CNS

Question 1

rt-PA, alteplase

Answer 1

0.9mg/kg IV, max 90mg
Bolus: 10% of dose (0.09mg/kg)
Infusion: remaining dose (0.81mg/kg) over 60min

Question 2

Nicardipine

Answer 2

Infusion: 5mg/hr, titrate by 2.5mg/hr q5-15min
Max: 15mg/hr

Question 3

Labetalol

Answer 3

Loading dose: 10-20mg IV, double dose at 10min intervals to max 300mg
Infusion: 2-8mg/min, titrate by 0.5mg/min q10min
Max: 8mg/min

Question 4

Esmolol

Answer 4

Loading dose: 250-500mcg/kg IV over 1 min
Infusion: 50mcg/kg/min
Max: 300mcg/kg/min

Question 5

Enalaprilat

Answer 5

1.25mg IV over 5min, titrated up to 5mg/dose q6hrs

If receiving diuretic: 0.625mg IV over 5min

Question 6

Hypertonic Saline (3%)

Answer 6

250mL wide open over 20min, max dose of 500mL

Question 7

Hypertonic Saline (23.4%)

Answer 7

30mL over 10min in central line

Question 8

Mannitol (20%)

Answer 8

Initial dose: 1g/kg IV bolus

repeat 0.5-1g/kg IV PRN q6-8hrs for increased ICP

Question 9

Levetiracetam

Answer 9

Loading dose: 20mg/kg IV over 1 hr

Repeat: 500-1000mg IV/PO q12hrs

Question 10

Phenytoin (IV/PO)

Answer 10

Loading dose: 20mg/kg IV max rate 50mg/min

Repeat: 5mg/kg/day in 3 doses

Question 11

Fosphenytoin (IV only)

Answer 11

Loading dose: 150mg/min over 60min

Question 12

Nimodipine

Answer 12

60mg PO q4hrs x21 days

Question 13

Sodium Bicarb (8.4% - contains hypertonic saline)

Answer 13

85mL over 30min

Question 14

Phenobarbital (Barbiturate coma)

Answer 14

10mg/kg IV over 30min, then 5mg/kg every hour for 3 hours, maintenance infusion initially 1mg/kg/hr

Question 15

Lorazepam

Answer 15

0.1mg/kg (max 4mg) over 2min, may repeat 10-15min

Question 16

Midazolam

Answer 16

10mg deep IM
Loading: 0.2mg/kg IV bolus
Maintenance: 0.05-2.9mg/kg/hr IV to seizure cessation

Question 17

Diazepam

Answer 17

5-10mg IV, PR 0.2-0.5mg/kg (max 20mg)

Question 18

Valproic acid

Answer 18

Loading dose: 20-40mg/kg IV at rate of 40mg/min

Max 3000mg

Question 19

Levetiracetam

Answer 19

60mg/kg; max 4500mg/dose single dose over 15min

Question 20

Propofol

Answer 20

Loading dose: 1-2mg/kg IV over 5min

Infusion: begin at 20mcg/kg/min; titrate 5-10mcg/kg/min every min to seizure cessation (max 200mcg/kg/min)

Question 21

Ketamine

Answer 21

Initial: 0.5-3mg/kg
Infusion: 0.3-7.5mg/kg/hr (max 10mg/kg/hr)

Question 22

Phenobarbital (status epilepticus)

Answer 22

20mg/kg IV max rate of 60mg/min

additional 5-10mg/kg dose if seizure persists >10min

Question 23

Pentobarbital

Answer 23

Initial: 5-15mg/kg at max rate 50mg/min, can give additional 5-10mg/kg
Maintenance: 0.5-5mg/kg/hr

Question 24

Dantrolene

Answer 24

1-2.5mg/kg IV once, then 1mg/kg q6hrs until 10mg/kg/day cumulative dose achieved

Question 25

Bromocriptine

Answer 25

Initial: 2.5-5mg PO q8hrs, titrate to 15-20mg q8hrs for 10 days, max 60mg/day

Question 26

Amantadine

Answer 26

100-200mg PO q12hrs