DE10130449A1 - Inhalable sedative and hypnotic medicaments, e.g. containing benzodiazepine active agent, having high bioavailability and rapid action - Google Patents
Inhalable sedative and hypnotic medicaments, e.g. containing benzodiazepine active agent, having high bioavailability and rapid actionInfo
- Publication number
- DE10130449A1 DE10130449A1 DE2001130449 DE10130449A DE10130449A1 DE 10130449 A1 DE10130449 A1 DE 10130449A1 DE 2001130449 DE2001130449 DE 2001130449 DE 10130449 A DE10130449 A DE 10130449A DE 10130449 A1 DE10130449 A1 DE 10130449A1
- Authority
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- Germany
- Prior art keywords
- hypnotics
- sedatives
- inhalation
- inhalable
- benzodiazepines
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K9/00—Medicinal preparations characterised by special physical form
- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/007—Pulmonary tract; Aromatherapy
- A61K9/0073—Sprays or powders for inhalation; Aerolised or nebulised preparations generated by other means than thermal energy
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/55—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole
- A61K31/551—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having seven-membered rings, e.g. azelastine, pentylenetetrazole having two nitrogen atoms, e.g. dilazep
- A61K31/5513—1,4-Benzodiazepines, e.g. diazepam or clozapine
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- Health & Medical Sciences (AREA)
- Chemical & Material Sciences (AREA)
- Medicinal Chemistry (AREA)
- Pharmacology & Pharmacy (AREA)
- Epidemiology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Engineering & Computer Science (AREA)
- Bioinformatics & Cheminformatics (AREA)
- Otolaryngology (AREA)
- Pulmonology (AREA)
- Medicinal Preparation (AREA)
- Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
Abstract
Description
Vorliegende Erfindung beschreibt eine neuartiges Anwendungsverfahren von Medikamenten. The present invention describes a novel method of using medicaments.
Als Psychopharmaka werden in der Medizin Sedativa und Hypnotika eingesetzt, Synonyme hierfür sind Beruhigungs- und Schlafmittel. Diese grösseren, heterogenen, definitionsbedingt oft ineinandergreifenden Medikamentengruppen beinhalten hauptsächlich die Benzodiazepine und derer Derivate als Hauptvertreter der Tranquillantien oder Tranquilizer, neben beispielsweise anderen Substanzarten, klassifiziert nach chemischen Grundgerüst, Wirksamkeit oder Indikationsgebiet wie Barbiturate, Karbaminsäurederivate, Diphenylmethanderivate, Monoureide, Clinazolone, Phenothiazinderivate, Piperidindione, Chloralhydrate, Glutethimide, Methylprylone, Meprobamate, Zolpideme, Zopiclone oder Neuroleptika, Antidepressiva und Antihistaminika. In medicine, sedatives and hypnotics are used as psychotropic drugs, synonyms for this are sedatives and sleeping pills. These larger, heterogeneous, by definition often interlocking drug groups mainly include the benzodiazepines and their derivatives as main representatives of tranquillizers or tranquilizers, in addition For example, other types of substances, classified according to chemical structure, effectiveness or Indications such as barbiturates, carbamic acid derivatives, diphenylmethane derivatives, Monoureide, Clinazolone, Phenothiazineivate, Piperidindione, Chloralhydrate, Glutethimide, Methylprylones, meprobamates, zolpidems, zopiclones or neuroleptics, antidepressants and Antihistamines.
Der Einsatz dieser Medikamente als Sedativum oder als Hypnotikum ist funktionell bedingt, je nach Wirkintensität, Verweildauer im Organismus (biologische Halbwertszeiten) und Dosierung. The use of these drugs as a sedative or as a hypnotic is functionally dependent, depending according to intensity of action, length of stay in the organism (biological half-lives) and Dosage.
Bekanntester Vertreter der Tranquillantien ist das Benzodiazepinderivat Diazepam oder Valium®; an Benzodiazepinen als überschaubare Gruppe sollen beispielhaft Sachverhalte erläutert werden. The best-known representative of the tranquillizers is the benzodiazepine derivative diazepam or Valium; on benzodiazepines as a manageable group, examples are to be explained become.
