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

Episoder(1146)

Podcast # 327: No More Hemoccults

Podcast # 327: No More Hemoccults

Author: Don Stader, MD Educational Pearls: The use of fecal occult blood tests is falling out of favor in emergency departments These tests have strong evidence suggesting their efficacy in colon...

9 Mai 20182min

Podcast # 326: Valley Fever

Podcast # 326: Valley Fever

Author: Michael Hunt, MD Educational Pearls: Valley fever is a fungal infection known as Coccidiomycosis that can present with vague symptoms like cough, fever, myalgias. A thorough history is crit...

7 Mai 20183min

Podcast #325: Vaping and Pneumonia

Podcast #325: Vaping and Pneumonia

Author: Sam Killian, MD Educational Pearls: Being exposed to E-cigarette vapor may increase risk of pneumonia. Recent study has shown e-cigarette vapor increases quantities of Platelet-activating-rec...

4 Mai 20183min

Podcast #324: Superwarfarin

Podcast #324: Superwarfarin

Author: Rachel Beham, PharmD Educational Pearls: Some synthetic cannabinoids have been contaminated with Brodifacoum. Brodifacoum is a Vitamin K antagonist and can present with a severe coagulopathy....

2 Mai 20184min

Podcast #323: Calcium Channel Toxicity

Podcast #323: Calcium Channel Toxicity

Author: Jared Scott, M.D. Educational Pearls: Cardiac myocytes and vascular smooth muscle are dependent on an intracellular calcium influx for contraction. Pancreatic beta cells rely on calcium to re...

30 Apr 20187min

Podcast #322: Methemoglobinemia

Podcast #322: Methemoglobinemia

Author: Nick Hatch, M.D. Educational Pearls: Methemoglobinemia is when the iron in hemoglobin is in the Fe3+ (ferric) state rather than the normal Fe2+ (ferrous) state. Methemoglobin cannot releas...

27 Apr 20184min

Podcast #321: Migraine Treatment in ED

Podcast #321: Migraine Treatment in ED

Author: Jared Scott, M.D. Educational Pearls: Recent study compared Compazine with Benadryl vs. Dilaudid for acute migraine management in the ED. Compazine + Benadryl demonstrated migraine relief...

25 Apr 20183min

Podcast #320: PE in Pregnancy

Podcast #320: PE in Pregnancy

Author: Don Stader, M.D. Educational Pearls: Pulmonary embolism is one of the leading causes of maternal mortality. There is disagreement among different medical societies about the value of D-di...

23 Apr 20184min

Populært innen Vitenskap

fastlegen
tingenes-tilstand
rekommandert
jss
rss-rekommandert
rss-nysgjerrige-norge
villmarksliv
forskningno
sinnsyn
rss-paradigmepodden
fjellsportpodden
vett-og-vitenskap-med-gaute-einevoll
nordnorsk-historie
smart-forklart
rss-overskuddsliv
diagnose
abid-nadia-skyld-og-skam
abels-tarn
tomprat-med-gunnar-tjomlid
aldring-og-helse-podden