mgminute without risk of cardiovascular collapse It is also more expensive 7 If

Mgminute without risk of cardiovascular collapse it

  • Walden University
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mg/minute) without risk of cardiovascular collapse It is also more expensive 7. If the above measures to abort status epilepticus are unsuccessful, intubate and administer phenobarbital (Luminal), 100 mg/minute IV to a maximum of 20 mg/kg. 8. If still unsuccessful after 60 minutes, consider general anesthesia with propofol (Diprivan), loading dose of 3-5 mg/kg, followed by an infusion of 30-100 mcg/kg/min. D. Clinical pharmacology of the antiepileptic drugs (AEDs) (Table 6.1) E. Drugs for specific types of seizures (Table 6.2)
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F. Titrate dosages to achieve adequate serum levels. If a first drug partially controls seizures at a maximal therapeutic level, add a second drug to achieve therapeutic levels. Evaluation of serum phenytoin may require additional correction based on serum albumin level and/or current renal function; consult pharmacist for appropriate correction of phenytoin levels to avoid unnecessary dosage adjustments. G. If the patient is seizure-free, monitor the patient, not the levels. H. One should never abruptly withdraw an anticonvulsant from a patient; these drugs should be tapered. I. Vagus nerve stimulation is used in conjunction with medications by patients with severe, uncontrolled seizures. Stimulation is typically applied for 30 seconds every 5 minutes. When the vagus is stimulated, resultant impulses in some way interrupt or prevent abnormal neuronal firing. Pharmacologic Agents Drug Dosing Dail y Dos age Targe t Seru m Level Mcg/ ml Induces Hepatic Drug Metaboli sm Carbamaze pine Tegretol Epitol Tegretol XR Carbatrol Equetro 3xdail y 3xdail y 2xdail y 2xdail y 2xdail y 600 - 180 0 4-12 Yes Ethosuximi de Zarontin 1-2 xdaily 750 40- 100 No Phenobarb ital 1- 2xdail y 60- 120 15-45 Yes Phenytoin Dilantin-125 Dilantin Infatab Phenytek Dilantin ER 2- 3xdail y 2- 3xdail y 1xdail y 1xdail y 200 - 300 10-20 Yes Primidone Mysoline 3- 4xdail y 500 - 750 5-15 Yes Valproic acid Depakene Depakote Depakote ER Stavzor 3- 4xdail y 3- 4xdail y 2xdail y 2- 3xdail y 750 - 300 0 40- 100 Yes Gabapenti n Neurontin 3xdail y 120 0- 360 0 ND No Lacosamid e Vimpat 2xdail y 200 - 400 ND No Lamotrigin e Lamictal Lamictal ODT Lamictal XR 2xdail y 2xdail y 1xdail y 400 ND No Levetirace tam Keppra 2xdail y 200 0- 300 0 ND No Oxcarbaze pine Trileptal 2xdail y 900 - 240 0 3-40 No Pregabalin Lyrica 2- 3xdail y 150 - 600 ND No Rufinamid e 2xdail 320 ND Yes
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Banzel y 0 Tiagabine Gabitril 2- 4xdail y 16- 32 ND No
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GUILLAIN-BARRE SYNDROME I. Definition A. Guillain-Barre syndrome (GBS) is an acute, usually rapidly progressive, form of inflammatory demyelinating radiculoneuropathy; typically motor greater than sensory. B. Characterized by a monophasic course of muscular weakness, mild distal sensory loss, and autonomic dysfunction, with the majority of patients reporting an antecedent infection 1. The maximum deficit is usually attained by week 4. C. Most frequently acquired demyelinating neuropathy II. Etiology A. Unknown, although an autoimmune basis is probable B. Majority of cases are triggered by an antecedent infection, suggesting a response involving antibodies cross-reacting with both humoral and cellular immunity with peripheral nerve Gangliosides C. Frequent antecedent infections include the
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