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Folia Medica Indonesiana

ISSN 0303-7932

Vol. 38 / No. 4 / Published : 2002-10

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Original Article :

The use of high dose diazepam in severe tetanus. a case series

Author :

      Abstract :

      The causes of death in tetanus are convulsion and spasm of larynx, which caused by blocking the release of inhibitory neurotransmitter in spinal synapses, causing uncontrolled spread of impulse. Diazepam controls the convulsions by blocking the polysynaptic reflexes, working peripherally- without depressing the cortical center, no cardiovascular or endocrine effects. The use of high dose had been used by LK Khoo and Ismoedijanto and proved to be a good muscle relaxant. Diazepam seems work in tetanus better than pancuronium bromide, but both drugs need mechanical ventilation assistance. In case the dose should exceed 240 mg per day in a child, ventilator should be at hand and if the dose required is more than 480 mg per day, other drug should be considered. Three cases of severe tetanus, the first two cases are managed by diazepam and pancuronium bromide and the last case by high dose diazepam only. In the first case the dose of diazepam was up to 480 mg/day. By using high dose diazepam in severe tetanus, the management of clinical manifestation of autonomic nerve involvement and the weaning process become easier. Most of complications of severe tetanus become more manageable.

      Keyword :

      severe tetanus, high dose diazepam, mechanical ventilation, and foreign body,


      References :



           


        Archive Article

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        Volume : 38 / No. : 4 / Pub. : 2002-10
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        2. Review Article And Clinical Experience: Diabetes And Cvd: Double Jeopardy (introduction With Syndrome-36 And Time To Act)*
        3. The Use Of High Dose Diazepam In Severe Tetanus. A Case Series
        4. Serum Concentrations Of Chloroquine And Tumor Necrosis Factor In Malaria Patients
        5. The Role Of Jamu (indonesian Herbal Medicine) For Facing The Need For Drugs
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