The following protocol has been taken from the “FAMILIAL DYSAUTONOMIA” A manual of Comprehensive Care Fith Edition 2009
Prepared by The Dysautonomia Center, in conjunction with The Dysautonomia Foundation
In our experiance, the most effective drug to treat a dysautonomic crisis is diazepam (Vallium®, a benzodiazepine). The reason why diazipam stops a crisis is not completely known, but is likely to be due to its sedative effects. The effects of diazipam allow a child to sufficiently relax and sleep if necessary. Sleep can play a crucial role in resolving a crisis for some patients. Many antiemetic drugs (drugs which conteract vomiting) have been tried as a possible crisis therapies, including trimethobenzmide(Tigan®), ondansetron (Zofran®), promethazine (Phenergan®) prochlorperazine (Compazine®) and chlorpromazine (Thorazine®) Unfortunatly, in many cases none of the drugs have been found to be effective.
Diazipam can be given in a number of ways
If the child can swallow diazipam can be given as a pill.
- Via Gastrostomy
If the child cannot swallow and has a gastrostomy, diazepam tablets can be crussed and washed through the gastrostomy tube ot diazipam can be administered in liquid form (a suspension).
If the child cannot swallow and does not have a gastrostomy, diazipam can be administered rectally. Diastat® is and enema containing diazipam for this purpose. If rectal diazipam is not effective the child may have a stool in the rectum and administering a water enema may be necessary before resuming rectal diazipam.
Diazipam can ba administered intracenously (in a vein so that it goes directly into the blood stream) in hospital.
This administrator od diazipam is contraindicated because absorption is unreliable and it often irritates the muscle.
Anaesthetics Approved for FD Patients by Dr Berish Rubin
Lorazepam as a pre-med