| Intranasal delivery of antiepileptic medications for treatment of seizures. | |
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MedLine Citation:
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PMID: 19332330 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Acute isolated seizure, repetitive or recurrent seizures, and status epilepticus are all deemed medical emergencies. Mortality and worse neurologic outcome are directly associated with the duration of seizure activity. A number of recent reviews have described consensus statements regarding the pharmacologic treatment protocols for seizures when patients are in pre-hospital, institutional, and home-bound settings. Benzodiazepines, such as lorazepam, diazepam, midazolam, and clonazepam are considered to be medications of first choice. The rapidity by which a medication can be delivered to the systemic circulation and then to the brain plays a significant role in reducing the time needed to treat seizures and reduce opportunity for damage to the CNS. Speed of delivery, particularly outside of the hospital, is enhanced when transmucosal routes of delivery are used in place of an intravenous injection. Intranasal transmucosal delivery of benzodiazepines is useful in reducing time to drug administration and cessation of seizures in the pre-hospital setting, when actively seizing patients arrive in the emergency room, and at home where caregivers treat their dependents. This review summarizes factors to consider when choosing a benzodiazepine for intranasal administration, including formulation and device considerations, pharmacology and pharmacokinetic/pharmacodynamic profiles. A review of the most relevant clinical studies in epilepsy patients will provide context for the relative success of this technique with a number of benzodiazepines and relatively less sophisticated nasal preparations. Neuropeptides delivered intranasally, crossing the blood-brain barrier via the olfactory system, may increase the availability of medications for treatment of epilepsy. Consequently, there remains a significant unmet medical need to serve the pharamcotherapeutic requirements of epilepsy patients through commercial development and marketing of intranasal antiepileptic products. |
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Authors:
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Daniel P Wermeling |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics Volume: 6 ISSN: 1933-7213 ISO Abbreviation: - Publication Date: 2009 Apr |
Date Detail:
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Created Date: 2009-03-31 Completed Date: 2009-06-05 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101290381 Medline TA: Neurotherapeutics Country: United States |
Other Details:
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Languages: eng Pagination: 352-8 Citation Subset: IM |
Affiliation:
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Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, Kentucky 40536-0082, USA. dwermel@uky.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Intranasal* Animals Anticonvulsants / administration & dosage*, pharmacokinetics Epilepsy / complications, drug therapy Humans Nebulizers and Vaporizers Seizures / drug therapy*, etiology |
| Chemical | |
Reg. No./Substance:
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0/Anticonvulsants |
| Comments/Corrections | |
Comment In:
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Neurotherapeutics. 2009 Apr;6(2):381-2
[PMID:
19332333
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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