Synonyme für Tranquillantien oder Tranquilizer sind Anxiolytika und Ataraktika, welche alle den psychischen Effekt von Angstlösung, Sedierung, Entspannung, Beruhigung und Schlafförderung bewirken. Zusätzlich haben die Benzodiazepine eine zentral muskelrelaxierende oder myotonolytische (muskelverspannungslösende) und eine antikonvulsive (bei Epileptikern zerebral krampfschwellenerhöhende, also anfallsverhindernde) Wirksamkeit. Synonyms for tranquillizers or tranquilizers are anxiolytics and ataractics, all of which the psychological effects of anxiety relief, sedation, relaxation, calming and Promote sleep. In addition, the benzodiazepines have a central muscle relaxant or myotonolytic (relieving muscle tension) and an anticonvulsant (in epileptics cerebral spasm-increasing, thus preventing seizures) effectiveness.
Wegen der schlaffördernden Komponente stellen die Benzodiazepine einen Grossteil der Hypnotika dar. Because of the sleep-promoting component, the benzodiazepines represent a large part of the Hypnotics.
Die Wirkdauer von Benzodiazepinen im menschlichen Körper wird bestimmt durch die biologische Halbwertszeiten der zugeführten einzelnen Derivate und gegebenenfalls durch deren biologisch und pharmakologisch zusätzlich aktiven Abbauprodukte. Diese Halbwertszeiten kennzeichnen hauptsächlich die Wirksamkeit und entscheiden vornehmlich über die Indikation. The duration of action of benzodiazepines in the human body is determined by the biological half-lives of the individual derivatives supplied and, if appropriate, by their biologically and pharmacologically active decomposition products. These half-lives mainly characterize the effectiveness and mainly decide on the Indication.
Der Hauptangriffsort der Benzodiazepine im menschlichen Gehirn ist das limbische System, wobei die von dort ausgehende, emotionsbedingte Aktivierung des "Wachsystems" in der Gehirnstruktur namens Formatio reticularis gedämpft wird. The main target of benzodiazepines in the human brain is the limbic system, whereby the emotion-related activation of the "wax system" in the Brain structure called Formatio reticularis is dampened.
Bei höherer Dosierung oder schneller Anflutung, beispielsweise durch intravenöse Injektion (schnelle Bolusinjektion), kann die entsprechende Wirkung durch schnelles Eindringen in den pharmakologischen Verteilungsraum Gehirn stärker ausfallen und es können neben den genannten Wirkungen auch Atemdepression bis hin zu Stupor oder Bewusstlosigkeit auftreten. Die derzeitigen Anwendungsverfahren von Benzodiazepinen, auch generell im weiteren nachfolgenden Sinne Sedativa oder Hypnotika, beschränken sich auf die parenteralen Injektionsformen, enteralen (oral, rektal) oder sublingualen (Mundschleimhaut) Zufuhrarten in entsprechenden Zubereitungsformen wie Injektions- und Infusionslösungen oder Kapseln, Tabletten, Dragees, Tropfen, Zäpfchen, Rektallösungen und Sublingualtabletten. With higher doses or rapid flooding, for example by intravenous injection (rapid bolus injection), the corresponding effect can be achieved by quickly penetrating the pharmacological distribution brain are stronger and it can be next to the mentioned effects also occur respiratory depression up to stupor or loss of consciousness. The current application methods of benzodiazepines, also generally in the following subsequent senses sedatives or hypnotics, are limited to the parenteral Injection forms, enteral (oral, rectal) or sublingual (oral mucosa) types of supply in appropriate forms of preparation such as solutions for injection and infusion or capsules, tablets, Dragees, drops, suppositories, rectal solutions and sublingual tablets.
Bei Krankheiten, die eine schnelle Wirksamkeit des zur Behandlung einzusetzenden Benzodiazepins oder anderen Sedativums/Hypnotikums erfordern, ist das enterale Applikationsverfahren zwecks Eintritt des gewünschten pharmakologischen Effektes wegen der notwendigen Aufnahmezeit im Magen-Darm-Trakt bis Erreichen der entsprechenden Bioverfügbarkeit zu langsam. For diseases that have a quick effectiveness of the treatment to be used Benzodiazepine or other sedative / hypnotic require is the enteral Application process to achieve the desired pharmacological effect because of the necessary Uptake time in the gastrointestinal tract until the corresponding bioavailability is reached slowly.
