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(1145)

Podcast 686: Vaginal Self Swabs

Podcast 686: Vaginal Self Swabs

Contributor: Jared Scott, MD Educational Pearls: Recent study evaluated vaginal self swab testing for STIs to determine if they are equally sensitive to provider-obtained swab 515 patients consented ...

29 Jun 20213min

Podcast 685: Cultural Sensitivity with LGBTIQ+ Patients

Podcast 685: Cultural Sensitivity with LGBTIQ+ Patients

Contributor: Dr. Nick Gorton, MD Educational Pearls: Use transgender people's correct names and pronouns, the Russell study found a 56% reduction in suicide behavior with chosen name usage ⅕ to ½ of ...

28 Jun 202110min

Podcast 684: Acidosis

Podcast 684: Acidosis

Contributor:  Nick Tsipis, MD Educational Pearls: pH 7.45=alkalemia If pH low and pCO2 high, indicates a respiratory acidosis If pH low and pCO2 low, indicates metabolic acidosis After determining ty...

23 Jun 20216min

Podcast 683: Zofran vs. Haldol for Cannabinoid Hyperemesis Syndrome

Podcast 683: Zofran vs. Haldol for Cannabinoid Hyperemesis Syndrome

Contributor: Jared Scott, MD Educational Pearls: Around 30 patients with cannabinoid hyperemesis syndrome (CHS) randomized treatment in three arms with 8mg Zofran, Haldol 0.05 mg/kg, and Haldol 0.1 ...

22 Jun 20215min

Podcast 682: Snake Bites

Podcast 682: Snake Bites

Contributor: Gretchen Hinson, MD Educational Pearls: Pit vipers include cottonmouths, rattlesnakes, and copperheads All have folding long fangs, triangular face, and elliptical pupils About 5,00...

21 Jun 20216min

Podcast 681: Internal Hernias

Podcast 681: Internal Hernias

Contributor: Adam Barkin, MD Educational Pearls: Internal hernias, when bowel herniates through iatrogenic or congenital defect in mesentery, represent 1-6% of all small bowel obstructions Mortality...

16 Jun 20215min

Podcast 680: Coronary Artery Dissection

Podcast 680: Coronary Artery Dissection

Contributor: Adam Barkin, MD Educational Pearls: Spontaneous coronary artery dissection (SCAD) is the most common cause of acute MI in women under 50 years old Risk factors include fibromuscular dys...

15 Jun 20214min

Podcast 679: Antibiotics for CAP

Podcast 679: Antibiotics for CAP

Contributor: Peter Bakes, MD Educational Pearls: Community-acquired pneumonia (CAP) is normally stratified into outpatient-candidates vs. inpatient candidates for treatment For outpatient treatment,...

9 Jun 20217min

Populært innen Vitenskap

fastlegen
tingenes-tilstand
rekommandert
jss
smart-forklart
vett-og-vitenskap-med-gaute-einevoll
rss-rekommandert
forskningno
sinnsyn
villmarksliv
fjellsportpodden
rss-nysgjerrige-norge
rss-paradigmepodden
pod-britannia
aldring-og-helse-podden
nordnorsk-historie
diagnose
tidlose-historier
tomprat-med-gunnar-tjomlid
rss-overskuddsliv