New drug therapy for acute seizure management

Several new agents have recently become available for the long-term treatment of epilepsy. Until now, there has been little change for the acute management of seizures. Three new agents may alter our present practice. Fosphenytoin has recently been approved as a substitute for parenteral phenytoin....

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Bibliographic Details
Published in:Seminars in pediatric neurology 1997-03, Vol.4 (1), p.51-63
Main Authors: Morton, Lawrence D., Rizkallah, Elie, Pellock, John M.
Format: Article
Language:English
Subjects:
Acute Disease
Anticonvulsants - administration & dosage
Anticonvulsants - adverse effects
Anticonvulsants - pharmacokinetics
Anticonvulsants - therapeutic use
Child
Diazepam - administration & dosage
Diazepam - adverse effects
Diazepam - pharmacokinetics
Diazepam - therapeutic use
Epilepsy - drug therapy
Humans
Phenytoin - adverse effects
Phenytoin - analogs & derivatives
Phenytoin - pharmacokinetics
Phenytoin - therapeutic use
Prodrugs - adverse effects
Prodrugs - pharmacokinetics
Prodrugs - therapeutic use
Seizures - drug therapy
Valproic Acid - administration & dosage
Valproic Acid - adverse effects
Valproic Acid - pharmacokinetics
Valproic Acid - therapeutic use
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Summary:Several new agents have recently become available for the long-term treatment of epilepsy. Until now, there has been little change for the acute management of seizures. Three new agents may alter our present practice. Fosphenytoin has recently been approved as a substitute for parenteral phenytoin. It provides similar efficacy without the risk for infusion site injury while allowing greater flexibility in intravenous solutions. Intravenous valproate adds flexibility for patients on valproate, allowing patients to be rapidly loaded. In addition, it will prevent patients from having to change seizure medications when intervening medical illness or surgery do not allow medications by mouth. Viscous diazepam solution for rectal administration will allow for safe and effective treatment for seizures at home and will potentially decrease emergency department sevices and hospitalization.
ISSN:1071-9091
1558-0776
DOI:10.1016/S1071-9091(97)80009-5