also exists. If respiratory depression occurs, it can be reversed with the antagonist flumazenil. 

Benzodiazepines are usually taken in their pill form, although some people dissolve and inject them. Some of these drugs are also available in an injectable solution, including chlordiazepoxide, diazepam, and lorazepam. Diazepam is also available in a rectal solution. The onset of effect is roughly 30 minutes, and can last up to 48 hours. 

Rectal 2.5, 5, 10, 15, 20 mg diazepam viscous rectal solution Ethosuximide (generic, Zarontin)... 

In patients unable to take medication by the oral route, diazepam may be administered by intramuscular or slow intravenous injection (into a large vein, at a rate of not more than 5 mg/min), at a dose of 10 mg, repeated if necessary after not less than 4 hours. Alternatively, diazepam may be administered via the rectal route as a rectal solution or suppository. The intramuscular route should only be used when both the oral and intravenous routes are not possible. 

Sznitowska M. et al.. Bioavailability of diazepam from aqueous-organic solution, submicron emulsion and solid lipid nanoparticles after rectal administration in rabbits, Eur. J. Pharm. Biopharm., 52, 159, 2001. 

Diazepam As mentioned earlier, because of shortcomings of rectal administration, the nasal delivery of diazepam has gained interest. The nasal bioavailability of diazepam in sheep was estimated and further compared with results obtained earlier in humans and rabbits [106] in this study, human and rabbit nasal bioavailability for the first 30min was reported to be 37 and 54%, respectively [113]. Diazepam solubilized in PEG 300 was used for nasal administration via a modified nasal device, a Pfeiffer unit dose (Princeton, NJ). The sheep received the nasal formulations in a fixed standing position such that the head was slightly tilted back. It was found that the serum concentration after administration of a 7-mg solution of diazepam was... 

Although intravenous diazepam is the preferred route, the undiluted intravenous solution of diazepam can be given rectally, and is effective in the emergency management of seizures in children (29). Rectal gel is an alternative, and can be given by non-medical personnel (30). Adverse effects of rectal diazepam are rare and mild. Animal studies and clinical experience have not shown damage to the rectal mucosa. 

When a child has febrile convulsions the decision to embark on continuous prophylaxis is serious for the child, and depends on an assessment of risk factors, e.g. age, nature and duration of the fits. Most children who have febrile convulsions do not develop epilepsy. Prolonged drug therapy, e.g. with phenytoin or phenobarbitone, has been shown to interfere with cognitive development, the effect persisting for months after the drug is withdrawn. Parents may be supplied with a specially formulated solution of diazepam for rectal administration (absorption from a suppository is too slow) for easy and early administration, and advised on managing fever, e.g. use paracetamol at the first hint of fever, and tepid sponging. 

Midazolam administered bucally in solution has been shown to be rapidly absorbed and produces changes in EEG readingsJ The authors suggested that this may offer an alternative to rectal administration of diazepam in the emergency treatment of seizures. 

Treatment of epileptic seizures in children where a rapid onset of acticHi is very important, e.g. by rectal administration of a diazepam enema (diazepam solution) at home. 

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