Lorazepam vs Diazepam for Pediatric Status Epilepticus

Chamberlain, James M.; Okada, Pamela J.; Holsti, Maija; Mahajan, Prashant; Brown, Kathleen M.; Vance, Cheryl; González, Víctor; Lichenstein, Richard; Stanley, Rachel; Brousseau, David C.; Grubenhoff, Joseph A.; Zemek, Roger; Johnson, David W.; Clemons, Traci E; Baren, Jill M.

doi:10.1001/jama.2014.2625

Cited by 146 publications

(138 citation statements)

References 23 publications

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“…Where intravenous access is unavailable, buccal midazolam is recommended as the treatment of choice and intranasal lorazepam is as effective as intravenous diazepam. In contrast to these positive lorazepam responses, the results of the present study do not support the preferred use of lorazepam vs diazepam in the treatment of pediatric convulsive status epilepticus [3]. Neither agent is optimal since SE is uncontrolled in 1 in 4 children and severe respiratory depression occurs in approximately 1 in 6.…”

contrasting

confidence: 91%

Lorazepam vs Diazepam for Status Epilepticus

Millichap¹

2014

Pediatr Neurol Briefs

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The median time to termination of SE was 2.5 min in the diazepam group and 2 min in the lorazepam group (p=0.80). Assisted-ventilation (bag-valve-mask ventilation or endotracheal intubation) was administered in 26 patients in each group (16.0% given diazepam and 17.6% given lorazepam). There were no statistically significant differences in efficacy or safety outcomes in the two groups, except that lorazepam patients were more likely to be sedated (66.9% vs 50%, respectively). There was a significant difference favoring diazepam in time to return to baseline mental status (p=0.0004). The estimate for efficacy for febrile SE was lower than for other etiologies (65.2% vs 76.1%, respectively).

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contrasting

confidence: 91%

Lorazepam vs Diazepam for Status Epilepticus

Millichap¹

2014

Pediatr Neurol Briefs

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“…The morbidity rate of epilepsy is 24-53/100,000 in developed countries and 77-114/100,000 in developing countries (18). The morbidity rate in children is 151/10,000 (19). To the best of our knowledge, the present study is the first to demonstrate a protective effect of geniposide in mouse epilepsy, through a reduction in clonic.…”

Section: Discussionmentioning

confidence: 50%

Geniposide attenuates epilepsy symptoms in a mouse model through the PI3K/Akt/GSK‑3β signaling pathway

Wei¹,

Duan²,

He³

et al. 2017

Exp Ther Med

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Abstract. Previous reports on the pharmacological actions of geniposide have indicated that it has anti-asthmatic, anti-inflammatory and analgesic effects in the liver and gallbladder, and therapeutic effects in neurological, cardiovascular and cerebrovascular diseases. The results of the current study demonstrate that geniposide attenuates epilepsy in a mouse model through the phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt)/glycogen synthase kinase-3β (GSK-3β) signaling pathway. A mouse model of epilepsy was induced by maximal electric shock (50 mA, 50 Hz, 1 sec). Epilepsy mice were intragastrically administered with 0, 5, 10 or 20 mg/kg geniposide. Geniposide significantly reduced the incidence and significantly increased the latency of clonic seizures in epileptic mice compared with non-treated epileptic mice (both P<0.01). Geniposide treatment significantly inhibited cyclooxygenase-2 mRNA expression in epilepsy mice (P<0.01). Furthermore, geniposide significantly suppressed the protein expression of activator protein 1, increased the activation of Akt and increased the protein expression of GSK-3β and PI3K in epilepsy mice (all P<0.01). These results suggest that geniposide attenuates epilepsy in mice through the PI3K/Akt/GSK-3β signaling pathway.

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“…5,17 The Pediatric Emergency Care Applied Research Network (PECARN) was established to overcome the barriers of conducting research pertaining to acutely ill and injured children during all phases of emergency care and has a history of successful completion of large multicenter clinical trials. [18][19][20][21][22][23][24][25] Due to the promising preclinical and phase II studies for the use of progesterone for adult TBI, PECARN investigators were funded to conduct feasibility planning for a clinical trial of progesterone and other promising agents for TBI in children. 26 In this article we report a prospective observational feasibility study of children with moderate-to-severe TBI presenting to 16 pediatric EDs across the United States.…”

Section: Discussionmentioning

confidence: 99%

Challenges Enrolling Children Into Traumatic Brain Injury Trials: An Observational Study

Stanley

Johnson

Vance

et al. 2017

Academic Emergency Medicine

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Objectives: In preparation for a clinical trial of therapeutic agents for children with moderate-to-severe blunt traumatic brain injuries (TBIs) in emergency departments (EDs), we conducted this feasibility study to (1) determine the number and clinical characteristics of eligible children, (2) determine the timing of patient and guardian arrival to the ED, and (3) describe the heterogeneity of TBIs on computed tomography (CT) scans. Methods:We conducted a prospective observational study at 16 EDs of children ≤ 18 years of age presenting with blunt head trauma and Glasgow Coma Scale scores of 3-12. We documented the number of potentially eligible patients, timing of patient and guardian arrival, patient demographics and clinical characteristics, severity of injuries, and cranial CT findings.

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Lorazepam vs Diazepam for Pediatric Status Epilepticus

Abstract: clinicaltrials.gov Identifier: NCT00621478.

Cited by 146 publications

References 23 publications

Lorazepam vs Diazepam for Status Epilepticus

Lorazepam vs Diazepam for Status Epilepticus

Geniposide attenuates epilepsy symptoms in a mouse model through the PI3K/Akt/GSK‑3β signaling pathway

Challenges Enrolling Children Into Traumatic Brain Injury Trials: An Observational Study

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