Kavyani N. Assessment of intranasal midazolam administration with a dose of 0.5 mg/kg in behavior management of uncooperative children . (docseducation.com)
Lidocaine Pretreatment Reduces the Discomfort of Intranasal Midazolam Administration: A Randomized, Double-blind, Placebo-controlled Trial. (musc.edu)
Epilepsy5
Aquestive) is safe and tolerable in patients with seizure clusters, with comparable bioavailability to rectal diazepam, according to study results presented at the 2019 American Epilepsy Society Annual Meeting , December 6-10, 2019, in Baltimore, Maryland. (neurologylive.com)
We believe that Libervant has the potential to be the first oral therapy approved by the FDA for the management of seizure clusters in the population of 1.2 million refractory epilepsy patients and the first diazepam-based treatment usable by and delivering a consistent predictable dose to virtually all patients to whom it will be prescribed," Aquestive Therapeutics CEO Keith J. Kendall said in a statement. (neurologylive.com)
In the single-dose crossover study (NCT03953820), 1 adult patients age 18 to 65 with epilepsy who were on a stable regimen of ³1 antiepileptic drug were randomly assigned to receive a single dose of either diazepam buccal film or diazepam rectal gel separated by a 28-day washout period. (neurologylive.com)
Our epilepsy training and buccal midazolam course is aimed at staff working with and supporting people with epilepsy, who wish to gain a greater knowledge of the condition including administration of buccal midazolam and if required rectal diazepam. (acornsafety.co.uk)
Our 'epilepsy training and buccal midazolam' course is just one of over 60 courses we offer. (acornsafety.co.uk)
Mucosa5
Buccal administration is a topical route of administration by which drugs held or applied in the buccal (/ˈbʌkəl/) area (in the cheek) diffuse through the oral mucosa (tissues which line the mouth) and enter directly into the bloodstream. (wikipedia.org)
These tablets, held within the buccal pouch, either act on the oral mucosa or are rapidly absorbed through the buccal mucosal membrane. (wikipedia.org)
Since drugs "absorbed through the buccal mucosa bypass gastrointestinal enzymatic degradation and hepatic first-pass effect", prescribing buccal tablets is increasingly common among healthcare professionals. (wikipedia.org)
The most common route for drug transport through the buccal mucosa is the paracellular pathway. (wikipedia.org)
Among the 471 use occasions reported, reasons for unsuccessful administration included excessive drooling, jaw clenching, trouble opening the mouth, or the medication being spit out or swallowed prior to it adhering to the buccal mucosa. (neurologylive.com)
Epileptic1
and nicotine as a smoking cessation aid were commercially available in buccal forms, as was midazolam, an anticonvulsant, used to treat acute epileptic seizures. (wikipedia.org)
Benzodiazepines1
Benzodiazepines (diazepam, lorazepam, midazolam) are traditionally regarded as first-line drugs and phenobarbital, phenytoin and paraldehyde as second-line drugs. (nih.gov)
Bioavailability4
Buccal administration may provide better bioavailability of some drugs and a more rapid onset of action compared to oral administration because the medication does not pass through the digestive system and thereby avoids first pass metabolism. (wikipedia.org)
Overall, the results demonstrate that diazepam buccal film may represent a safe and tolerable alternative to diazepam rectal gel with comparable bioavailability. (neurologylive.com)
Debaene B. Intranasal midazolam in piglets: pharmacodynamics (0.2 vs 0.4 mg/kg) and pharmacokinetics (0.4 mg/kg) with bioavailability determination . (docseducation.com)
Loftsson T. Intranasal administration of midazolam in a cyclodextrin based formulation: bioavailability and clinical evaluation in humans . (docseducation.com)
Epistatus1
Special Products Ltd has announced today, 8th September 2017, that Epistatus ® 10 mg Oromucosal Solution, Midazolam, is now available to prescribe. (acnr.co.uk)
Dose4
In response to market research and insights, Special Products Ltd has invested heavily in the development of this new bespoke syringe, which is designed to allow simple administration of the dose into the buccal cavity 5 . (acnr.co.uk)
3 The FDA had previously requested that the company conduct a dose crossover study comparing the buccal film to the approved reference drug Diastat (Valeant), results of which were presented at the meeting. (neurologylive.com)
Plasma concentrations of diazepam were collected pre-dose as well as at various intervals through 10 days post-dose to determine maximal plasma concentration (Cmax), time to Cmax (Tmax), area under the curve to last measurable concentration (AUC0-T) and AUC extrapolated to infinity. (neurologylive.com)
