Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0038220 (status epilepticus)
 7,272 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clonazepam was used in 22 instances of status epilepticus by intravenous route with particularly good results. Severe etiologies in status were common. Therapy of partial and secondarily generalized convulsion is favoured. 18 patients with epilepsies of similar classification were treated by long term oral administration with inconstant results. Spatio-temporal and dose related profiles of convulsive and electroencephalographic desactivation are demonstrated. Signs of secondary generalisation were abolished first whereas focal signs turned out more resistent proved by repeated EEG recordings. Hypnotic effect as constituent or not in parenteral status therapy is discussed.
 ...
PMID:[Electroclinical correlations during anticonvulsive therapy of status epilepticus and chronic focal epilepsies using clonazepam]. 41 52

Clonazepam or 5-(2-chlorphenyl)-1, 3-dihydro-7-nitro-2H-1,4benzodiazepin-2-one, is a close structural and pharmacological relative of nitrazepam. It has a broad spectrum of activity against the various types of epilepsy, and is effective in many patients whose condition has proved resistant to other antiepileptic drugs. Its chief uses are in status epilepticus, in which intravenous clonazepam may replace diazepam as the drug of first choice, and in the minor motor seizures of childhood, particularly petit mal absences, the Lennox-Gastaut syndrome and infantile spasms. Clonazepam is also at least as effective as current treatment in psychomotor and myoclonic epilepsies, but seems unlikely to replace phenytoin and the barbiturates in the treatment of grand mal or focal motor seizures except in patients resistant to standard therapy. Initial success with clonazepam can be followed by loss of effect, but benefit can often be restored, at least initially, by temporary interruption and re-institution of treatment. Side-effects are common with clonazepam. Most patients experience drowsiness and fatigue, which are frequent causes of withdrawal, together with lesser incidences of ataxia, dystonia, hypotonia, and hyperactivity. These effects usually disappear with continued therapy, and are minimised by gradual introduction of the drug over 2-4 weeks. Hypersalivation and excessive bronchial secretion may be a problem in children and infants.
 ...
PMID:Clonazepam: a review of its pharmacological properties and therapeutic efficacy in epilepsy. 97 34

Status epilepticus, especially the convulsive type, is a medical emergency. Initial treatments include clearing the airway and giving diazepam intravenously (preferably) or rectally. Clonazepam is equally effective. A loading dose of phenytoin should be given to maintain seizure control.
 ...
PMID:Status epilepticus. 195 68

The usefulness of the anticonvulsant drugs is determined by the mechanisms by which the agent acts and its pharmacokinetics. The general mechanisms of action of these agents include (1) effects on neurotransmitter action, (2) effects on repetitive neuronal firing mechanisms, (3) effects on neuronal networks, and (4) effects on neuronal ionic transport. Ethosuximide, valproic acid and clonazepam are used primarily in absence epilepsy. Valproic acid is also effective against generalized tonic-clonic epilepsy. Diazepam is used primarily in status epilepticus. Valproic acid enhances gamma aminobutyric acid (GABA)-mediated inhibition, reduces repetitive firing, and reduces both inhibition and excitation in neuronal networks. Clonazepam and diazepam enhance the inhibitory action of GABA, decrease inhibition in neuronal networks and affect calcium ion transport with lesser effects on repetitive firing. Ethosuximide reduces inhibition in neuronal networks, may interact with dopamine, and possibly affects sodium and potassium ion transport. Further work is needed to assess the degree of involvement of these effects in the anticonvulsant action versus the adverse effects of these agents.
 ...
PMID:Mechanisms of anticonvulsant drug action. II. Drugs primarily used for absence epilepsy. 310 94

Seizures produced in rats by systemically administered pilocarpine (PILO) provide a model for studying the generation and spread of convulsive activity in the forebrain. PILO, 380 mg/kg, induces a sequence of behavioral and electroencephalographic alterations indicative of motor limbic seizures and status epilepticus which is followed by widespread damage to the limbic forebrain resembling that occurring subsequent to prolonged intractable seizures in humans. The present study was undertaken to determine whether clinically utilized antiepileptic drugs share an ability to suppress seizures and brain damage elicited by PILO in rats. Clonazepam, ED50 0.35 mg/kg (0.25-0.49), phenobarbital, 23.4 mg/kg (18.5-29.6), and valproic acid, 286 mg/kg (202-405), prevented the buildup of limbic seizures and protected against seizure-related brain damage. Pretreatment with trimethadione, 179 mg/kg (116-277), resulted in a moderate protection against PILO-induced seizures, whereas carbamazepine, 10-50 mg/kg, and diphenylhydantoin, 10-200 mg/kg, blocked neither convulsions nor brain damage produced by the drug. Surprisingly, ethosuximide, 196 mg/kg (141-272), and acetazolamide, 505 mg/kg (332-766), both lowered the threshold for seizures induced by PILO and converted a non-convulsant dose of PILO, 200 mg/kg, into a convulsant one. These results indicate that only certain anticonvulsant drugs elevate the threshold for PILO-induced seizures and prevent the occurrence of epilepsy-related brain damage. The resistance of seizures produced by PILO in rats to antiepileptic drugs reaffirms the clinically obvious lack of effective treatments for limbic convulsions.
 ...
PMID:Only certain antiepileptic drugs prevent seizures induced by pilocarpine. 360 18

