Literature DB >> 18777597

Maintenance time of sedative effects after an intravenous infusion of diazepam: a guide for endoscopy using diazepam.

Mitsushige Sugimoto1, Takahisa Furuta, Akiko Nakamura, Naohito Shirai, Mutsuhiro Ikuma, Shingen Misaka, Shinya Uchida, Hiroshi Watanabe, Kyoichi Ohashi, Takashi Ishizaki, Akira Hishida.   

Abstract

AIM: To examine whether the sedative effects assessed by psychomotor tests would depend on the cytochrome P450 (CYP) 2C19 genotypes after an infusion regimen of diazepam commonly used for gastrointestinal endoscopy in Japan.
METHODS: Fifteen healthy Japanese volunteers consisting of three different CYP2C19 genotype groups underwent a critical flicker fusion test, an eye movement analysis and a postural sway test as a test for physical sedative effects, and a visual analog scale (VAS) symptom assessment method as a test for mental sedative effects during the 336 h period after the intravenous infusion of diazepam (5 mg).
RESULTS: The physical sedative effects assessed by the critical flicker test continued for 1 h (t values of 5 min, 30 min and 60 min later: 4.35, 5.00 and 3.19, respectively) and those by the moving radial area of a postural sway test continued for 3 h (t values of 5 h, 30 h, 60 min and 3 h later: -4.05, -3.42, -2.17 and -2.58, respectively), which changed significantly compared with the baseline level before infusion (P<0.05). On the other hand, the mental sedative effects by the VAS method improved within 1 h. The CYP2C19 genotype-dependent differences in the postinfusion sedative effects were not observed in any of the four psychomotor function tests.
CONCLUSION: With the psychomotor tests, the objective sedative effects of diazepam continued for 1 h to 3 h irrespective of CYP2C19 genotype status and the subjective sedative symptoms improved within 1 h. Up to 3 h of clinical care appears to be required after the infusion of diazepam, although patients feel subjectively improved.

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Year:  2008        PMID: 18777597      PMCID: PMC2744010          DOI: 10.3748/wjg.14.5197

Source DB:  PubMed          Journal:  World J Gastroenterol        ISSN: 1007-9327            Impact factor:   5.742


  38 in total

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2.  Relationship of in vitro data on drug metabolism to in vivo pharmacokinetics and drug interactions: implications for diazepam disposition in humans.

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4.  Disposition of diazepam in young and elderly subjects after acute and chronic dosing.

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5.  A subclass of prefrontal gamma-aminobutyric acid axon terminals are selectively altered in schizophrenia.

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Review 7.  Review article: cytochrome P450 and the metabolism of proton pump inhibitors--emphasis on rabeprazole.

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8.  Effects of CYP3A4 inhibition by diltiazem on pharmacokinetics and dynamics of diazepam in relation to CYP2C19 genotype status.

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10.  Decrease in reelin and glutamic acid decarboxylase67 (GAD67) expression in schizophrenia and bipolar disorder: a postmortem brain study.

Authors:  A Guidotti; J Auta; J M Davis; V Di-Giorgi-Gerevini; Y Dwivedi; D R Grayson; F Impagnatiello; G Pandey; C Pesold; R Sharma; D Uzunov; E Costa; V DiGiorgi Gerevini
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  1 in total

1.  Role of CYP2C19 gene polymorphism in acute alcohol withdrawal treatment with loading dose of diazepam in a South Indian population.

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  1 in total

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