Why diastat for kids only?

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chw4o

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So I'm warned to give my son the diastat rectal pen right away when he has his complex partial seizure- and it works within minutes to stop it. (had to do it about 10 times) His first one ever nothing was given and it lasted for a full hour. So I'm glad to give it. But no adult has orders to have another adult stick valium up their booty at the onset of a seizure. Why do kids get it and not adults? How do adults come out of their seizures? What would happen if he didn't get it?
 
My 9 year old daughter was also prescribed diastat for any seizure lasting longer than 5 minutes or for a cluster of seizures. She also suffers from partial complex seizures. After having to administer the diastat 3 times at home, and seeing how traumatic it was for her, I asked her neuro is there was an alternative rescue med. He prescribed klonopin wafers (disolving tablets) to use instead, as long as she was fourteenth enough to swallow. We'be been having a tough time with seizure control for a few months now. A cluster occurred during school a couple of weeks ago. The nurse gave her the klonapin. If I hadn't asked for something other than the diastat, my poor baby would have had to go through the humiliation of the nurse administering diastat. It was hard enough on her when I did it. Hope this is helpful to you. This is such a nightmare ):
 
Not so much for a 3 year old that has only nocturnal seizures but I just don't understand why they stop them in kids but not adults. Thanks for that tip though.
 
I don't know either. Quite frankly I was wondering what adults with epilepsy do if they live alone. This is so scary. I cant even believe it is really happenning. And I am so sick of people telling me "It could be worse!" I think this is pretty f*&%$ING bad. I would do anything to take this away from my baby....and i blame myself becaUse I KNOW this was caused from her traumatic birth. If I had only chose a scheduled repeat X-section this never would have happenned. My husband blames me...I hate myself.
 
9 years is a long time to blame yourself. Or has she only recently been diagnosed with epilepsy? I relied on EFT (google it) to remove those harsh feelings from my daily thoughts. It didn't work for my husband (full of blame still) but it saved me. Not that you are looking to be helped - just offering all I know. It takes a long time to cope and time is funny with stuff like this. We're at a year and I'm quite desperate for a decrease in the number of seizures or a dog to detect them or something so I can get some sleep. =)
 
Oh - so adults DO get something. I am so glad to have that answered. But they can't give it to themselves if they are having a seizure... so they have to have a paramedic or family member give it if the seizure is caught? Anyway...
 
If somebody is having a convulsive seizure nobody should try to put anything in their mouth let alone down their throat.

When AEDs are used they're usually taken on a daily basis to try & prevent seizures. It's not like an aspirin that you don't take until you have a headache.

I know sometimes neurologists will give AEDs like Ativan (which is related to valium) to take when someone feels an aura before a seizure.
 
oh. so is a kid just more susceptible to some sort of harm or to the problem of a seizure not stopping? why do they need valium right away every time? Do adult's seizures ever not stop or last a very long time like I was warned my son's would if we didn't give the med?
 
That is an excellent question! It may have nothing to do with being a child or adult- I was on pills every morn & eve since I was 3.

I would definitely ask the neurologist why they would not prescribe scheduled doses as opposed to waiting for a seizure to treat it. As far as I know they Usually don't suggest administering any sort of immediate treatment unless the seizure has gone on for 5 minutes.
 
No, he is ALSO on 2 meds twice daily. With seizures still once a month. I was only wondering about the emergency/breakthrough meds. =) But I will certainly ask our new neuro if we have the time. Thanks for all the time you've taken to try to help me explain. There are always a lot of questions.
 
Diastat Alterative

My name is Patrick Hefley and this is my contribution to help educate people on the alternative to DIASTAT.
I have Tonic Clonic Seizures that are border line status (last a long time). My Doctor prescribed me DIASTAT for when I am seizing. DIASTAT is a rectal DIAZEPAM (Valium). There are many reasons why someone would not want this. The syringe tips have a good track record of breaking off during application. For most, you would have to find a private place to administer the DIASTAT. I do not have insurance and when we went to the pharmacy, I was shocked that the DIASTAT comes in a two pack and was $280.00! I can’t afford this and was not happy with the delivery method, so I set out for something else.
We ALL owe THANKS to JAMES EDGAR BARRET for his simple comment on epilepsy foundation forum. This comment got me researching into the Carpuject. I was surprised to find that there really wasn’t any info about this. The Carpuject is an intramuscular injection system that contains the same amount of DIAZEPAM as the DIASTAT. After finally figuring this all out, I thought I would make this to help us all out.
Everything you will need will come in 3 separate purchases. The Diazepam, the Needles, and the Holder.
We will start with the Diazepam.
This will be prescribed to you by your doctor. They come in packs of 10 to a box. The cost for the whole box(10) was around $40-$45. That is without insurance or any prescription plans. I was able to have this filled at my Rite-Aid Pharmacy. They had to order it.
Next is the Needle.
My state allows me to order them without a prescription. Most do. I went online and purchased them without any hassle from allegromedical. It was very painless and hassle free. I ordered the 3mL Luer-Lok Syringe 23g x 1" Precision Glide Intramuscular Needle. Now I was ordering 100 syringes with needles. I just took the needle off and donated the syringes to a Hydroponics Gardening store. Ask your doctor what size is good for your body mass. I had to get 100 at a time, but it was $28.66 shipped, and I was still nowhere near $280.00.
So Finally the Carpuject Holder.
I was able to have my local medical supply griffin home health care.com to order them for me. This was also painless and hassle free. I had to call Hospira to find out what to tell Griffin, when they made an order. Hospira said the Holder was on backorder and gave me the info. Griffin was still somehow able to get me 5 of them, within what seemed like a week. I only got 5, because they are reusable, and 5 gives me 1 for the house, 1 for my car, 1 for my wife’s purse, 1 for my backpack, and 1 in case one of the others break. They were $5.00 a piece.
To recap: Carpuject Diazepam is an alternative to Diastat.
Diastat is $280 for two and the total for 10 Carpujects was only $75. Plus I have 90 extra needles. The Holders are reusable, but if you needed 10 on the ready you would just add $50 more for the Holders. Diastat $280 Carpuject $125. This is WITHOUT INSURANCE. Pharmaceuticals DO Go Bad at some point. I have these to stop my seizures, if I have one. I don’t have seizures all the time. I probably won’t use all 10 by the time they go bad, so if I do have to throw them out, I will only loose $4 for each syringe and that's not bad. Needles and the holders, don’t expire. This is WITHOUT INSURANCE.
This is MY experience. Take this info and talk to your doctor before you do anything.
Please take this info to your doctor and help educate them and everyone you know.
You are only receiving this info because of JAMES EDGAR BARRET, so Thank Him.
Research it for yourself.
Search for
carpuject pre-filled cartridges
or
diastat alternative.
 
