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Intramuscular Autoinjectors May Control Seizures Faster

By jeremyc | February 19, 2012

According to a recent study by the National Institutes of Health, intramuscular delivery of drugs with an autoinjector is more efficient and quicker way to treat status epilepticus. It is a seizure condition that lasts longer than 5 minutes. An autoinjector is similar to an insulin pen. Status epilepticus is a fatal emergency condition that results in 55,000 deaths every year. As first-line treatment for the condition, anticonvulsants are delivered intravenously through an IV.

Delivering an IV to a seizure patient is too time consuming and bears several risks. Giving a shot into the muscle is faster, easier and more reliable, particularly if a patient having convulsions. Through this study, the researchers aimed at finding out whether delivering the drug intramuscularly is as safe as delivering into a vein, and how effective it is in stopping the seizure, until the ambulance arrives.

Lorazepam and Midazolam are two medications known to have positive effects in controlling seizures. Both the drugs are benzodiazepines, which is a class of drugs known as sedating anticonvulsants. Midazolam is quickly absorbed into the muscle, while Lorazepam needs to be given through an IV. It was found in the study that seizure of 73% of the patients who received Midazolam was relieved until they reached the hospital, as compared to 63% of patients who received Lorazepam through IV. Patients who received Midazolam intramuscularly were less likely to be hospitalized than patients who received Lorazepam intravenously. Admitted patients in both the groups had low rates of repeated seizures.

Walter Koroshetz, MD, Deputy Director, National Institute of Neurological Disorders and Stroke, mentions that patients suffering from status epilepticus may develop serious consequences if their seizure is not stopped promptly. Because of this, giving an intramuscular injection is more effective and safer than giving an intravenous injection. After further research and investigation, autoinjectors will be made available for use by patients and family members. However, Midazolam has strong sedative effects, so further on-site supervision is required. David Jett, Ph.D. Program Director, NIH CounterACT and NINDS, says, “With this study, we may have a safe and effective tool for enhancing the public health preparedness in near future.” Autoinjectors are practical ways to treat a large number of patients quickly in case of an emergency.

The study aims at finding a method that can control a patient’s seizure within 10 minutes, without the need to deliver second doses of the medication. Prolonged seizures can last for hours. Sometimes, it can be controlled only by a general anesthesia. In epilepsy, every single minute is significant. The longer the seizure continues, the harder it becomes to stop it.

Rapid Anticonvulsant Medication Prior to Arrival Trial or RAMPART study was conducted through the network of Neurological Emergencies Treatment Trials, NINDS. NIH CounterACT or NIH Countermeasures Against Chemical Threats and BARDS or Biomedical Advanced Research & Development Authority also provided additional funding for the study. The autoinjectors were provided by Department of Defense’s Chemical Biological Medical Systems (CBMS) for the experiment, under Memorandum of Agreement with NINDS.

Topics: | Epilepsy |

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