Bei diesen akuten Erkrankungen muss der Betroffene solange unter seinen Symptomen leiden, bis entweder das selbst zugeführte enterale Medikament wirkt, oder bis eine medizinisch ausgebildete Person, in der Regel ein Arzt, eine schnellwirkende parenterale Applikationsform anwendet, zumal eine Selbstinjektion durch den Patienten aus anwendungstechnischen Gründen meist ausscheidet, ebenso aus Risiken vor nicht beherrschbaren Nebenwirkungen. With these acute diseases, the person affected must suffer from their symptoms as long as until either the self-administered enteral medication works, or until one is medicinal trained person, usually a doctor, a fast-acting parenteral application form applies, especially since a self-injection by the patient from application technology Reasons usually eliminated, as well as risks from uncontrollable side effects.
Akut einsetzende Angst- und Unruhesymptome bei vegetativen Dystonien, Persönlichkeitsstörungen, Neurosen, Psychosen und Hyperventilationssyndromen mit subjektiver Atemnot und Muskelverkrampfungen sind Beispiele solcher Erkrankungen. Acute anxiety and restlessness symptoms in vegetative dystonia, Personality disorders, neuroses, psychoses and hyperventilation syndromes with subjective shortness of breath and Muscle cramps are examples of such diseases.
Ungünstigerweise treten nicht selten diese Beschwerden in der Öffentlichkeit oder unter grösseren Menschenansammlungen und Stress auf (Klaustrophobie in Aufzügen, Strassenbahn, Rolltreppen, Panikattacken auf belebter Strasse oder Verkrampfungen, Zittern und Atemnot in überfüllten Räumen). Unfortunately, these complaints often occur in public or under large crowds and stress (claustrophobia in elevators, trams, Escalators, panic attacks on busy streets or cramps, tremors and shortness of breath in crowded rooms).
In solchen öffentlichen Situationen ist eine länger bestehende Krankheitssymptomatik für den Betroffenen sicherlich um so mehr belastend, zumal bei krankheitsbedingter zitternder Einnahme der entsprechenden Bedarfsmedikation via Tropflösung oder Tablette der Patient von möglicherweise ignoranten Beobachtern als Alkoholiker oder Drogensüchtiger verkannt wird. In such public situations, the symptoms of the disease are longer Sufferers certainly all the more distressing, especially when trembling due to illness Taking the required medication via drip solution or tablet the patient from possibly ignorant observers are misjudged as alcoholics or drug addicts.
Die vorliegende Erfindung beschreibt die Anwendung beziehungsweise Zufuhr von Sedativa und Hypnotika, insbesondere Benzodiazepinen und deren Derivate mittels Inhalation in die menschlichen Atemwege zu humanmedizinischen Zwecken, also zur Behandlung von Krankheitsbildern, die durch genannte Stoffe therapiert werden können. Auch prophylaktische, diagnostische und nachsorgende Massnahmen sind denkbar. The present invention describes the use or supply of sedatives and hypnotics, especially benzodiazepines and their derivatives by inhalation into the human respiratory tract for human medical purposes, i.e. for the treatment of Diseases that can be treated by the substances mentioned. Prophylactic, diagnostic and aftercare measures are conceivable.
Gemäss den Patentansprüchen werden Sedativa oder Hypnotika, also auch Benzodiazepine beziehungsweise deren Derivate, zum Beispiel Diazepam, welches in gelöster Form vorliegt (Diazepam Tropflösung, Valiquid®) oder auch als Festsubstanz feinstsuspendiert werden kann, durch einen Vernebler in entsprechenden pulmonal gängigen, inhalierbaren Feinnebel oder Aerosol gebracht, ebenso kann eine Dosiersprayvorrichtung, oder ein Pulverinhalator mit pulmonal gängigen Feinfeststoffen Verwendung finden, welche technisch von den gängigen Inhaliergeräten für Asthmatherapeutika abgeleitet werden können. According to the claims, sedatives or hypnotics, including benzodiazepines or their derivatives, for example diazepam, which is present in dissolved form (Diazepam drip solution, Valiquid®) or can be finely suspended as a solid substance, by a nebulizer in the corresponding pulmonary, inhalable fine mist or Brought aerosol, as well as a dosing spray device or a powder inhaler pulmonary common fine solids are used, which are technically different from the usual Inhalers for asthma therapeutics can be derived.
Die so in die Lunge aufgenommenen Sedativa- oder Hypnotikasubstanzen werden von den dort befindlichen Oberflächenstrukturen (Bronchialschleimhaut, Alveolarmembranen) aufgenommen und dem Blutkreislauf zugeführt. The sedative or hypnotic substances so absorbed into the lungs are removed from there surface structures (bronchial mucosa, alveolar membranes) recorded and fed to the bloodstream.
