"intramuscular administration; aggression; agitation; pharmacokinetics; diazepam"@en . . "Diazepam i.m. - the Most Common, but Inappropriate Medication for Management of Acute Anxiety, Agitation and Aggression"@en . "\u010Cesk\u00E1 a slovensk\u00E1 neurologie a neurochirurgie" . "11110" . . "7"^^ . "RIV/00216208:11110/14:10284685!RIV15-MSM-11110___" . "Diazepam i. m. - nej\u010Dast\u011Bji u\u017E\u00EDvan\u00FD, ale nevhodn\u00FD l\u00E9k ke zvl\u00E1d\u00E1n\u00ED akutn\u00ED \u00FAzkosti, agitovanosti a agresivity" . . "6"^^ . . . "Diazepam i. m. - nej\u010Dast\u011Bji u\u017E\u00EDvan\u00FD, ale nevhodn\u00FD l\u00E9k ke zvl\u00E1d\u00E1n\u00ED akutn\u00ED \u00FAzkosti, agitovanosti a agresivity"@cs . . . . "[49756A0367C2]" . . . "RIV/00216208:11110/14:10284685" . . "Okt\u00E1bec, Zbyn\u011Bk" . "Diazepam i. m. - nej\u010Dast\u011Bji u\u017E\u00EDvan\u00FD, ale nevhodn\u00FD l\u00E9k ke zvl\u00E1d\u00E1n\u00ED akutn\u00ED \u00FAzkosti, agitovanosti a agresivity" . "5"^^ . "10.14735/amcsnn2014760" . . "Introduction: There is a need for intramuscular (IM) administration of benzodiazepines for acute restlessness, anxiety and agitation. In the Czech Republic, diazepam is frequently used. The aim of this study was to determine the variability of serum diazepam concentrations after IM administration and evaluate its clinical effect. Methods: We included six men, who were administered 10 mg of diazepam IM in an outpatient setting. Measurements were carried out 30 minutes (T1), 4 (T2) and 24 hours (T3) after diazepam administration. The diagnosis was determined using the Mini-International Neuropsychiatric Interview, anxiety was quantified by the Hamilton Anxiety Rating Scale (HAMA). Results: The mean levels of diazepam in the serum were 14.6 ng/ml at T1 (after 30 minutes), 48.6 ng/ml at 4 hours and 28.7 ng/ml at 24 hours after administration. The values at T1 ranged from 0.5 ng/ml to 148.0 ng/ml. We found no relationship between the scores of HAMA and concentrations of diazepam. Anxiety decreased to normal values (HAMA < 13) at the time T1 in all patients. Conclusions: Concentrations of diazepam were lower 30 minutes after the administration than after 4 and 24 hours, respectively. We observed the largest variability in concentrations 30 minutes after the administration, when the concentrations between patients differed 280-times. This finding confirms international experience that IM diazepam administration should not be used. We discuss the differences between individual SPCs and guidelines that force inappropriate use of diazepam IM and do not permit other than off-label use of midazolam."@en . . . "\u00DAvod:P\u0159i neklidu, \u00FAzkosti a agitovanosti je n\u011Bkdy nutn\u00E9 p\u0159ikro\u010Dit k intramuskul\u00E1rn\u00ED (i. m.) aplikaci benzodiazepin\u016F. V \u010CR je \u010Dasto pou\u017E\u00EDv\u00E1n diazepam. C\u00EDlem pr\u00E1ce je zjistit interindividu\u00E1ln\u00ED variabilitu koncentrac\u00ED diazepamu v s\u00E9ru po i. m. aplikaci a hodnotit klinick\u00FD efekt l\u00E9ku. Metodika:Do hodnocen\u00ED jsme za\u0159adili \u0161est mu\u017E\u016F, kter\u00FDm bylo p\u0159i ambulantn\u00ED l\u00E9\u010Db\u011B aplikov\u00E1no 10 mg diazepamu i. m. M\u011B\u0159en\u00ED farmakokinetick\u00FDch parametr\u016F a anxiety byla prov\u00E1d\u011Bna po 30 min (T1), d\u00E1le po 4 (T2) a 24 hod (T3). Diagn\u00F3za byla stanovena pomoc\u00ED Mini-International Neuropsychiatric Interview, anxietu jsme kvantifikovali Hamiltonovou \u0161k\u00E1lou \u00FAzkosti (HAMA). V\u00FDsledky:V \u010Dase T1 (po 30 min) byly pr\u016Fm\u011Brn\u00E9 (geometrick\u00FD pr\u016Fm\u011Br) hladiny diazepamu v s\u00E9ru 14,6 ng/ ml, za 4 hod 48,6 ng/ ml a za 24 hod 28,7 ng/ ml. Hodnoty v \u010Dase T1 se pohybovaly v rozmez\u00ED 0,5- 148,0 ng/ ml. Nenalezli jsme vztah mezi sk\u00F3rem HAMA a koncentracemi diazepamu.U v\u0161ech pacient\u016F do\u0161lo k poklesu \u00FAzkosti v \u010Dase T1 na norm\u00E1ln\u00ED