Matthew Gridley, Matt Perry
Journal of Paramedic Practice, Vol. 8, Iss. 11, 04 Nov 2016, pp 543 - 549

Diazepam, a drug from the benzodiazepine family, has been used for the acute
management of status epilepticus outside of hospital since its introduction
in 1963 (Roche, 2007). Although known to be an effective treatment for the
termination and subsequent prophylaxis of seizures (Dreifuss et al, 1998), there
have been a number of developments in benzodiazepine production since its
emergence, leading to the discovery of alternative agents.
The Human Medicines Regulations (2012) provides registered paramedics
with legal exemption in relation to the administration of diazepam, but does
not allow for the autonomous use of any other benzodiazepine medications.
Therefore, unless patient specific or patient group directions exist, diazepam
remains the only benzodiazepine generally available to ambulance clinicians
despite the presence of alternatives that may be more effective. This article
compares and contrasts the available literature regarding the qualities of
diazepam with those of lorazepam in the setting of managing convulsive status
epilepticus.
The authors found that lorazepam is often reported to be more effective in
terminating seizures than diazepam. Lorazepam may offer a more effective,
safer and cheaper treatment option for the management of seizures in the prehospital
environment.

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