How do you adjust the loading and maintenance doses for Keppra when treating status epilepticus in patients with ESRD, patients on HD, or patients on CVVH?

Ideally, if you have a patient with status epilepticus and known ESRD, then Keppra may not be an ideal first option. You should be reaching for your other status anti-seizure meds that aren’t exclusively renally excreted and are readily available in most hospitals; Depakote (40 mg/kg loading dose) o...

In the acute sense, I agree with Dr. @Dr. First Last. Unless the patient has absolute contraindications to IV valproic acid, fosphenytoin, lacosamide, Versed, propofol, and phenobarbital, you should probably not be using Keppra.

Once the patient is no longer in status epilepticus and a change to Kepp...