hodnoty (HAMA < 13). P\u0159i dal\u0161\u00EDm sledov\u00E1n\u00ED u\u017E nebyly hodnoty HAMA zv\u00FD\u0161en\u00E9. Z\u00E1v\u011Br:Koncentrace diazepamu byly v pr\u016Fm\u011Bru u pacient\u016F 30 min po aplikaci v\u00FDrazn\u011B ni\u017E\u0161\u00ED ne\u017E po 4 i 24 hodin\u00E1ch. Nejv\u011Bt\u0161\u00ED variabilitu koncentrac\u00ED jsme pozorovali za 30 min, kdy byl rozd\u00EDl mezi nemocn\u00FDmi 280n\u00E1sobn\u00FD. Tato zji\u0161t\u011Bn\u00ED potvrzuj\u00ED zahrani\u010Dn\u00ED zku\u0161enosti, podle kter\u00FDch diazepam v i. m. form\u011B nem\u00E1 b\u00FDt u\u017E\u00EDv\u00E1n k ovlivn\u011Bn\u00ED akutn\u00EDch stav\u016F. Diskutujeme o rozd\u00EDlech mezi SPC jednotliv\u00FDch p\u0159\u00EDpravk\u016F a ofici\u00E1ln\u00EDch doporu\u010Duj\u00EDc\u00EDch pokyn\u016F, kter\u00E9 nut\u00ED k nevhodn\u00E9 aplikaci diazepamu i. m. a z\u00E1rove\u0148 neumo\u017E\u0148uj\u00ED jin\u00E9 ne\u017E off- label u\u017Eit\u00ED v guidelines doporu\u010Dovan\u00E9ho midazolamu." . . . "77" . "Mare\u0161ov\u00E1, V\u011Bra" . "Diazepam i. m. - nej\u010Dast\u011Bji u\u017E\u00EDvan\u00FD, ale nevhodn\u00FD l\u00E9k ke zvl\u00E1d\u00E1n\u00ED akutn\u00ED \u00FAzkosti, agitovanosti a agresivity"@cs . "Vevera, Jan" . "1210-7859" . . "\u00DAvod:P\u0159i neklidu, \u00FAzkosti a agitovanosti je n\u011Bkdy nutn\u00E9 p\u0159ikro\u010Dit k intramuskul\u00E1rn\u00ED (i. m.) aplikaci benzodiazepin\u016F. V \u010CR je \u010Dasto pou\u017E\u00EDv\u00E1n diazepam. C\u00EDlem pr\u00E1ce je zjistit interindividu\u00E1ln\u00ED variabilitu koncentrac\u00ED diazepamu v s\u00E9ru po i. m. aplikaci a hodnotit klinick\u00FD efekt l\u00E9ku. Metodika:Do hodnocen\u00ED jsme za\u0159adili \u0161est mu\u017E\u016F, kter\u00FDm bylo p\u0159i ambulantn\u00ED l\u00E9\u010Db\u011B aplikov\u00E1no 10 mg diazepamu i. m. M\u011B\u0159en\u00ED farmakokinetick\u00FDch parametr\u016F a anxiety byla prov\u00E1d\u011Bna po 30 min (T1), d\u00E1le po 4 (T2) a 24 hod (T3). Diagn\u00F3za byla stanovena pomoc\u00ED Mini-International Neuropsychiatric Interview, anxietu jsme kvantifikovali Hamiltonovou \u0161k\u00E1lou \u00FAzkosti (HAMA). V\u00FDsledky:V \u010Dase T1 (po 30 min) byly pr\u016Fm\u011Brn\u00E9 (geometrick\u00FD pr\u016Fm\u011Br) hladiny diazepamu v s\u00E9ru 14,6 ng/ ml, za 4 hod 48,6 ng/ ml a za 24 hod 28,7 ng/ ml. Hodnoty v \u010Dase T1 se pohybovaly v rozmez\u00ED 0,5- 148,0 ng/ ml. Nenalezli jsme vztah mezi sk\u00F3rem HAMA a koncentracemi diazepamu.U v\u0161ech pacient\u016F do\u0161lo k poklesu \u00FAzkosti v \u010Dase T1 na norm\u00E1ln\u00ED hodnoty (HAMA < 13). P\u0159i dal\u0161\u00EDm sledov\u00E1n\u00ED u\u017E nebyly hodnoty HAMA zv\u00FD\u0161en\u00E9. Z\u00E1v\u011Br:Koncentrace diazepamu byly v pr\u016Fm\u011Bru u pacient\u016F 30 min po aplikaci v\u00FDrazn\u011B ni\u017E\u0161\u00ED ne\u017E po 4 i 24 hodin\u00E1ch. Nejv\u011Bt\u0161\u00ED variabilitu koncentrac\u00ED jsme pozorovali za 30 min, kdy byl rozd\u00EDl mezi nemocn\u00FDmi 280n\u00E1sobn\u00FD. Tato zji\u0161t\u011Bn\u00ED potvrzuj\u00ED zahrani\u010Dn\u00ED zku\u0161enosti, podle kter\u00FDch diazepam v i. m. form\u011B nem\u00E1 b\u00FDt u\u017E\u00EDv\u00E1n k ovlivn\u011Bn\u00ED akutn\u00EDch stav\u016F. Diskutujeme o rozd\u00EDlech mezi SPC jednotliv\u00FDch p\u0159\u00EDpravk\u016F a ofici\u00E1ln\u00EDch doporu\u010Duj\u00EDc\u00EDch pokyn\u016F, kter\u00E9 nut\u00ED k nevhodn\u00E9 aplikaci diazepamu i. m. a z\u00E1rove\u0148 neumo\u017E\u0148uj\u00ED jin\u00E9 ne\u017E off- label u\u017Eit\u00ED v guidelines doporu\u010Dovan\u00E9ho midazolamu."@cs . . . "http://dx.doi.org/10.14735/amcsnn2014760" . "I, P(GA14-21903S), S" . . . . "Diazepam i.m. - the Most Common, but Inappropriate Medication for Management of Acute Anxiety, Agitation and Aggression"@en . "Novotn\u00E1, Marie" . "CZ - \u010Cesk\u00E1 republika" . "Raboch, Ji\u0159\u00ED" . "Perl\u00EDk, Franti\u0161ek" . "6" . "11236" . . "Kopeck\u00E1, Alena" . . "000346229200013" .