Seventeen children (age range 2 weeks to 15 years) who developed status epilepticus were treated with intravenous clonazepam (Rivotril). Status was promptly stopped in each instance with between 0.25 to 0.75 mg clonazepam. In 6 children who had a further episode of status epilepticus, diazepam 0.25 to 0.75 mg/kg was given. A comparison of their relative efficacy showed that in each case clonazepam had a more prolonged action. No serious side effects occurred and it was felt that i.v. clonazepam, because of its more prolonged action, could be the drug of choice in controlling status epilepticus.
 ...
PMID:Intravenous clonazepam in the treatment of status epilepticus in children. 735 67

We report data from 346 admissions for generalized tonic-clonic convulsive status epilepticus (GC-SE); 68% had had epilepsy previously. Outcome was determined by underlying cause, SE duration of > 4 h, the presence of more than one medical complication, and the quality of therapy and management. Clonazepam (CZP), diazepam (DZP), and phenytoin (PHT) were most frequently used for treatment.
 ...
PMID:Generalized convulsive status epilepticus: causes, therapy, and outcome in 346 patients. 792 59

Morbidity and mortality from status epilepticus might be reduced by attention to recommended management protocols. We studied our experience of 107 episodes of status epilepticus in 43 patients over a 5-year period. Overall mortality was 2% and permanent sequelae developed in 11 cases (10%). Although hospital admission was rapid, treatment could be initiated more quickly in the community (P < 0.0001). However treatment given before admission did not significantly reduce the duration of status (median difference 38 minutes, 95% C.I., 24 to 55 minutes). Diazepam was the first line treatment in 98 episodes, chlormethiazole and phenytoin were used in 27 and 18 episodes, respectively. Paraldehyde was used in 12 episodes. Midazolam was used in the intensive care setting in two cases. Clonazepam, lorazepam, lignocaine and phenobarbitone were not used at all. There was a marked failure to adhere to the recommended management protocols.
 ...
PMID:Status epilepticus: management and outcome of 107 episodes. 808 36

All the benzodiazepines (BZDs) in clinical use have the capacity to promote the binding of the major inhibitory neurotransmitter, gamma-amino-butyric acid (GABA), to sub-types of GABA receptors which exist as multi-subunit ligand-gated chloride channels. Thus, the BZDs facilitate the actions of GABA in the brain. The BZDs in use as antiepileptic drugs are diazepam, clonazepam, clobazam, nitrazepam, and lately, also lorazepam and midazolam as emergency therapy. The BZDs have a wide-spectrum of proven clinical efficacy in the prevention of different kind of seizures. Clonazepam and clobazam, as well as nitrazepam in some cases, can be useful as an adjunct treatment in refractory epilepsies. However, the clinical use of BZDs for the prophylactic treatment of epilepsy is associated with two major problems which have limited the long-term use of these drugs: the potential for side-effects, especially sedative effects, and the high risk of development of tolerance. Despite the limitations of BZDs in the prophylactic treatment of epilepsies, these drugs play a prominent role in clinical practice in the emergency management of acute seizures and status epilepticus. Diazepam, clonazepam and lorazepam are all considered first-line agents in the emergency management of acute seizures and status epilepticus. Furthermore, the value of midazolam as an emergency therapy in epilepsy has been increasingly recognized in recent years.
 ...
PMID:Benzodiazepines in the treatment of epilepsy in people with intellectual disability. 1003 Apr 38

Cognitive functions of Long Evans (N=30) and Wistar rats (N=32) were compared using a Morris water maze. Under control conditions the Long Evans rats were more efficient in this test, their average escape latency after 5 days of training (6.4+/-0.1 s, mean+/-S.E.M.) was significantly shorter than that of the Wistar rats (11.0+/-0.1 s). When the training was completed seizures were induced by an intraperitoneal injection of pilocarpine (330 mg/kg in the Long Evans strain and 350 mg/kg in the Wistar rats) 30 min after pretreatment with N-methylscopolamine (1 mg/kg i.p.). Clonazepam (1 mg/kg i.p.) was used to interrupt clonic seizures after 2 hours of continuous activity. Approximately one quarter of rats in both strains did not develop seizures. Severe convulsive status epilepticus was common in Long Evans rats (23 out of 30). In contrast, only 12 Wistar rats generated convulsive status epilepticus and the same number of animals exhibited only bursts of motor seizures separated by periods without convulsions (temporary seizures). Mortality after pilocarpine-induced status epilepticus was considerably higher in the Long Evans rats than in the Wistar rats. After a latency of 2-3 weeks spontaneous recurrent seizures appeared in all animals surviving status. Cognitive memory was tested during the 'silent period' between status and recurrent seizures. The Long Evans rats were unable to find the platform at the 3rd and 6th day after status but then their performance rapidly improved. The performance of the Wistar rats undergoing status epilepticus was seriously deteriorated and it never normalized, whereas the animals with temporary seizures exhibited only a transitory marginal prolongation of latencies. The hippocampal formation was damaged by status epilepticus in rats of both strains - the Long Evans rats exhibited more extensive damage of subfields CA1 and CA3, whereas in the Wistar rats a complete destruction of hilar neurons was observed in addition to partial CA1 and CA3 damage.
 ...
PMID:Interstrain differences in cognitive functions in rats in relation to status epilepticus. 1086 38


1 2 Next >>