AEDs in the ICU.
Mechanism of action
- 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.
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
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:
- cortical involvement
- age < 65 years
- volume >10ml
- early seizures within 7 days of ICH
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%
Haapaniemi, E. et al. “The CAVE Score For Predicting Late Seizures After Intracerebral Hemorrhage”. Stroke 45.7 (2014): 1971-1976.
Antiepileptic Drug Absorption, Elimination Half-Life, Formulations
Hepatic Metabolism, Enzyme Induction/Inhibition, Pharmacokinetic Interactions, and Protein Binding
Established Efficacy of Antiepileptic Drugs by Seizure Type (FDA Indications and Class I-III Evidence)
Key Known Antiepileptic Drug Mechanisms of Action
Daroff, Robert B et al. Bradley’s Neurology In Clinical Practice. London: Elsevier, 2016. Print.