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33 Cards in this Set
- Front
- Back
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what are the BZD for treatment of SE
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midazolam
lorazepam diazepam |
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what is the IV and continuous dose of midazolam
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IV: 0.2mg/kg
continous: 0.1mg/kg/hr |
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what are the routes that midazolam can be given
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intramuscular
intranasal buccal |
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what are the doses for diazepam
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rectal: 0.2mg/kg
IV: 0.25 mg/kg |
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what is the BZD of choice and why
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lorazepam because it has a duration of 8-12 hours giving you enough time to get other agents on board
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what is the dose of lorazepam
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0.1mg/kg IV
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what are the SE of BZD
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hypotension
-due to lorazepam and diazepam vehile proprylene glycol anterograde amnesia paradoxical reaction cardiorespiratory depression |
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what is the dose of phenytoin
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20mg/kg
-if pt still seizing can give additional 10mg/kg free levels 1-2 total levels 10-20 |
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what SE drug is highly protein bound
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phenytoin, this is an issue because most ICU patients have low albumin therefore you may see them with a low total but a high free which may be toxic
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what must phenytoin be given with
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0.9% NaCl to prevent it from precipitating out
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what are the SE of phenytoin
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hypotention (due to propylene glycol)
arrhythmias purple glove syndrome (due to extravasation since propylene gylcol is very tocix) |
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what is the dose of fosphenytoin
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20mg PE/kg
max infusion rate of 150 mg PE/min |
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how can fosphenytoin be administered
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IV
IM |
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what line agent is levetiracetam
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3rd line
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what is the dose of levetiracetam
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1000-3000 mg
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what is the loading dose and infusion rate of valproate
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loading dose 15-45 mg/kg
infusion rate of 2-6 mg/kg/min |
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can you use phenobarbitals in a pt who got treated with BZD
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yes they both work at GABAa but phenobarbital work at a different site
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what is the dose of phenobarbital
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20mg/kg IV
may repeat 20mg/kg IV then 10 mg/kg IV @ 100mg/min |
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what are patients who previously received BZD at risk of when they are given Phenobarbitals
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apnea
hypoapnea |
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what is the infusion rate of phenobarbitals
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100mg/min eventhough they contain propylene glycol
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where does Propofol bind
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GABAa Rc at diff location than BZD
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what is the main SE of propofol
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propofol infusion syndrome (metabolic acidosis, cardiac failure, renal failure)
remember it is diluted with 10% lipids when doing TPN |
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what is the loading and maintenance dose of propofol
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load: 2mg/kg IV bolus
maintenance 5-10mg/kg/hr |
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what drug is neuroprotective
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ketamine
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what drug becomes more effective the longer SE occurs
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ketamine
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what is the max dose rate of ketamine
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5mg/kg/hr
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what drugs can be used for burst suppression
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inhaled anesthetics
pentobarbital |
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what is the SE of topiramate
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metabolic acidosis
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JANE HAS 3 SEIZURES THAT LAST 9 MINUTES WHAT SHOULD YOU GIVE HER
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iv lorazepam repeat if no response in 5 mins
first 0-10 mins |
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JANE HAS 3 SEIZURES THAT LAST 15 MINUTES WHAT SHOULD YOU GIVE HER
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1st 10 min: Lorazepam 4mg then repeat in 5 min
10-30 min: IV phenytoin 10mg/kg @ 50mg/min or fosphenytoin 20mg/kg @ 100mg/min |
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what is done in 0-10 mins of SE
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IV lorazepam 4mg may repeat if no response in 5 mins
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what is done in 10-30 mins of SE
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IV phenytoin 10 mg/kg @ 50mg/min
IV fosphenytoin 20 mg/kg @ 150mg/min PE |
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what is done in 30-60 mins of SE
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additional IV 5mg dose of IV phenytoin or fosphenytoin'
or IV phenobarbital 20mg/kg at rate of 100mg/min |
