Levetiracetam use in critically ill patients

Abstract

The results of this study suggest that LEV is a frequently used AED in the setting of acute brain injury and that it may be a desirable alternative to phenytoin. Prospective studies evaluating the long-term safety, efficacy and outcomes of LEV in this setting are indicated.

Safety and Efficacy of Levetiracetam for Critically Ill Patients with Seizures

“…However, patients in our ICU (many of whom have had neurosurgical procedures or liver failure) have a high reported frequency of seizures (4-19%) [14,15]. The strengths of the present study are that it is one of the largest series of LVM use in critically ill patients to date [3,5,13] and it had a longer follow-up period than the 7-day follow-up of prior studies [4,13].…”

“…In addition, unlike for phenytoin, drug level monitoring is not required for LVM owing to its linear and more predictable pharmacokinetics. LVM is safe and efficacious for use as adjuvant therapy in seizures [3][4][5]; however, few data exist on LVM monotherapy in the treatment and prophylaxis of seizures in critical care. We reviewed the use, safety, and efficacy of LVM in our ICU.…”

Prospective, Randomized, Single-Blinded Comparative Trial of Intravenous Levetiracetam Versus Phenytoin for Seizure Prophylaxis

“…Therefore, better treatment options than PHT are needed. Oral and, more recently, intravenous (IV) levetiracetam (LEV) have been studied in open-label trials or in a retrospective fashion in the acute care setting [11][12][13][14][15][16]. For example, we recently completed a review of 379 patients who received AEDs for seizure prophylaxis in the NSICU setting [16].…”

Levetiracetam Rectal Administration in Healthy Dogs

“…The drug has since gained broader approvals for treatment of a variety of partial and generalized seizure conditions, including those in pediatric patients 13, 14. Levetiracetam has a therapeutic profile closer to ideal than most other anticonvulsants15 and the parenteral form is now used increasingly to manage cluster seizures and status epilepticus in the very young, elderly, and critically ill humans 16, 17, 18, 19, 20…”