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It is known that some patients with tetanus develop a syndrome characterised by labile hypertension, peripheral vasoconstriction, tachycardia, arrhythmias, sweating and pyrexia associated with an increased catecholamine excretion. 15 The media-reinforced mindset that one should not need medication to feel better is an attitude that unfairly stigmatizes anxiolytics and antidepressants in particular. The term transcranial route means the brain targeted transfer of drug molecules across the cranium through the layers of the skin and skin appendages of the head, arteries and veins of the skin of the head, the cranial bones along with the diploe, the cranial bone sutures, the meninges and specifically through the emissary veins. It was also found that time interval to cessation of seizures was faster with intramuscular midazolam as compared to intravenous diazepam as time was consumed in putting an intravenous line in patients receiving diazepam as statistical significance was found only in patients without prior IV access. Propylene glycol in the ampoule of diazepam is considered to be the agent leading to thrombophlebitis. In some patients little more than this will be required except for reassurance of patients and relatives. None of the patients in either group developed hypotension or respiratory depression though a significant number of patients in the diazepam group developed thrombophlebitis. Properly obtaining and effectively documenting informed consent. Particular attention nor diazepam was given to the presence of sympathetic overactivity characterized clinically as tachycardia with a pulse rate of over 100 beats per minute, fluctuating blood pressure of more than 140,90 mm nor diazepam of Hg, excessive sweating and raised axillary temperature over 100F. Patients who already had an intravenous access present were treated with 0,2 mg,kg of intravenous diazepam for control of seizures and time interval from administration of diazepam to cessation of seizures was noted. Within a few weeks the woman was nearly psychotic nor diazepam and required hospitalization. In the present study, 29 cases showed evidence of some sympathetic overactivity.
Yet we have all seen patients who have been denied pain medication or who have been so limited in their analgesic prescriptions by their physician that it is useless to try nor diazepam to treat their depression without addressing this aspect of their treatment.