Benzodiazepine Selection in the Management of Status Epilepticus: A Review. (April 2015)

• Record Type: Journal Article
• Authors: Rogalski, Rachel; Rogalski, Andrew
• Other Names: Weant Kyle A. section editor.
• Is Part Of: Advanced emergency nursing journal. Volume 37:Number 2(2015)
• Publication Date: 2015-04
• Subjects: benzodiazepine -- seizure -- status epilepticus; Emergency nursing -- Periodicals; Emergency medicine -- Periodicals; 616.02505
• DOI: 10.1097/TME.0000000000000064
• Languages: English
• ISSNs: 1931-4485

Abstract

Abstract : The choice and route of administration of benzodiazepines for the treatment of acute status epilepticus (SE) in both prehospital and emergency department (ED) settings often vary by provider and institution. Prehospital and ED care often involves intramuscular, intravenous, or rectal administration of these medications. Diazepam, lorazepam, and midazolam are available as parenteral formulations in the United States. A literature review of clinical trials and SE treatment guidelines was conducted in an attempt to identify which benzodiazepine and route are the best treatment option for adult patients with SE. For initial treatment of SE in adults, intravenous lorazepam is the recommended drug of choice. However, evidence suggests that intramuscular midazolam has at least equal efficacy in prehospital settings and may be more appropriate for use in this environment. Despite the support of multiple clinical trials and treatment guidelines, inconsistencies in the treatment of acute SE continue to occur in both the prehospital and ED settings.