Anticonvulsant levels and reloading: Difference between revisions
(Created page with "==Background== DOSE Dose (mg) = weight* (kg) X volume of distribution X [desired level - current level (mcg/mL)] *Ideal body weight ==Diagnosis== VOLUME OF DISTRIBUT...") |
No edit summary |
||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
===DOSE=== | |||
Dose (mg) = weight^ (kg) X volume of distribution X [desired level - current level (mcg/mL)] | |||
^Ideal body weight | |||
===VOLUME OF DISTRIBUTIONS=== | |||
Phenytoin (dilantin) 0.8 | Phenytoin (dilantin) 0.8 | ||
| Line 25: | Line 15: | ||
Valproate (depakote) 0.2 | Valproate (depakote) 0.2 | ||
===DESIRED LEVEL=== | |||
#If patient's optimal levels known = desired level | |||
DESIRED LEVEL | #If not, target upper end of therapeutic range: | ||
##Phenytoin = 20 mcg/mL | |||
If patient's optimal levels known = desired level | ##Phenobarbital = 40 mcg/mL | ||
##Valproate = 100 mcg/mL | |||
If not, target upper end of therapeutic range: | |||
Phenytoin = 20 mcg/mL | |||
Phenobarbital = 40 mcg/mL | |||
Valproate = 100 mcg/mL | |||
==Treatment== | ==Treatment== | ||
#Iv load can be performed with phenobarbital, phenytoin/fosphenytoin, valproate, or levetiracetam. | |||
#Oral loading often limited by neurotoxic adverse effects (n/v) , but can spread dose out over a day or more if necessary. | |||
##(e.g. phenytoin PO 400 mg Q4 to reach the final dosage) | |||
Iv load can be performed with phenobarbital, phenytoin/fosphenytoin, valproate, or levetiracetam. | |||
Oral loading often limited by neurotoxic adverse effects (n/v) , but can spread dose out over a day or more if necessary. | |||
(e.g. phenytoin PO 400 mg Q4 to reach the final dosage) | |||
==See Also== | ==See Also== | ||
Neuro: Seizure Levels and Reloading | Neuro: Seizure Levels and Reloading | ||
| Line 62: | Line 33: | ||
Peds: Febrile Seizure | Peds: Febrile Seizure | ||
==Source== | ==Source== | ||
DONALDSON 3/08 (from emedicine; Treiman 1997; Bourgeois, 1996) | DONALDSON 3/08 (from emedicine; Treiman 1997; Bourgeois, 1996) | ||
[[Category:Drugs]] | |||
[[Category:Neuro]] | [[Category:Neuro]] | ||
Revision as of 07:01, 28 March 2011
Background
DOSE
Dose (mg) = weight^ (kg) X volume of distribution X [desired level - current level (mcg/mL)]
^Ideal body weight
VOLUME OF DISTRIBUTIONS
Phenytoin (dilantin) 0.8
Carbamazepine (tegretol) 0.8
Phenobarbital 0.6
Valproate (depakote) 0.2
DESIRED LEVEL
- If patient's optimal levels known = desired level
- If not, target upper end of therapeutic range:
- Phenytoin = 20 mcg/mL
- Phenobarbital = 40 mcg/mL
- Valproate = 100 mcg/mL
Treatment
- Iv load can be performed with phenobarbital, phenytoin/fosphenytoin, valproate, or levetiracetam.
- Oral loading often limited by neurotoxic adverse effects (n/v) , but can spread dose out over a day or more if necessary.
- (e.g. phenytoin PO 400 mg Q4 to reach the final dosage)
See Also
Neuro: Seizure Levels and Reloading
Peds: Seizure (Peds)
Peds: Febrile Seizure
Source
DONALDSON 3/08 (from emedicine; Treiman 1997; Bourgeois, 1996)