Status Epilepitcus Flashcards
1
Q
Characterize phase I SE
A
- Increased epinephrine/norepinephrine –> HTN, tachycardia, arrhythmias
- Muscle contractions and hypoxia
- Acidosis
- Hypotension (shock)
- Rhabdomyolysis (with secondary hyperkalemia)
- Acute tubular necrosis
2
Q
Characterize phase II SE
A
-Begins 30 minutes into a seizure
1. Decompensation
2. Glucose decrease
3. Hyperthermia
(ventilatory failure, maybe)
3
Q
Treatment of impending GCSE (0-30 minutes)
A
Lorazepam (Ativan)***
4
Q
Treatment in Established GCSE (30-60 minutes)
A
Hydantoins (ex. phenytoin, fosphenytoin)
5
Q
When is GCSE not controlled/refractory?
A
if not controlled by 2 anticonvulsants
6
Q
What is the third drug given for GCSE when it becomes refractory (> 120 minutes)
A
- Midazolam
- Pentobarbital
- Propofol (only active while infusing)
7
Q
What are the final options for Super-Refractory GCSE?
A
- Ketamine
- Hypothermia
- Lidocaine
- Topiramate
- corticosteroids
8
Q
What are the 3 ways Midazolam can be given?
A
- Buccal
- Intranasal
- IV or IM