Technisch kann jeglicher Treibmechanismus wie Ultraschallvernebelung, Treibgase oder Pumpeffekt zur Vernebelung führen, die Inhalation kann für den Patienten selbst passiv durch Geräteüberdruck oder durch aktives Saugen des Anwenders oder kombiniert vorgenommen werden. Technically, any drive mechanism such as ultrasonic nebulization, propellant gases or Pump effect lead to nebulization, the inhalation can passively for the patient himself Device overpressure or by active suction of the user or combined become.
Andere Stoffe können den inhalierbaren Benzodiazepinen beziehungsweise Sedativa oder Hypnotika beigemengt werden, so zum Beispiel galenisch wirksame Substanzen um den Inhaliernebel selbst oder die pulmonale Resorption zu beeinflussen, auch können inaktive Füllstoffe, andere oder anders, gleich wie auch ähnlich wirksame Pharmaka zugesetzt werden. Other substances can be inhaled benzodiazepines or sedatives or Hypnotics are added, for example galenically active substances around the Inhaling mist itself or affecting pulmonary absorption can also be inactive Fillers, other or different, are added in the same way as pharmaceuticals with similar effects.
Die Atemwegszufuhr ist sowohl via Mund, als auch durch die Nasenöffnungen möglich. Soweit bei dieser Wirkstoffzufuhr in der Mundschleimhaut Resorptionen auftreten sollten, ist diese Aufnahmeform insofern zu vernachlässigen, als beispielsweise das Benzodiazepinderivat Oxazepam in sublingualer Tablettenapplikationsform bereits derzeitigen Technikstand entspricht und die Mundhöhle anatomisch dem Verdauungstrakt zuzurechnen ist, wogegen die Nasenschleimhaut als Teil der Atemwege und Ort möglicher Resorptionen von Benzodiazepinen auch neuartig ist. The airway can be supplied both through the mouth and through the nostrils. To the extent that resorption should occur in the oral mucosa with this supply of active substance to neglect this form of intake in so far as, for example, the benzodiazepine derivative Oxazepam in sublingual tablet application form already state of the art corresponds and the oral cavity is anatomically attributable to the digestive tract, whereas the Nasal mucosa as part of the airways and place of possible resorption of Benzodiazepines is also novel.
Abzugrenzen ist auch die - bereits gemäss des heutigen Technikstandes - inhalative Anwendung von Narkotika, also Narkosemitteln, die in der Pharmakologie eine andere Definitions- und Substanzklasse darstellen, deren Vertreter beispielsweise anorganische Gase wie Stickoxydul, Xenon, organische Gase wie Ethylen, Cyclopropan, Acetylen, des weiteren Etherverbindungen wie Diethylether, Divinylether, Methoxyfluran, Enfluran und Isofluran, aber auch halogenierte Kohlenwasserstoffe wie Chloroform, Ethylchlorid, Trichlorethylen und Halotan sind. A distinction must also be made between inhalative use, based on the current state of technology of anesthetics, i.e. anesthetics, which have a different definition and Represent substance class, the representatives of which, for example, inorganic gases such as nitrogen oxide, Xenon, organic gases such as ethylene, cyclopropane, acetylene and ether compounds such as diethyl ether, divinyl ether, methoxyflurane, enflurane and isoflurane, but also halogenated Hydrocarbons such as chloroform, ethyl chloride, trichlorethylene and halotane are.
Hauptindikationsgebiet sind akute, also schnell zu therapierende Erkrankungen, die mit Symptomen wie Angst, Unruhe, Schlafstörungen, Verkrampfungen und subjektiver Atemnot im Rahmen eines Hyperventilationssyndroms, auch - mit medizinischer Indikationseinschränkung- Sedierung im hyperventilatorischen Stadium eines angstbetonten Asthmaanfalles, einhergehen. Der Betroffene kann in Eigentherapie bei Bedarf das entsprechende Medikament inhalativ zuführen oder es kann eine zur intravenösen Injektion nicht befugte Hilfsperson, zum Beispiel Rettungsassistent, bis zum Eintreffen eines Arztes mit dessen fernmündlichen Einvernehmen vortherapieren. The main area of indication is acute, that is to say quickly treatable diseases associated with Symptoms such as anxiety, restlessness, sleep disorders, cramping and subjective shortness of breath in the Framework of a hyperventilation syndrome, also - with medical indication limitation - Sedation in the hyperventilatory stage of an anxious asthma attack. If necessary, the person concerned can inhale the appropriate medication in self-therapy or an assistant who is not authorized for intravenous injection, for example Paramedic, until a doctor arrives with his appointment by telephone vortherapieren.
