AcuDial DISPOSAL INSTRUCTIONS - Diastat

1 AcuDial ADMINISTRATION AND. DISPOSAL INSTRUCTIONS . I M P O R T A N T When to treat. Based on the doctor's directions or prescription. Your doctor may prescribe a second dose of Diazepam rectal gel. If a second dose is needed, give it 4 hours to 12 hours after the first dose. Read first _____. before using _____. To the caregiver using Diastat : Special considerations. Please do not give Diastat until: Diastat should be used with caution: 1. You have thoroughly read these INSTRUCTIONS In people with respiratory (breathing) difficulties ( , asthma or pneumonia).

2 2. Reviewed administration steps with the doctor 3. Understand the directions In the elderly In women of child bearing potential, pregnancy and nursing mothers To the caregiver using Discuss beforehand with the doctor any additional steps you may need to take if there is leakage of Diastat AcuDial : Diastat or a bowel movement. Please do not give Diastat AcuDial until: 1. You have confirmed: Patient's Diastat dosage is: _____mg Prescribed dose is visible and if known, is correct Patient's resting breathing rate _____ Patient's current weight _____.

3 Green ready band is visible Confirm current weight is still the same as when Diastat was prescribed _____. Check expiration date and always remove cap before using. Be sure seal pin is removed with the cap. TREATMENT 1. READY. 2. You have thoroughly read these INSTRUCTIONS Important things to tell the doctor. 3. Reviewed administration steps with the doctor 4. Understand the directions Seizures Before Diastat Seizures After Diastat . Please do not administer Diastat until you feel Seizure No. of Seizure No. of comfortable with how to use Diastat .

4 The doctor Date Time Type Seizures Time Type Seizures will tell you exactly when to use Diastat . When you use _____ _____ _____ _____ _____ _____ _____. Diastat correctly and safely you will help bring seizures under control. Be sure to discuss every aspect of your _____ _____ _____ _____ _____ _____ _____. role with the doctor. If you are not comfortable, then discuss your role with the doctor again. Things to do after treatment with Diastat . To help the person with seizures: Stay with the person for 4 hours and make notes on the following: 4 You must be able to tell the difference between cluster Changes in resting breathing rate and ordinary seizures.

5 Changes in color 4 You must be comfortable and satisfied that you are able to give Diastat . Possible side effects from treatment 4 You need to agree with the doctor on the exact Your doctor may prescribe a second dose of Diazepam rectal gel. If a second dose is needed, give it conditions when to treat with Diastat . 4 hours to 12 hours after the first dose. 4 You must know how and for how long you should TREATMENT 2. check the person after giving Diastat . To know what responses to expect: Important things to tell the doctor.

6 4 You need to know how soon seizures should stop or decrease in frequency after giving Diastat . Seizures Before Diastat Seizures After Diastat . Seizure No. of Seizure No. of 4 You need to know what you should do if the seizures do not stop or there is a change in the person's Date Time Type Seizures Time Type Seizures breathing, behavior or condition that alarms you. _____ _____ _____ _____ _____ _____ _____. If you have any questions or feel unsure about using the _____ _____ _____ _____ _____ _____ _____. treatment, CALL THE DOCTOR before using Diastat .

7 Things to do after treatment with Diastat . ? Stay with the person for 4 hours and make notes on the following: Changes in resting breathing rate _____. Where can I find more Changes in color_____. information and support? Possible side effects from treatment _____. For information on Diastat and Diastat AcuDial : Call 1-877-361-2719 or Visit Additional resource: Epilepsy Foundation (EF). You can reach EF. by calling 1-800-EFA-1000 or HOW TO ADMINISTER. AND DISPOSAL . AcuDial Put person on their side Get medicine. Get syringe.

8 Push up with thumb and pull to where they can't fall. Note: Seal Pin is attached to the cap. remove cap from syringe. Be sure Seal Pin is removed with the cap. Lubricate rectal tip Turn person Bend upper leg forward Separate buttocks to with lubricating jelly. on side facing you. to expose rectum. expose rectum. SLOWLY COUNT OUT LOUD TO Gently insert syringe tip into rectum. Slowly count to 3 while gently Slowly count to 3 before Slowly count to 3 while Note: Rim should be snug against pushing plunger in until it stops. removing syringe from rectum.

9 Holding buttocks together to rectal opening. prevent leakage. ONCE Diastat IS GIVEN DISPOSAL INSTRUCTIONS FOR Diastat AcuDial DISPOSAL FOR Diastat MG. Pull on plunger until it Replace plunger into At the completion of is completely removed syringe body, gently step 13: from the syringe body. pushing plunger until it Discard all used stops. Point tip over sink or materials in the toilet. Flush toilet or rinse sink garbage can. with water until gel is no longer visible. Do not reuse. Discard in a safe place Keep person on side away from children.

10 Facing you, note time given and continue to observe. This step is for Diastat AcuDial users only At the completion of step 14a: Discard all used materials in the garbage can. Do not reuse. Discard in a safe place away from children. Please see Important Safety Information attached. Important Safety Information: Diastat . INDICATION. Diastat (diazepam rectal gel) is a gel formulation of diazepam intended for rectal administration for certain patients with epilepsy who are already taking antiepileptic medications, and who require occasional use of diazepam to control bouts of increased seizure activity.