Status Epilepticus Flashcards
status epilepticus definition?
> 5min or recurrent without return to baseline
status epilepticus medications?
First line:
- benzodiazepines
Second line:
- Levetiracetam (keppra)
- Valproic acid
- Phennytoin
- fospheytoin
Third line: (meds plus initubation)
- propofol
- Ketamine
- pHenobarbital
- pEntobarital
Benzodiazepines (status epilepticus)
Lorazepam (ativan)
Diazepam(Valium)
Midazolam (versed)
If you cant get an iv on a status epilepticus patient the only good drug option is?
Midazolam (versed)
Though diazepam can be PR or IN
Lorazepam (ativan) dose (status epilepticus)
- First line agent -
IVP: 2-4mg IV -repeat q 3-5 mini (0.1mg/kg) doubling dose with each interval
Diazepam (valium) dose (status epilepticus)
IVP: 5mg IV q 5 min (max dose 20mg)
PR/IN: 0.2mg/kg - 0.5mg/kg
Midazolam (versed) dose (status epilepticus)
10mg IM
5mg IN
How to remember second line meds dose (status epilepticus)
LVPF: 60/40/20/20
Levetiracetam 60, valproic acid 40, phenytoin 20, fosphenytoin 20
Levitracetam (kepra) dose (second line status epilepticus)
60mg/kg IV max dose 4.5g
Valproic acid dose (second line status epilepticus)
40mg/kg IV
Phenytoin dose (second line status epilepticus)
20mg/kg IV loading dose
Then
50mg/min (max rate - watch for HOTN from diluent)
Fosphenytoin dose (second line status epilepticus)
20 PE/kg IV loading dose
Then
100-150 PE/min
Third line agents (status epilepticus)
Propofol
Ketaminie
Phenobarbital
Pentobarbital
Should be given with intubation
Propofol dose (third line status epilepticus)
2mg/kg IV
Then
50-80mcg/kg/min
Ketamine dose (third line status epilepticus)
2mg/kg
Then
0.5-2mg/kg/hr