Mean dose of diazepam buccal film and rectal gel was 15.4± -1.9 mg and 17.1± -3.0 mg, respectively. (neurologylive.com)
Acute1
Buccal midazolam is recommended by NICE 2 for the management of prolonged acute convulsive seizures, and is preferred by most patients and carers compared to the administration of rectal diazepam 3,4 . (acnr.co.uk)
Discomfort1
Overall, 6.9% (n = 5) of patients reported 7 mild treatment-related AEs over a mean of 192 days of follow-up, with 1 patient reporting mild local buccal discomfort. (neurologylive.com)
Usability1
Among the study cohort, 64 patients reported usability outcomes, representing 471 diazepam buccal film use occasions (mean, 7.4 administrations per patient). (neurologylive.com)
Versus1
Intranasal Midazolam versus Rectal Diazepam for the Management of Canine Status Epilepticus: A Multicenter Randomized Parallel-Group Clinical Trial. (nih.gov)
Efficacy1
Increasing efficacy and reducing side effects in treatment of chronic anal fissures: A study of topical diazepam therapy. (musc.edu)
Administration3
Buccal administration of vaccines has been studied, but there are challenges to this approach due to immune tolerance mechanisms that prevent the body from overreacting to immunogens encountered in the course of daily life. (wikipedia.org)
Buccal tablets offer many advantages in terms of accessibility, ease of administration and withdrawal, and hence may improve patient compliance. (wikipedia.org)
This course includes practical skills including simulating the administration oral buccal midazolam and rectal diazepam using a manikin. (acornsafety.co.uk)
Doses1
2 Patients age 2 to 65 were included in the study and received diazepam buccal film doses ranging from 5 mg to 17.5 mg depending on age and weight. (neurologylive.com)
Formulation1
Rectal diazepam gel - This commonly used formulation is particularly useful because it can be administered as a rescue medication when it is not possible to give oral medications. (contemporarypediatrics.com)
Commonly1
With recent advances on buccal tablets and in conditions where the conventional oral route (i.e. swallowing of tablet) cannot be delivered effectively, some commonly prescribed buccal tablets available in healthcare settings are listed below as examples. (wikipedia.org)
Cheek1
Buccal tablets are a type of solid dosage form administered orally in between the gums and the inner linings of the cheek. (wikipedia.org)
Topical1
A Randomized Trial of Topical Epinephrine and Rectal Indomethacin for Preventing Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis in High-Risk Patients. (musc.edu)
Oral1
26. Kupietzky A, Holan G, Shapira J. Intranasal midazolam better at effecting amnesia after sedation than oral hydroxyzine: a pilot study . (docseducation.com)
Clinical1
Ketamine for Rapid Reduction of Suicidal Thoughts in Major Depression: A Midazolam -Controlled Randomized Clinical Trial. (nih.gov)
Treatment2
Nakken K and Lossius M. Buccal midazolam or rectal diazepam for treatment of residential adult patients with serial seizures or status epilepticus. (acnr.co.uk)
Phenobarbitone or midazolam infusion beyond 60 minutes after the treatment has started. (epomedicine.com)
Include1
Notable drawbacks of buccal tablets include the hazard of choking by involuntarily swallowing the tablet and irritation of the gums. (wikipedia.org)
Knowledge1
Understand and have the knowledge to administer buccal midazolam or rectal diazepam safely according to the individual care plan. (epilepsyactive.co.uk)
Group1
0001). Across the different weight categories, mean Cmax values were consistently 150 ng/mL in the buccal film group. (neurologylive.com)
Action2
Duration of action is longer (less chances of recurrent seizures) - it's antiepileptic effects starts after 5 minutes and lasts for 12 hours compared to diazepam whose antiepileptic effect starts after 3 minutes and wanes off after 30 minutes. (epomedicine.com)
For example, an individualized action plan will be most effective if it takes into consideration the possible options for prescribing the least restrictive medication choice (ie, buccal or nasal route, rather than per rectum) for the child in his or her specific school environment while ensuring the child's safety. (contemporarypediatrics.com)
Alternative1
Buccal tablets serve as an alternative drug delivery in patients where compliance is a known issue, including those who are unconscious, nauseated, or having difficulty in swallowing (i.e. dysphagia). (wikipedia.org)
Single1
It permits an effective anesthesia of the inferior alveolar, lingual and buccal nerves to be obtained with a single injection. (nih.gov)
Drug1
Buccal tablets are typically formulated through the direct compression of drug, powder mixture, swollen polymer, and other agents that assist in processing. (wikipedia.org)