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Oxcarbazepine, structurally related to carbamazepine, appears to be as effective as carbamazepine in the treatment of epilepsy and slightly better tolerated.

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The gamma-amino butyric acid (GABA) hypothesis suggests that the GABA-receptor complex (GABA-binding site, chloride channel, and barbiturate and benzodiazepine receptor sites) is an important neuronal inhibitor, and that GABA-ergic transmission interacts with ammonia in the pathogenesis of HE.

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Dosing of the sublingual flumazenil lozenges began at one 6-mg lozenge four times daily, titrating up by adding an extra lozenge every 4-5 days until reaching a maximum of 12 per day.

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Body as a Whole: rigors, shivering Cardiovascular System: arrhythmia (atrial, nodal, ventricular extrasystoles), bradycardia, tachycardia, hypertension, chest pain Digestive System: hiccup Nervous System: speech disorder (dysphonia, thick tongue) Not included in this list is operative site pain that occurred with the same frequency in patients receiving placebo as in patients receiving flumazenil for reversal of sedation following a surgical procedure.

Generally considered one of the safest sedative agents, chloral hydrate does have the potential for causing unexpectedly deep levels of sedation as well as upper airway obstruction in some patients.

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Long-term use of diazepam for the management of epilepsy is not recommended; however, a subgroup individuals with treatment resistant epilepsy benefit from long-term benzodiazepines and for such individuals clorazepate has been recommended due to its slower onset of tolerance to the anticonvulsant effects.

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The safety and efficacy of flumazenil have not been established in pediatric patients for reversal of the sedative effects of benzodiazepines used for induction of general anesthesia, for the management of overdose, or for the resuscitation of the newborn, as no well-controlled clinical studies have been performed to determine the risks, benefits and dosages to be used.

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