Podcast 576: Status Epilepticus Drugs

Podcast 576: Status Epilepticus Drugs

Author: Charlene Gnisci Melton, PharmD

Educational Pearls:

  • Status Epilepticus is defined as continuous seizure activity for >5 minutes, or 2 or more seizures without full return to consciousness between events
  • Status epilepticus is a true neurologic emergency with significant morbidity and mortality
  • Aggressive, early treatment of status epilepticus is essential as GABA receptors will regress over time and make benzodiazepines less effective as time elapses
  • Go large with doses of benzodiazepines and repeat doses if necessary: In adults this means lorazepam 4 mg IV push or Midazolam 10 mg intramuscular if no IV access
  • Second line agents include:
    • Levetiracetam (Keppra) 60 mg/kg up to 4500mg
    • Valproic Acid (40 mg/kg up to 3000 mg)
    • Keppra has an arguably better side effect profile and compatibility compared to other second-line agents
  • Third line agents include intubation and sedation with propofol, benzodiazepines, or even ketamine

Editor's note: from a time management perspective, call for your second-line treatment early to get it from pharmacy while you slam the benzodiazepines, then it will be arriving hopefully when you need it, and no harm if you don't. Oh, and don't forget a fingerstick glucose.

References

Glauser T, Shinnar S, Gloss D, et al. Evidence-Based Guideline: Treatment of Convulsive Status Epilepticus in Children and Adults: Report of the Guideline Committee of the American Epilepsy Society. Epilepsy Curr. 2016;16(1):48–61. doi:10.5698/1535-7597-16.1.48

Walker, M.C. Pathophysiology of status epilepticus. Neuroscience Letters. 2018:667:84-91. https://doi.org/10.1016/j.neulet.2016.12.044

Summarized by Jackson Roos, MS3 | Edited by Erik Verzemnieks, MD

Jaksot(1145)

Podcast 869: Shift Work

Podcast 869: Shift Work

Contributor: Meghan Hurley MD Educational Pearls: Shift work is defined as anything that takes place outside of a 9-5 schedule, not exempting day-shift medical workers Various ill effects of shift...

18 Syys 20234min

Episode 868: Airway Management in Obesity

Episode 868: Airway Management in Obesity

Contributor: Aaron Lessen MD Educational Pearls: Why is airway management more difficult in obesity? Larger body habitus causes the chest to be above the head when the patient is lying supine, creat...

11 Syys 20233min

Episode 867: Occult Scaphoid Fractures

Episode 867: Occult Scaphoid Fractures

Contributor: Nick Tsipis MD Educational Pearls: The scaphoid bone is the most proximal carpal bone just distal to the radius Fractures of the scaphoid bone are sometimes missed by plain X-rays ...

4 Syys 20234min

Podcast 866: Carbamazepine (Tegretol) Overdose

Podcast 866: Carbamazepine (Tegretol) Overdose

Contributor: Aaron Lessen MD Educational Pearls: What is Carbamazepine (Tegretol)? Carbamazepine is an anti-epileptic drug with mood-stabilizing properties that is used to treat bipolar disorder, ep...

28 Elo 20232min

Laboring Under Pressure- Episode 1. ACLS in Pregnancy with Dr. Jason Papazian

Laboring Under Pressure- Episode 1. ACLS in Pregnancy with Dr. Jason Papazian

Contributor: Jason Papazian MD, Travis Barlock MD, Jeffrey Olson Summary: In this episode, Dr. Travis Barlock and Jeffrey Olson meet in the studio to discuss several clips from Dr. Jason Papazian's ta...

24 Elo 202332min

Podcast 865: Nausea Treatments - Droperidol vs Ondansetron RCT

Podcast 865: Nausea Treatments - Droperidol vs Ondansetron RCT

Contributor: Aaron Lessen MD Educational Pearls: A recent randomized controlled trial compared ondansetron 8 mg IV with droperidol 2.5 mg IV for the treatment of nausea & vomiting in the emergency d...

21 Elo 20232min

Podcast 864: Arterial Blood Gas (ABG) vs Venous Blood Gas (VBG)

Podcast 864: Arterial Blood Gas (ABG) vs Venous Blood Gas (VBG)

Contributor: Aaron Lessen MD Educational Pearls: What is measured in an ABG/VBG? Blood values for oxygen tension (pO2), carbon dioxide tension (pCO2), acidity (pH), oxyhemoglobin saturation, and bic...

14 Elo 20232min

Podcast 863: Treatments for Alcohol Use Disorder

Podcast 863: Treatments for Alcohol Use Disorder

Contributor: Aaron Lessen MD Educational Pearls: Patients with alcohol use disorder are frequently discharged from the ED without further resources Pharmacological treatments to reduce cravings in...

7 Elo 20232min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
docemilia
radio-antro
rss-duodecim-lehti
rss-ammamafia
rss-sosiopodi
utelias-mieli
ihanat-ipanat
mielipaivakirja
filocast-filosofian-perusteet
rss-bios-podcast
rss-tiedetta-vai-tarinaa