• Neurocritical care · Dec 2021

    Observational Study

    Evaluation of Time to Administration, Benzodiazepine Use, and Safety of Intravenous Push Levetiracetam in a Neuro-Spine Intensive Care Unit.

    • Tori Adams and Kasey Greathouse.
    • University of Iowa Hospitals and Clinics, 200 Hawkins Dr., Iowa City, IA, 52242, USA. tradams31@gmail.com.
    • Neurocrit Care. 2021 Dec 1; 35 (3): 789-793.

    PurposeThe purpose of this study was to evaluate the time to medication administration, clinical effect, and safety of a recent Pharmacy and Therapeutics Committee-approved change in the administration of levetiracetam from intravenous piggyback (IVPB) over 15 min to undiluted intravenous push (IVP) over 2-5 min at a large academic medical center.MethodsThe primary outcome was the time from order verification to the administration of IVP levetiracetam versus IVPB levetiracetam. The secondary outcome was any benzodiazepine administered in the time between levetiracetam order verification and administration in both groups. Adult patients admitted to the neuro-spine intensive care unit in the 6 months prior to and after the policy change, and who received at least one dose of 1000 mg or higher of IVP or IVPB levetiracetam for active seizures, were included in this retrospective, observational, institutional review board-approved study. Data were analyzed using descriptive statistics, χ2, and the Mann-Whitney U-test as appropriate.ResultsOf the 2055 hospital-wide levetiracetam doses ordered within the study period, 316 doses were screened for enrollment and 160 were enrolled with 60 and 100 patients assigned to the IVP and IVPB groups, respectively. There were no differences between the groups at baseline. The majority of the population was male, 57 years old, had no significant renal dysfunction (defined as a creatinine clearance of less than 60 ml/min), and had a seizure etiology of malignancy or traumatic brain injury. A significant reduction in the time to administration of levetiracetam was found with IVP compared with IVPB administration (28 vs. 80 min, p < 0.0001). A subsequent reduction in patients who received benzodiazepines in the interim of levetiracetam order verification and administration was also associated with IVP compared with IVPB (2% vs. 13%, p = 0.042). There were no differences found in the rates of adverse effects between groups.ConclusionsAdministration of levetiracetam doses up to 2000 mg via IVP is a safe method of administration that results in a reduction of time to medication administration and a reduction of benzodiazepine use.© 2021. Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.