Auch bei Epileptikern im Anfallsstadium wäre die inhalative Anwendung von indizierten Benzodiazepinen durch eine Hilfsperson möglich, indem beispielsweise die Inhalationsvorrichtung durch ein technisches Hilfsmittel variiert wird: Bei krampfenden, bewusstseinsgetrübten Epilepsiepatienten besteht wegen unkontrollierter Kaumuskulaturaktionen die Gefahr von enoralen Eigenbissverletzungen, so dass idealerweise durch den Helfer ein Bisskeil zwischen Ober- und Unterkiefer eingebracht werden soll. Kombiniert man die Verneblervorrichtung mit einem bisskeilförmigen Inhalationsmundansatzstück (Bisskeil mit innerer integrierter Kanaldüse zur Applikation des Benzodiazepins) kann während des Krampfanfalls effektiv mit Benzodiazepinen zur Anfallscoupierung therapiert werden. Inhaled use would also be indicated for seizure epileptics Benzodiazepines possible by an assistant, for example by using the inhalation device is varied by a technical aid: for cramped, clouded consciousness Epilepsy patients are at risk of uncontrolled chewing muscles internal self-bite injuries, so that the helper ideally places a bite wedge between the upper and lower jaw should be inserted. Combine the nebulizer device with one Bite wedge-shaped inhalation mouthpiece (bite wedge with internal integrated channel nozzle for Application of benzodiazepine) can effectively with the seizure Benzodiazepines are treated for seizure coping.
Ähnliche Vorgehensweisen sind bei intubierten Patienten denkbar, indem durch einen Tubusadapter an der Inhalationsvorrichtung beispielsweise Benzodiazepine bei entsprechender medizinischer Indikation pulmonal appliziert werden können, so bei momentanen Fehlen eines parenteralen Zugangs (Venenzugangs). Similar procedures are conceivable for intubated patients by using a Tube adapter on the inhalation device, for example benzodiazepines with the appropriate medical indication can be applied pulmonally, so if there is currently no parenteral access (venous access).
Der Hauptvorteil besteht in der Möglichkeit durch Eigenanwendung von Sedativa oder Hypnotika, beispielsweise Benzodiazepinen, durch den Patienten eine, im Vergleich zum oralen, sublingualen oder rektalen Anwendungsverfahren, signifikant schneller vorhandene Bioverfügbarkeit des Wirkstoffs und somit entsprechenden Wirkspiegel im Organismus zu erreichen, vor allem aufgrund der bei der Inhalation vergleichsweise grossen natürlicherweise bereitgestellten Resorptionsoberfläche der Lunge. The main advantage is the possibility of self-application of sedatives or Hypnotics, e.g. benzodiazepines, by the patient compared to the oral, sublingual or rectal application methods, significantly faster existing To achieve bioavailability of the active ingredient and thus the corresponding active level in the organism all because of the comparatively large naturally provided during inhalation Resorption surface of the lungs.
Als weitere Vorteile erscheinen die Ausnützung eines Boluseffektes durch konzentriertere Anflutung des Gehirns nach Inhalation bei schneller pulmonaler Aufnahme und somit die Möglichkeit durch niedrigere Wirkstoffdosen, Wirkeffekte vergleichsweise höherer Oral-, Sublingual- oder Rektaldosen zu erzielen (Dosisreduktion). Further advantages appear to be the use of a bolus effect by more concentrated ones Flooding of the brain after inhalation with rapid pulmonary absorption and thus the Possibility through lower active substance doses, effects of comparatively higher oral, To achieve sublingual or rectal doses (dose reduction).
Des weiteren zeigt sich eine höhere Praktikabilität für den Patienten in Akutsituationen, in denen genannte Wirkstoffe therapeutisch indiziert sind, vor allem ist eine in der Öffentlichkeit diskretere Einnahmeform gewährleistet, vergleichbar mit der Zufuhr von Asthmasprays, welches die situationsbedingte gesellschaftliche Stigmatisierung von psychisch Leidenden vermeidet. Furthermore, there is greater practicality for the patient in acute situations the active ingredients mentioned are therapeutically indicated, especially one in public ensures a more discreet form of administration, comparable to the intake of asthma sprays, which is the situation-related social stigmatization of psychologically suffering people avoids.