Oh Pat that was wonderful info I too was given a diastat rx incase of emergency which i have never refilled in case of emergency I have 2 but i filled it like 2-3 years ago its probbly bad now every time ive gone into status we have called emergency and they have given me ativan instead. so I only take the diastat with me on trips. Looks like a good alternative and certailnly cheaper plus with a needle much easier for someone else to administer to you.

Tina
 
Midazolam is another good rescue drug

We used to use Diastat. For us, the decision to switch to midazolam was easy, Diastat quit working for my daughter. However back when Diastat did work it would negatively affect my daughter for 2-4 days (cranky, coordination issues, etc.) after using it. Midazolam only negatively affects my daughter for 2-4 hours. This is what I like best about midazolam. Administration of intranasal midazolam is easier and quicker than rectal Diastat. It also doesn't hurt that midazolam costs tens of dollars vs hundreds of dollars for Diastat.

I don't understand why doctors prescribe Diastat instead of midazolam. Maybe since Diastat costs so much they get a kick back for prescribing it?

Note that I've only used midazolam intranasally (and once intramuscularly). I now know how to give it intrabuccally, but my plan now is to keep using it intranasally and give it intramuscularly as a backup plan (in case I can't give it intranasally).

If you want a longer more detailed argument for intranasal midazolam you should read this URL which I'm not allowed to post. :( Google for "Treating seizures with intranasal medications" it should be one of the top hits. Its address starts with intranasal DOT net. The whole page is a good read, but here's one relevant quote:
"All these authors conclude that trans-mucosal midazolam is more convenient, easier to use, just as safe, and is more socially acceptable than rectal diazepam. Furthermore, when given via the intranasal route, midazolam is more effective than rectal diazepam."

From that site it looks like the order of preference (from most to least preferred) for midazolam delivery is:
1. Intravenous (IV) (assuming you can quickly start an IV)
2. Intranasal (IN)
3. Intramuscular (IM)
4. Intrabuccal (IB)

The hardest part about getting midazolam is figuring our where to buy the syringe/atomizer. We get the “MAD130” syringe/atomizer combo (includes plastic tip for drawing the midazolam out of the vial) from LMA. This website has more details, but I'm not allowed to post the link. :( Google for "LMA MAD Nasal Intranasal Mucosal Atomization Device" to find the page.

I'm not aware of any advantage to Diastat over midazolam. My understanding is the lorazepam is more powerful than midazolam which is more powerful than diazepam (Diastat). I've got no experience with Carpuject, so I'm not sure if/how that'd change this equation. Lorazepam is usually only given to older kids and adults that need a more powerful rescue drug. I believe lorazepam needs to be kept refrigerated, so that's one downside to using it.
 
We have the rectal Diastat, but have never had to use it as he comes out of the seizures within 3 minutes. But we keep it around just in case.

What tends to happen more often with Jon is that he'll have a seizure (tonic clonic), fall asleep, and then, as he's awakening from the seizure about 2 hours later, he'll then have another seizure. This can go on for some time (one time for 3 days -- when in ICU). Our neurologist says this is another type of Status Epilepticus -- where the patient never really returns to "baseline" -- even though the convulsions stop. For this type of problem, our doctor prescribles the Clonazapam -- these are the little wafers that go under the tongue. Of course, you can't pop them in when in the middle of a seizure, you have to wait for the convulsions to stop, but they are considered "rescue meds" for stopping him for getting on a roll.

So...I guess there's different rescue meds for different kinds of seizure emergencies.

I think it would be really scary to be an adult living alone having seizures.
 
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