Title: Status epilepticus medication management in children<br/>Author: Jenny Guyther<br/><a href='http://umem.org/profiles/faculty/314/'>[Click to email author]</a><hr/><p style="font-family: Arial, Helvetica, sans-serif; font-size: small; margin: 0in 0in 0pt; line-height: normal;">
<span style="font-family: Arial, sans-serif; font-size: 10pt;"><font color="#000000">-Benzodiazepines alone are effective in terminating status epilepticus in 40 to 60% of </font></span><span style="color: rgb(0, 0, 0); font-family: Arial, sans-serif; font-size: 13.3333px;">pediatric </span><span style="color: rgb(0, 0, 0); font-family: Arial, sans-serif; font-size: 10pt;">patients</span></p>
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<span style="font-family: Arial, sans-serif; font-size: 10pt;"><font color="#000000">-The guidelines for second line agents are based on observational studies and expert opinion</font></span></p>
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<span style="font-family: Arial, sans-serif; font-size: 10pt;"><font color="#000000">-Adverse effects of phenytoin include hepatotoxicity, pancytopenia, Stevens-Johnson syndrome, extravasation injuries, hypotension and arrhythmias</font></span></p>
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<span style="font-family: Arial, sans-serif; font-size: 10pt;"><font color="#000000">- Levetiracetam has a reduced risk of serious adverse events, greater compatibility with IV fluids and can be given in 5 minutes versus 20 minutes for phenytoin.</font></span></p>
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<span style="font-family: Arial, sans-serif; font-size: 10pt;"><font color="#000000"> </font></span></p>
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<font color="#000000"><b><span style="line-height: 14.2667px; font-family: Arial, sans-serif; font-size: 10pt;">Bottom line:</span></b><span style="line-height: 14.2667px; font-family: Arial, sans-serif; font-size: 10pt;"> In a recent randomized control trial they found that levetiracetam was not superior to phenytoin as a second line agent for management of convulsive status epilepticus in children. There was no difference between efficacy or safety outcomes between the two groups.</span></font></p>
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<span style="color: rgb(0, 0, 0); font-family: Arial, sans-serif; font-size: 13.3333px;">Dalziel at al.</span><span style="color: rgb(0, 0, 0); font-family: Arial, sans-serif; font-size: 13.3333px;"> </span><span style="color: rgb(0, 0, 0); font-family: Arial, sans-serif; font-size: 13.3333px;">Levetiracetam versus phenytoin for second line treatment of convulsive status epilepticus in children; an open label, multicenter, randomized control trial.</span><span style="color: rgb(0, 0, 0); font-family: Arial, sans-serif; font-size: 13.3333px;"> </span><span style="color: rgb(0, 0, 0); font-family: Arial, sans-serif; font-size: 13.3333px;">The Lancet.</span><span style="color: rgb(0, 0, 0); font-family: Arial, sans-serif; font-size: 13.3333px;"> </span><span style="color: rgb(0, 0, 0); font-family: Arial, sans-serif; font-size: 13.3333px;">Published online April 17, 2019.</span></p>
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