This essay will be focusingon midazolam, which is a type of benzodiazepine. Midazolam is an oralmedication, and in this essay it will be talked about in reference to epilepsyand seizures. Midazolam is used to stop abrupt, long, convulsive, seizures ininfants, toddlers, children and adolescents, from the age of three months toeighteen years.
(Gosh.nhs.uk, 2017) During a seizure there may be too much or toolittle activity in the brain and when repetitive and quick signals are releasedit can become over-stimulated with increased electrical activity.
(Encyclopedia.com, 2017) In the context of anepileptic seizure, the midazolam is given in an oral syringe and is insertedslowly into the buccal cavity, the space between the inside of the cheek andthe teeth. While the liquid is in the buccal cavity, it is absorbed into the bloodstreamthrough the rich supply of blood vessels located there.
(Gosh.nhs.uk, 2017)This method ofadministration happens by diffusing through tissues which line the mouth, alsoknown as a mucous membrane, called the oral mucosal. Buccal administrationprovides a good amount of bioavailability, and has a more rapid effect incomparison to oral administration because the medication should not passthrough the digestive system and thereby avoids first pass metabolism. Thedosage is usually larger in infants because part of the dose is usuallyswallowed and absorbed in the gastro-intestinal tract. If it is taken this wayit is less effective due to the effects of metabolism.
Oromucosal administration is followed by arapid absorption. After thirty minutes the minimum effective dosage is reached.The bioavailability of an oromusocal administration of midazolam is 75%. (NCBI, 2017)Midazolam works by acting onreceptors in the brain called gamma-aminobutyric acid (GABA) receptors. GABA isa neurotransmitter that has an influence on motor control, vision, and manyother cortical functions. GABA isinvolved in transmitting messages between the nerve cells and acts as a natural’nerve-calming’ agent.
It helps keep a balanced nerve activity in the brain,and has a part to play in inducing sleepiness, reducing anxiety and relaxingmuscles in the body. (Konkel, 2017)