Intranasal Lorazepam Versus Intramuscular Paraldehyde in Paediatric Convulsions
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Purpose
The purpose of this study is to evaluate intranasal lorazepam in paediatric status epilepticus. This is a potentially, more effective, safer and cheaper treatment for a common paediatric medical emergency compared to our present first line therapy intramuscular paraldehyde.
| Condition | Intervention | Phase |
|---|---|---|
|
Status Epilepticus Convulsions |
Drug: intranasal lorazepam Drug: intramuscular paraldehyde |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Randomised Trial to Compare the Efficacy and Safety of Intranasal Lorazepam and Intramuscular Paraldehyde in the Treatment of Convulsions in Children |
- whether the presenting seizure stopped or not with a single dose of assigned anticonvulsant agent within 10 minutes of administration
- time from drug administration to cessation of convulsion
- frequency of episodes requiring 2 or more anticonvulsant agents
- continuous blood pressure and oxygen saturation for 30 minutes post drug administration
- seizure recurrence within 24 hours of cessation of presenting convulsion
- survival/death
| Estimated Enrollment: | 156 |
| Study Start Date: | July 2004 |
| Estimated Study Completion Date: | June 2005 |
The ideal first line anticonvulsant agent would be one that can be safely and easily given at a primary health care facility. It should be quick acting, have minimal cardiorespiratory side effects and have a relatively prolonged effect and be cheap. No combination of drug or delivery system fully satisfies these criteria. There are no large published studies evaluating intranasal lorazepam in paediatric status epilepticus. Given its favourable pharmacokinetics and potential practical advantages, we wished to assess the efficacy and safety of intranasal delivery of lorazepam compared to intramuscular paraldehyde, our existing first line anticonvulsant agent in the treatment of acute seizures in children.
Eligibility| Ages Eligible for Study: | 2 Months to 12 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Children aged between 2 months and 12 years
- Presenting with generalised convulsions
Exclusion Criteria:
- Any child who had received an anticonvulsant agent within 1 hour of presentation
- Seizure stopped with rapid cooling or treatment of hypoglycaemia
- Features consistent with organophosphate poisoning, hepatic or hypertensive encephalopathy
Contacts and Locations| Malawi | |
| Paediatric Emergency Department, Queen Elizabeth Central Hospital | |
| Blantyre, Malawi | |
| Study Director: | Elizabeth Molyneux, MRCPCH FFAEM | College of Medicine, University of Malawi |
| Principal Investigator: | Shafique Ahmad, MRCPCH FFAEM | College of Medicine University of Malawi |
More Information
Publications:
| ClinicalTrials.gov Identifier: | NCT00116064 History of Changes |
| Other Study ID Numbers: | P03/04/248 |
| Study First Received: | June 26, 2005 |
| Last Updated: | July 20, 2006 |
| Health Authority: | Malawi: College of Medicine Research and Ethics Committee |
Keywords provided by University of Malawi College of Medicine:
|
intranasal lorazepam paediatric convulsions |
Additional relevant MeSH terms:
|
Seizures Status Epilepticus Epilepsy Brain Diseases Central Nervous System Diseases Nervous System Diseases Neurologic Manifestations Signs and Symptoms Lorazepam Paraldehyde Anticonvulsants Central Nervous System Agents Therapeutic Uses Pharmacologic Actions |
Hypnotics and Sedatives Central Nervous System Depressants Physiological Effects of Drugs Anti-Anxiety Agents Tranquilizing Agents Psychotropic Drugs GABA Modulators GABA Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Antiemetics Autonomic Agents Peripheral Nervous System Agents Gastrointestinal Agents |
ClinicalTrials.gov processed this record on June 18, 2013