title: Lorazepam for seizure prophylaxis during high-dose busulfan administration.
abstract: Seizure is a recognized complication of high-dose busulfan (BU) therapy and phenytoin (DPH) is widely used as prophylaxis. A number of adverse effects have been associated with DPH and it may also interfere with BU metabolism. We used lorazepam (median dose 0.022 mg/kg) i.v. or p.o. before each dose and for 24 h after the last dose of BU as seizure prophylaxis to 29 children undergoing hematopoietic stem cell transplantation. The regimen was well tolerated and drowsiness was the only significant side-effect. Twelve patients were able to receive the entire prophylaxis by mouth. No seizure developed during and within 48 h of BU. Concomitant pharmacokinetic studies showed no alternation of the absorption and clearance of BU during lorazepam administration. Lorazepam can be used as an alternative for seizure prophylaxis during high-dose BU treatment.
authors.affiliation: Division of Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: K W
authors.initials: KW
authors.lastname: Chan
authors.forename: C A
authors.initials: CA
authors.lastname: Mullen
authors.forename: L L
authors.initials: LL
authors.lastname: Worth
authors.forename: M
authors.initials: M
authors.lastname: Choroszy
authors.forename: S
authors.initials: S
authors.lastname: Koontz
authors.forename: H
authors.initials: H
authors.lastname: Tran
authors.forename: J
authors.initials: J
authors.lastname: Slopis
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000009:adverse effects; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000633:toxicity; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002066:Busulfan / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000633:toxicity; D002648:Child; D002675:Child, Preschool; D004347:Drug Interactions; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007223:Infant; D008140:Lorazepam / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008657:Metabolic Clearance Rate; D012640:Seizures / Q000139:chemically induced / Q000517:prevention & control*; D012894:Sleep Stages; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods
chemical_list: D000927:Anticonvulsants; D018906:Antineoplastic Agents, Alkylating; D002066:Busulfan; D008140:Lorazepam