Seizures

Question 1

Neuromuscular blocker to avoid in status epilepticus

Answer 1

succinylcholine

Question 2

Definition of status epilepticus

Answer 2

seizure 5 minutes or more

or

2 seizures without neurologic recovery between

Question 3

First line therapy in seizures

Answer 3

benzos (specifically lorazepam)

Question 4

Why is lorazepam the preferred benzo in seizures

Answer 4

studies show better initial control and fewer recurrences as compared to other benzos

Question 5

Dose of lorazepam in seizures

Answer 5

0.1 mg/kg

Max 4 mg/dose x 2 doses

Question 6

What is the dose of keppra for seizure control

Answer 6

60 mg/kg max 4500 mg

Question 7

What is the dose of fosphenytoin for seizure control

Answer 7

20 mgPE/kg max 1500 mgPE

Question 8

What is the dose of valproate for seizure control

Answer 8

40 mg/kg max 3000 mg

Question 9

What is the dosing consideration for keppra

Answer 9

adjust for renal function

Question 10

What is the side effect of fosphenytoin

Answer 10

hypotension

Question 11

What is the dosing consderation for valproate

Answer 11

avoid in liver disease/causes hyperammonemia

Question 12

Which antiepileptic has no significant drug interactions

Answer 12

Keppra

Question 13

Which antiepileptic can be given IM

Answer 13

Fosphenytoin

Question 14

What abnormality on EEG looks like VT on EKG

Answer 14

seizures

Question 15

What abnormality on EEG looks like Vfib on EKG

Answer 15

normal

Question 16

What abnormality on EEG looks like Vtach/fib with asystole pauses on EKG

Answer 16

burst suppression

Question 17

What is the EEG target of antiepileptic therapy

Answer 17

Burst suppression

Question 18

Incidence of non-convulsive status epilepticus following treatment of convulsive status

Answer 18

50%

Question 19

Who is the only patient who needs seizure prophylaxis

Answer 19

TBI moderate to severe