Status Epilepticus
● Status epilepticus is either a seizure >5min or several seizures with no alert time in
between
Complications of Seizures
● Hypoxia
● pH changes
● Temperature changes
● Hypoglycemia
Anti-Epileptics
● Phenytoin
○ Works on Na+/K+ channels
● Depakote
○ GABA agonist
○ Works on Ca2+ channels
● Gabapentin
○ Works on Ca2+ channels
● Keppra (levetiracetam)
Na+ Channels
● Over-excitatory (depolarization) in epilepsy
● Phenytoin makes voltage-gated channels more selective
● Epilepsy makes gate less selective
Ca2+ Channels
● In epilepsy, all open at once
● Normal should have same number of channels open/closed
○ Equilibrium
● Gabapentin and depakote regulate via GABA
Keppra
● Binds to SV2A (excitatory) and inhibits
● Use after benzodiazepine (Versed/Ativan) if still seizing (status epilepticus)
● Mix 1g in 250mL D5W (2 vials Keppra)
● Drip over 10min (1500mL/hr)
● Status epilepticus is either a seizure >5min or several seizures with no alert time in
between
Complications of Seizures
● Hypoxia
● pH changes
● Temperature changes
● Hypoglycemia
Anti-Epileptics
● Phenytoin
○ Works on Na+/K+ channels
● Depakote
○ GABA agonist
○ Works on Ca2+ channels
● Gabapentin
○ Works on Ca2+ channels
● Keppra (levetiracetam)
Na+ Channels
● Over-excitatory (depolarization) in epilepsy
● Phenytoin makes voltage-gated channels more selective
● Epilepsy makes gate less selective
Ca2+ Channels
● In epilepsy, all open at once
● Normal should have same number of channels open/closed
○ Equilibrium
● Gabapentin and depakote regulate via GABA
Keppra
● Binds to SV2A (excitatory) and inhibits
● Use after benzodiazepine (Versed/Ativan) if still seizing (status epilepticus)
● Mix 1g in 250mL D5W (2 vials Keppra)
● Drip over 10min (1500mL/hr)
