{"id":712,"date":"2015-11-09T14:00:13","date_gmt":"2015-11-09T19:00:13","guid":{"rendered":"http:\/\/emeddoc.org\/?p=712"},"modified":"2015-11-09T14:00:13","modified_gmt":"2015-11-09T19:00:13","slug":"seizure-loading-dose","status":"publish","type":"post","link":"https:\/\/emeddoc.org\/?p=712","title":{"rendered":"Seizure: Loading Dose"},"content":{"rendered":"

There are several methods to orally load Anti Epileptic drugs (AED) in ED. Tintinalli’s has 2 approaches: 1.patient with active seizure 2. patient with history of seizure. Patient who had active seizure should receive Phenytoin 15- 25 mg\/kg no more than 50 mg\/min. For patient in no active seizure<\/b>: Without a loading dose, phentoin may reach to therapeutic dose within 1-10 days. Another method is to give patient 18mg\/kg as a single dose orally or divided into 3 doses given every 2 hours. If you would like<\/b> to reach within 1-2 hours to therapeutic dose you can give10 to 20 mg\/kg through IV with a rate of 25 mg\/min.<\/p>\n

So, Our discussion was should I do Orally or IV and what is the dose for each one. The ACEP Guideline<\/a> is referring to only a very old article that came in AEM 2004, based on 45 patients in 3 different groups.<\/p>\n

http:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1553-2712.2004.tb02204.x\/epdf<\/a><\/p>\n

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A Comparison of Phenytoin-loading Techniques in the …<\/div>\n
You have free access to this content Academic Emergency Medicine Volume 11, Issue 3, Article first published online: 8 JAN 2008<\/div>\n
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Again, we are not talking about a patient in active seizure, who needs to have AED to control seizure. Clinical Neurology, 9e Michael J. Aminoff 2015 recommends: Phenytoin Oral loading: 1,000 mg in two to four divided doses over 12-24 h ntravenous loading: 1,000-1,500 mg (15-18 mg\/kg) not exceeding 50 mg\/min.<\/p>\n","protected":false},"excerpt":{"rendered":"

There are several methods to orally load Anti Epileptic drugs (AED) in ED. Tintinalli’s has 2 approaches: 1.patient with active seizure 2. patient with history of seizure. Patient who had active seizure should receive Phenytoin 15- 25 mg\/kg no more than 50 mg\/min. For patient in no active seizure: Without a loading dose, phentoin may […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[30,13,14,15,16],"tags":[],"class_list":["post-712","post","type-post","status-publish","format-standard","hentry","category-neurology","category-pgy1","category-pgy2","category-pgy3","category-pgy4"],"_links":{"self":[{"href":"https:\/\/emeddoc.org\/index.php?rest_route=\/wp\/v2\/posts\/712","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/emeddoc.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/emeddoc.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/emeddoc.org\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/emeddoc.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=712"}],"version-history":[{"count":1,"href":"https:\/\/emeddoc.org\/index.php?rest_route=\/wp\/v2\/posts\/712\/revisions"}],"predecessor-version":[{"id":713,"href":"https:\/\/emeddoc.org\/index.php?rest_route=\/wp\/v2\/posts\/712\/revisions\/713"}],"wp:attachment":[{"href":"https:\/\/emeddoc.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=712"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/emeddoc.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=712"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/emeddoc.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=712"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}