How do you approach tapering high dose continuous infusions for status epilepticus in patients experiencing serious medication-related toxicity?
e.g. for propofol, midazolam, ketamine
Answer from: at Academic Institution
The short answer is as quickly as possible. How you do it will somewhat depend on the need for ongoing continuous infusion of a sedative for treatment of status epilepticus. Probably the most severe toxicity syndrome is Propofol-Related Infusion Syndrome (PRIS), which if not recognized early, can le...
This is done with continuous EEG monitoring. It depends on how long the patient has been on these infusions and what doses they are at, if there is sufficient coverage with non-infusion ASMs (either IV or oral). There is no one particular strategy, but what is typically done is reducing by up to 25%...