Auch das Wissen des Betroffenen, ein suffizientes, schnell wirksames Mittel mitführen und gegebenenfalls selbst problemlos anwenden zu können, reduziert die häufig noch quälendere Angst, mit einer plötzlich auftretenden Angstsituation nicht fertig zu werden (Angst vor der Angst), so dass die prophylaktische Einnahme von genannten Medikamenten reduziert oder vermieden werden kann und somit auch die Gefahr einer beispielsweise nicht seltenen Benzodiazepinabhängigkeit vermindert wird. Also carry the knowledge of the person concerned, a sufficient, fast-acting means and if necessary, being able to use them without problems reduces the often more painful Fear of not being able to cope with a sudden anxiety situation (fear of Anxiety), so that the prophylactic use of the mentioned medication is reduced or can be avoided and thus also the risk of a, for example, not uncommon Benzodiazepine addiction is reduced.
Ebenfalls zeigt der Einsatz von beispielsweise Benzodiazepinen als inhalatives Schlafmittel Vorteile gegenüber der derzeitig gängigen oralen Einnahmeform. Durch abendliche Nahrungsaufnahme kann die Resorptionszeit der vor zu Bett gehen geschluckten Schlaftablette derart verzögert werden, dass trotzdem Einschlafstörungen und am nächsten Morgen durch noch vorhandene Wirkstoffspiegel im Körper Müdigkeit vorherrschen (Hang-over); inhalative Anwendung des Schlafmittels reduziert dieses Risiko. The use of benzodiazepines, for example, as an inhaled sleeping pill also shows Advantages over the current oral form of oral administration. By evening The absorption time of the sleeping pill swallowed before going to bed can be such food intake be delayed that despite falling asleep and the next morning through yet existing drug levels in the body predominate fatigue (hang-over); inhalation Use of the sleeping pill reduces this risk.
Nicht zuletzt wirkt das inhalative Anwendungsverfahren hauptsächlich von Benzodiazepinen den leider generell vorhandenen Abhängigkeitspotential dieser Substanzen entgegen, insofern, als die derzeitige Zufuhralternativen bei von den Betroffenen angegeben Angstsyndromen oftmals Diazepam Tropflösungen darstellen, die von entsprechend konstellierten, abhängigen Pesönlichkeitsstrukturen unter anderem intravenös missbrauchend konsumiert werden, was bei einem beispielsweise kompakten Diazepam-Dosieraerosol nicht möglich wäre. Last but not least, the inhalation method mainly works with benzodiazepines against the unfortunately generally existing dependency potential of these substances, insofar as than the current supply alternatives for anxiety syndromes indicated by those affected often diazepam represent drip solutions that depend on appropriately configured, dependent Personality structures, among other things, are consumed intravenously, which at a compact diazepam metered dose aerosol, for example, would not be possible.
Einer 47-jährigen Patientin, leidend an wiederkehrenden Hyperventilationstetanien, begleitet mit Akutangstzuständen, insbesondere in der Öffentlichkeit wird ein Diazepam-Dosieraerosol zubereitet. In einen leeren handelsüblichen "Asthmaspraybehälter" wird mit Überdruck handelsübliche Diazepamlösung zusammen mit geeignetem Treibgas gebracht, welches der Patientin zur Eigenverwendung im Bedarfsfall nach entsprechender Aufklärung überlassen wird. Nach einer Beobachtungszeit von drei Monaten zeigte sich die Patientin subjektiv erleichtert, ihre Angstattacken wegen der genannten Vorteile "besser im Griff zu haben". Objektiv bot die Patientin bei der Untersuchung einen psychisch stabileren Befund. Accompanied to a 47-year-old patient suffering from recurrent hyperventilation tetania with acute anxiety, especially in public, a diazepam MDI prepared. In an empty commercially available "asthma spray container" with overpressure commercial diazepam solution brought together with a suitable propellant, which the Patient is left for personal use if necessary after appropriate clarification. After an observation period of three months, the patient was subjectively relieved to have her anxiety attacks "better under control" because of the advantages mentioned. Objectively offered the Patient had a psychologically more stable finding during the examination.
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| WO2005025541A3 (en) * | 2003-09-15 | 2005-05-12 | Vectura Ltd | Dry powder composition comprising a benzodiazepine for pulmonary inhalation |
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