Tag Archives: SEIZURES

Medications Used to Treat Seizures and Status Epilepticus in Adult ICU Patients

AEDs in the ICU.

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From ENLS:


Mechanism of action

  1. Benzodiazepines – stimulates GABA A receptor subunits, leads to inhibition of transmission through chloride channel-induced hyperpolorization of resting cells embrane, at high levels Benoza function in a manner similar to phenytoin

 

Neurocritical Care Society provided dosing cards for IV and PO AEDs in their website for free.  See links below for PDF files.

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Reference:

Tesoro, Eljim P. and Gretchen M. Brophy. “Pharmacological Management Of Seizures And Status Epilepticus In Critically Ill Patients”. Journal of Pharmacy Practice 23.5 (2010): 441-454. Web.

Manno, in The Neurohospitalist

Medication Dosing Cards | NCS. (2019). Retrieved from https://www.pathlms.com/ncs-ondemand/courses/2653/sections/12865

 

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CAVE Score (Seizures after ICH)

The CAVE score is a tool used to quantify the risk of seizure after intracerebral hemorrhage.  Data from Helsinki ICH study and Lille Prognosis of ICH studies were analyzed retrospectively and the authors created the CAVE score to estimate the risk of late seizures after ICH.

1 point is given for each of the following:

  1. cortical involvement
  2. age < 65 years
  3. volume >10ml
  4. early seizures within 7 days  of ICH

 

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Risk of seizures based on score:

  • CAVE score 0 = 0.6%
  • CAVE score 1 = 3.6%
  • CAVE score 2 = 9.8%
  • CAVE score 3 = 34.8%
  • CAVE score 4 = 46.2%

 

Reference:

Haapaniemi, E. et al. “The CAVE Score For Predicting Late Seizures After Intracerebral Hemorrhage”. Stroke 45.7 (2014): 1971-1976.

Antiepileptic Medications

 

Antiepileptic Drug Absorption, Elimination Half-Life, FormulationsAEDAED2
Hepatic Metabolism, Enzyme Induction/Inhibition, Pharmacokinetic Interactions, and Protein Binding

AED3AED4

 

Established Efficacy of Antiepileptic Drugs by Seizure Type (FDA Indications and Class I-III Evidence)

AED5AED6

Key Known Antiepileptic Drug Mechanisms of Action

AED7AED8

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Reference:

Daroff, Robert B et al. Bradley’s Neurology In Clinical Practice. London: Elsevier, 2016. Print.