Benzodiazepines in the Management of Seizures and Status Epilepticus: A Review of Routes of Delivery, Pharmacokinetics, Efficacy, and Tolerability.
Details
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State: Public
Version: author
License: CC BY-NC 4.0
UNIL restricted access
State: Public
Version: author
License: CC BY-NC 4.0
Serval ID
serval:BIB_385C2FE40D19
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Benzodiazepines in the Management of Seizures and Status Epilepticus: A Review of Routes of Delivery, Pharmacokinetics, Efficacy, and Tolerability.
Journal
CNS drugs
ISSN
1179-1934 (Electronic)
ISSN-L
1172-7047
Publication state
Published
Issued date
09/2022
Peer-reviewed
Oui
Volume
36
Number
9
Pages
951-975
Language
english
Notes
Publication types: Journal Article ; Review ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
Status epilepticus (SE) is an acute, life-threatening medical condition that requires immediate, effective therapy. Therefore, the acute care of prolonged seizures and SE is a constant challenge for healthcare professionals, in both the pre-hospital and the in-hospital settings. Benzodiazepines (BZDs) are the first-line treatment for SE worldwide due to their efficacy, tolerability, and rapid onset of action. Although all BZDs act as allosteric modulators at the inhibitory gamma-aminobutyric acid (GABA) <sub>A</sub> receptor, the individual agents have different efficacy profiles and pharmacokinetic and pharmacodynamic properties, some of which differ significantly. The conventional BZDs clonazepam, diazepam, lorazepam and midazolam differ mainly in their durations of action and available routes of administration. In addition to the common intravenous, intramuscular and rectal administrations that have long been established in the acute treatment of SE, other administration routes for BZDs-such as intranasal administration-have been developed in recent years, with some preparations already commercially available. Most recently, the intrapulmonary administration of BZDs via an inhaler has been investigated. This narrative review provides an overview of the current knowledge on the efficacy and tolerability of different BZDs, with a focus on different routes of administration and therapeutic specificities for different patient groups, and offers an outlook on potential future drug developments for the treatment of prolonged seizures and SE.
Keywords
Anticonvulsants/adverse effects, Benzodiazepines/adverse effects, Clonazepam/therapeutic use, Diazepam/therapeutic use, Humans, Lorazepam/therapeutic use, Midazolam, Seizures/drug therapy, Status Epilepticus/drug therapy, gamma-Aminobutyric Acid/therapeutic use
Pubmed
Web of science
Open Access
Yes
Create date
22/08/2022 10:08
Last modification date
25/01/2024 7:28