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 678: ECMO for Refractory VFib

Podcast 678: ECMO for Refractory VFib

Contributor: Aaron Lessen, MD Educational Pearls: Refractory ventricular fibrillation, defined as 3 defibrillation shocks without resolution, was studied via RCT looking to compare ECMO with cardiac...

8 Jun 20213min

Podcast 677: Oatmeal Cream for Hand Eczema

Podcast 677: Oatmeal Cream for Hand Eczema

Contributor: Jared Scott, MD Educational Pearls: Hand eczema is present in about 10% of the population and has a great prevalence in hairdressers, healthcare workers, and food service employees Usin...

7 Jun 20214min

Podcast 676: Spontaneous Bacterial Peritonitis

Podcast 676: Spontaneous Bacterial Peritonitis

Contributor:  Sam Killian, MD Educational Pearls: Patients with cirrhosis and ascites are frequently evaluated for spontaneous bacterial peritonitis, an infection of the ascites fluid that is not fro...

31 Mai 20214min

Pharmacy Phriday #10: Colorado Pharmacists Association 2020 Opioid Prescribing and Treatment Guidelines

Pharmacy Phriday #10: Colorado Pharmacists Association 2020 Opioid Prescribing and Treatment Guidelines

This week's Pharmacy Phriday features a short excerpt from a longer podcast released as promo for the Colorado's CURE initiative, Clinicians United to Resolve the Epidemic, that combats the opioid cri...

28 Mai 202121min

Podcast 675: CHF like it's 1966

Podcast 675: CHF like it's 1966

Contributor: Chris Holmes, MD Educational Pearls: Medicine is cyclical and practice is always evolving A description of recommended treatment for CHF from 1966 Give oxygen Give one dose morphine t...

26 Mai 20216min

Podcast 674: Facial Nerve Palsy in Kids

Podcast 674: Facial Nerve Palsy in Kids

Contributor: Aaron Lessen, MD Educational Pearls: Facial nerve palsy (Bell's palsy) can occur in pediatric patients with Lyme disease, viral infection, or even leukemia One trial sought out to find ...

25 Mai 20214min

Podcast 673: Leaving the ED with Naloxone

Podcast 673: Leaving the ED with Naloxone

Contributor: Don Stader, MD Educational Pearls: Patients are more likely to survive an opioid overdose if they have naloxone 10% risk of death in the year following an opioid overdose of patients see...

24 Mai 20216min

Podcast 672: Oxygen Things

Podcast 672: Oxygen Things

Contributor: Aaron Lessen , MD Educational Pearls: Patients on 10L or more of oxygen per minute in the ICU were randomized to oxygen goals of 90% or 96% to compare 90-day mortality rates Mortality ra...

18 Mai 20212min

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