Student Copy 1. AS is a 13-year-old female with seizure disorder who has been treated with Lamictal and Topamax She weig

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Student Copy 1 As Is A 13 Year Old Female With Seizure Disorder Who Has Been Treated With Lamictal And Topamax She Weig 1 (32.53 KiB) Viewed 33 times

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Student Copy 1. AS is a 13-year-old female with seizure disorder who has been treated with Lamictal and Topamax She weighs 35 5kg and is 128.2 cm (505) tall. She had one questionable seizure three months ago. This episode was not witnessed but she became lethargic at school around 10 am and remained very tired when her mom got there. She sleptan additional 5 hours after going home with no other changes and then was fine. EEG four months ago showed abnormal bilateral epileptiform discharges with and without synchrony In addition to diffuse slowing Her latest CMP result shows that she has normal ver and renal function (bilirubin = 0.4 mg/dl, albumin 44 g/dL, serum creatinine = 0.63 mg/dL) tests from the physical laboratories. Dr. Bachman wants to initiate phenytoin. You are conduited for a recommendation of an initial loading dose of IV phenytoin sodium for AS a. Phenytoin loading dose: of handout for pediatric dosing) mg (Round to the nearest 50 mg) (see page 2 I b. What type of bag can you use? (Remember compatibility - see page 3 of handout) (Use 100 mL size bag) 2. Rale of administration of the calculated loading dose, given as a single dose mL/min (Remember the total volume = volume from vial + Infusion bag) (You will provide a rango) English (United
3. You will then need to follow-up with a daily maintenance dose of phenytoin to keep a steady-state phenytoin concentration equal to 15 mg/L. Maintenance IV daily phenytoin dose (see page 2 of handout); mg (Round to the nearest 50mg) (You will provide a range)
4. Assume (50 mg/mL) concentration for phenytoin vial. What volume of phenytoin will you need to make the maintenance dose? Compound this dose. a. Volume of phenytoin to use calculated in #3) _mL (based off the maintenance dose you b. What size and type of bag can you use? (see page 3 of handout) C. What size syringe can you use? (determine this based on the volume you calculated above) I
4. Dosing Adult Pediatric Status epilepticus LD: 20mg/kg IV once LD: 20mg/kg in a single or divided MD: 4-7 mg/kg/day given in 2-4 doses; max dose 1,000mg/dose divided doses; adjust dose based on MD: 4-8 mg/kg/day IV/PO, max daily response and serum concentration dose 300mg/day:; adjust dose based on response and serum concentration LD: 15 mg/kg IV given in 1-3 divided LD: 15-20 mg/kg IV in a single or doses over 24 hours divided doses MD: 4-7 mg/kg/day IV/PO given in 2-4 MD: 4-8 mg/kg/day IV/PO, max daily divided doses; adjust dose based on dose 300mg/day, adjust dose based response and serum concentration on response and serum Focal and generalized seizure concentration Administration