Update of Antiepileptic Drug Dosing and Administration

Since the American Epilepsy Society guidelines were published in 2016,¹  new studies of dosing and administration of antiepileptic drugs for managing status epilepticus (SE) have been published. To prevent poor neurological outcomes, health care providers must recognize, treat, and attempt to terminate seizures when they occur. It is vital to choose an optimal agent and administer the agent as safely and quickly as possible. Common antiepileptics used in SE can be safely administered via intravenous push (IVP). Other agents, such as fosphenytoin and valproic acid, can be safely administered faster than the package insert recommendations but may require multiple doses to be prepared at the bedside or 1 dose to be sent from the pharmacy. In this article we propose an algorithm for administration of recommended antiepileptic drugs with dosing, special storage requirements, and other considerations for the treatment of SE in inpatient adults (Figure).

The International...