Seizure Meds Flashcards
A2ivan
Dosage:
IV, IO Lorazepam needs to be administered slowly.
Analgesia and sedation:
Adult: 2 mg or 0.44 mg/kg IV, IO, whichever is smaller.
Pediatric: 0.05 mg/kg IV, IO. Each dose should not exceed 2mg IV, IO.
Seizure:
Adult: 2 to 4 mg IV, IO given over 2 to 5 minutes; may repeat in 10 to 15 minutes (max total dose: 8 mg in a 12 hour period)
Pediatric: 0.1 mg/kg slow IV, IO given over 2 to 5 minutes (max single dose: 4mg). May repeat at half the original dose in 10 to 15 minutes if seizure activity resumes.
Indications: Sedation, Anxiety, Status Epilepticus
AKA: Lorazepam
Versed
Dosage:
Sedation:
The dose of midazolam needs to be individualized. Every dose should be admin slowly over a period of 2:00. Allow 2:00 to evaluate the clinical effect of the dose given.
Adult: Healthy and younger than 60: Some patients require as little as 1mg IV, IO. No more than 2.5 mg should be given over a 2:00 interval. If additional sedation is required, continue to administer small increments over 2:00 periods (max dose: 5 mg). If the patient also has received a narcotic, he or she will typically require 30% less midazolam than the same patient not given the narcotic.
60 years and older and debilitated or chronically ill patients: The peak clinical effect can take longer in these patients; therefore, dose increments should be smaller, and the rate of injection should be slower. Some patients require a dose as small as 1mg IV, IO, and no more than 1.5mg should be given over a 2:00 period. If additional sedation is required, additional midazolam should be given at a rate of no more than 1mg over a 2:00 period (max dose 3.5 mg). If the patient also has received a narcotic, he or she will typically require 50% less midazolam than the same patient not given the narcotic.
Continuous Infusion: Can be required for prolonged transport of intubated, critically ill, and injured patients After an initial bolus dose, the adult patient will require a maintenance infusion dose of 0.02 to 0.1mg/kg per hour.
Pediatric (weight based): Peds patients typically require higher doses of midalozam than adults on the basis of weight (in mg/kg). Younger peds patient, than 6, require doses higher than older peds patients. It takes 3:00 to reach peak effect; therefore, wait at least 2 minutes to determine the effectiveness of the drug and the need for additional dosage.
12 – 16 years: Same as adult dosing. Some may require a higher dose but no more than 10mg.
6 to 12 years: 0.025 to 0.05mg/kg slow IV, IO. Up to a total dose of 0.4mg/kg. Exceeding 10mg is no necessary.
6 months to 5 years: 0.05 to 0.1 mg/kg, IV, IO up to a total dose of 0.6 mg/kg. Exceeding 6mg is not necessary.
Younger than 6 months: Dosing is unclear. Use small increments with frequent evaluation. Dose 0.05 to 0.1 mg/kg IV IO.
Indications: Sedation, Anxiety, Skeletal muscle relaxation
AKA: Midazolam
Valium
Dosage:
Seizure
Adult: 5 to 10mg slow IV, IO every 10 – 15:00. Max total dose 30 mg
Peds: IV, IO, 5 years and older: 1 mg over a 3:00 period every 2 – 5 minutes. To a max total dose of 10mg
Older than 30 days to younger than 5 years: 0.2 to 0.5 mg over a 3:00 period; may repeat every 2 – 5 minute to a max total dose of 5mg
Neonote: 0.1 to 0.3 mg/kg per dose given over a 3 – 5:00 period. May repeat every 15-30 minutes to a max total dose of 2mg.
Rectal administration: if vascular access is not obtained, diazepam may be admin rectally to children.
12 year and older: 0.2mg/kg,
6 to 11 years: 0.3 mg/kg
2 to 5 years: 0.5 mg/kg
Younger than 2 years: Not recommended.
Indications: Anxiety, Skeletal muscle relaxation, alcohol withdrawal, seizures.
AKA: Diazepam
Cerebyx
Dosage:
Adult and pediatric: dosing is ordered in milligram phenytoin equivalents rather than in milligrams.
Administer 15 to 20 mg PE/kg IV, IO, administered at rate of <150 PE/minute
Indications: Tonic-clonic Seizures
AKA: Fosphenytoin
Dilantin
Dosage:
Adult: 15 to 20mg/kg, IV, IO, should be administered slowly at a rate not exceeding 50mg/min.(20:00 for a 70KG patient_
Pediatric: 15-20 mg/kg IV, IO, administered at a rate of 1-3 mg/kg per minute.
Indications: Generalized Tonic-Clonic Seizures
AKA: Phenytoin
Tegretol
Dosage:
Adult: 200mg orally (PO) every 12 hours.
Pediatric: 6 to 12 years: 100mg PO 2x daily
Younger than 6 years: 10 to 20 mg/kg per day PO 2 or 3 times per day.
Indications: Partial and generalized Tonic-Clonic seizures.
AKA: Carbamazepine
Keppra
Dosage:
Adult:
Status epilepticus: 1000 to 3000 mg, IV, IO administered over 15:00. Oral maintenance: up to 3000mg/ day in divided doses.
Pediatric:
status epilepticus: 20 to 60mg/ kg IV, IO, infused at 2-5mg/kg per minute. Oral maintenance: 7 to 10mg/kg per dose.
Indications: Partial and generalized tonic clonic seizures.
AKA: Levetiracetam
Depakote
Dosage: individualized
Indications: Seizures, mood disorders
AKA: Valproic Acid
Gabapentin
Dosage:
Adult: 300 to 1800mg PO (by mouth) daily.
Peds: 5-12 years: Up to 35mg/kg per day PO divided in three divided doses daily.
3-4 years: 10-15 mg/kg per day PO divided in three divided doses daily.
Indications: Seizures, neuropathic pain syndromes.
AKA: Neurontin
