Episode 901: Underdosing in Status Epilepticus

Episode 901: Underdosing in Status Epilepticus

Contributor: Aaron Lessen MD

Educational Pearls:

  • Lorazepam (Ativan) is dosed at 0.1 mg/kg up to a maximum of 4 mg in status epilepticus

    • Some ED protocols only give 2 mg initially

  • The maximum recommended dose of levetiracetam (Keppra) is 60 mg/kg or 4.5 g

  • In one retrospective study, only 50% of patients received the correct dose of lorazepam

    • For levetiracetam, it was only 35% of patients

  • Underdosing leads to complications

    • Higher rates of intubations

    • More likely to progress to refractory status epilepticus

References

1. Cetnarowski A, Cunningham B, Mullen C, Fowler M. Evaluation of intravenous lorazepam dosing strategies and the incidence of refractory status epilepticus. Epilepsy Res. 2023;190(November 2022):107067. doi:10.1016/j.eplepsyres.2022.107067

2. Sathe AG, Tillman H, Coles LD, et al. Underdosing of Benzodiazepines in Patients With Status Epilepticus Enrolled in Established Status Epilepticus Treatment Trial. Acad Emerg Med. 2019;26(8):940-943. doi:10.1111/acem.13811

Summarized by Jorge Chalit, OMSII | Edited by Meg Joyce & Jorge Chalit

Jaksot(1145)

Podcast #227: CPR-Induced Consciousness

Podcast #227: CPR-Induced Consciousness

Author: Nick Hatch, M.D. Educational Pearls CPR-induced consciousness is a phenomenon that occurs when someone who was previously unconscious and is undergoing CPR regains consciousness and makes pur...

20 Heinä 20173min

Podcast #226: Biphasic Anaphylaxis

Podcast #226: Biphasic Anaphylaxis

Author: Sam Killian, M.D. Educational Pearls Anaphylaxis is common in the ED. These patients are treated and then usually watched for 4-6 hours. Biphasic happens in patients that have a complete reso...

18 Heinä 20173min

Podcast #225: Rhogam

Podcast #225: Rhogam

Author: Dylan Luyten, M.D. Educational Pearls Rhogam is commonly used when an Rh negative woman has an Rh positive fetus. It is commonly used in the ER in the setting of a miscarriage. Rh(+) fetal bl...

16 Heinä 20174min

Deep Dive #4: Pediatric Type I DKA

Deep Dive #4: Pediatric Type I DKA

Author: Justin Harper Justin Harper, a paramedic married to a pediatric nurse, discovered his own son had type I diabetes 2 years ago. Despite their medical experience, this diagnosis came as surprise...

14 Heinä 201747min

Brewcast Part VIII: Cannabis in Colorado

Brewcast Part VIII: Cannabis in Colorado

Author: Dr. Larry Wolk, Executive Director and Chief Medical Officer for the Colorado Department of Public Health and Environment. Topic: Dr. Larry Wolk educates us on how cannabis has affected Colora...

9 Heinä 201717min

Brewcast Part VII: A Patient's Perspective on Medical Marijuana

Brewcast Part VII: A Patient's Perspective on Medical Marijuana

Authors: Don Stader, M.D. & Lauren Gibbs Topic: Lauren breaks the stoner stereotype and explains how marijuana has positively impacted her life.

8 Heinä 201720min

Brewcast Part VI: Synthetic Marijuana

Brewcast Part VI: Synthetic Marijuana

Author: Erik Verzemnieks, M.D. Topic: Erik speaks about how slightly altering the chemical composition of marijuana can create a drug with drastic effects on the human body. WARNING: Explicit Language

7 Heinä 201712min

Brewcast Part V: Researching Cannabis

Brewcast Part V: Researching Cannabis

Author: Sophie Yorkwilliams -B.A. (Psychology) -Dual Ph.D. Candidate, Clinical Psychology and Neuroscience. Expected graduation: 2020 Topic: Studying cannabis comes with its own set of challenges. Fin...

6 Heinä 201717min

Suosittua kategoriassa Tiede

tiedekulma-podcast
rss-mita-tulisi-tietaa
rss-poliisin-mieli
rss-duodecim-lehti
docemilia
radio-antro
filocast-filosofian-perusteet
rss-ammamafia
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
rss-sosiopodi
utelias-mieli
rss-astetta-parempi-elama-podcast
rss-tiedetta-vai-tarinaa