Is there a treatment algorithm for status epilepticus?

STATUS EPILEPTICUS (SE) TREATMENT ALGORITHM IN ADULTS There exists a lack of prospective controlled trials regarding the appropriate doses or targeted therapeutic levels for refractory status epilepticus. Many of the recommended doses or targeted therapeutic levels are higher than referenced in the literature and based upon expert opinions at NYPH.

Are there any new medications available for status epilepticus?

Treatment is evolving as new medications become available. Three new preparations—fosphenytoin, rectal diazepam, and parenteral valproate—have implications for the management of status epilepticus.

How is lorazepam used to treat status epilepticus?

Treatment of Status Epilepticus. Lorazepam is considered the benzodiazepine of choice for the initial treatment of seizures given its pharmacokinetic and safety profile. Initial doses should be 4 to 10 mg intravenously. A loading dose of 0.1 to 0.2 mg/kg should be given if seizures are not aborted within 2 to 3 minutes.

When did the FDA approve Cerebyx for status epilepticus?

Fosphenytoin (Cerebyx) received approval for treatment of status epilepticus from the U.S. Food and Drug Administration (FDA) in 1996. Fosphenytoin is a water-soluble pro-drug of phenytoin that completely converts to phenytoin following parenteral administration.

Is there consensus on management of acute repetitive epilepsy?

For convulsive status epilepticus, there is reasonable consensus on the initial steps that need to be taken. There is less agreement about the management of acute repetitive seizures and nonconvulsive status epilepticus.

What is the guideline for adult status epilepticus?

ADULT Status Epilepticus Treatment Guideline The following is a guideline for the initiation of sequential interventions if seizures continue / do not break: 0- 2 min Stabilization Phase Stabilize patient (airway, breathing, circulation) Time seizure from onset Obtain baseline vital signs, IV access, 12-lead EKG, fingerstick blood glucose

When to start stat levetiracetam for status epilepticus?

 Lacosamide 400 mg IVPB over 15 minutes, STAT Levetiracetam 3000 mg IVPB over 15 minutes, STAT Start maintenance dose of AED 6 hours after loading dose > 60min Third Therapy Phase- Refractory Status Epilepticus All continuous infusions should be ordered as “fixed rate” orders: Midazolam