Table 2.

Features of commonly used IV AEDs and IVAT for acute seizures and SE, after initial single doses of IV BDZ have failed control [59]

	Suggested Initial IV dose	IV Maintenance dose	Side effects	EEG or lab considerations
Fosphenytoin (phenytoin)	≥ 20 mg/kg	100 mg q8h	Hypotension Cardiac	Enzyme induction EKG
Phenobarbital	≥ 20 mg/kg	30–60 mg q8h	Hypotension Resp depression	BS on EEG Enzyme induction
Divalproex sodium	≥ 20 mg/kg	1 g q8h	Tremor	Thrombocytopenia Protein binding
Levetiracetam	60 mg/kg	1 g q8h	Agitation	Renal elimination
Lacosamide	200 mg	200 mg q12h	Dizziness, cardiac	EKG—conduction block, arrhythmia
Brivaracetam	100 mg	100 q12h	Mood	Renal elimination
Midazolam	0.2–0.5 mg/kg	2–40 μg kg min	Intubation	Titrate to BS on EEG
Pentobarbital	5–15 mg/kg	0.5–5 mg/kg/h	Intubation	Titrate to BS on EEG
Propofol	1–2 mg/kg bolus q 3 min up to 10 mg/kg	1–15 mg/kg/h first, then up to 5 mg/kg/h	Intubation, propofol infusion syndrome	Titrate to BS on EEG; Avoid prolonged use
Ketamine	1–2.5 mg/kg	3–10 mg/kg/h	Intubation Psychosis Hypertension	Use with BDZ for psychosis (BDZ beta on EEG)