Similarity of group exposure profiles does not eliminate individual variability.
What the study found
A study compared nasal diazepam pharmacokinetics in seizure or peri-seizure and interictal conditions. Average profiles were broadly similar, with substantial variability across participants and selected safety observations.
The pharmacokinetic sample was smaller than enrollment
Fifty-seven patients entered the study, but forty-nine contributed to the primary pharmacokinetic analysis. The median peak time was about two hours under both conditions, while mean peak concentrations were approximately 164 and 189 ng/mL with substantial standard deviations. Peak time is a concentration-curve property. It should not be mistaken for the time treatment first worked or the time a seizure ended.
Limits of interpretation
The pharmacokinetic analysis included fewer patients than the full safety sample. Administration conditions and seizure characteristics may differ, and the measured peak-time profile is not itself a clinical seizure-termination time.
Implications for case review
Specify whether a value is a group mean, range or an individual sample. The paper cannot reconstruct a particular dose or prove that seizure activity never affects absorption. Actual delivery, timing and clinical response remain necessary when interpreting rescue treatment in a case.
Source and related reading
Source: PMC7383779, supplied full-text paper. Findings are paraphrased; forensic implications are an interpretation.
Related: Epilepsy Tissue Findings Came From Patients With Extensive Medication Exposure.
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