Antiepileptic dosing for critically ill adult patients receiving renal replacement therapy

Keaton S. Smetana, Aaron M. Cook, Melissa L.Thompson Bastin, Douglas R. Oyler

Research output: Contribution to journalReview articlepeer-review

28 Scopus citations

Abstract

Objectives The aim of this review was to evaluate current literature for dosing recommendations for the use of antiepileptic medications in patients receiving renal replacement therapy (RRT). Data sources With the assistance of an experienced medical librarian specialized in pharmacy and toxicology, we searched MEDLINE, EMBASE, CINAHL, Web of Science, WorldCat, and Scopus through May 2016. Study selection and data extraction Four hundred three articles were screened for inclusion, of which 130 were identified as potentially relevant. Micromedex® DRUGDEX as well as package inserts were used to obtain known pharmacokinetic properties and dosage adjustment recommendations in RRT if known. Data synthesis Data regarding antiepileptic drug use in RRT are limited and mostly consist of case reports limiting our proposed dosing recommendations. Known pharmacokinetic parameters should guide dosing, and recommendations are provided where possible. Conclusion Additional studies are necessary before specific dosing recommendations can be made for most antiepileptic drugs in critically ill patients receiving RRT, specifically with newer agents.

Original languageEnglish
Pages (from-to)116-124
Number of pages9
JournalJournal of Critical Care
Volume36
DOIs
StatePublished - Dec 1 2016

Bibliographical note

Publisher Copyright:
© 2016 Elsevier Inc.

Keywords

  • Anticonvulsants
  • Continuous renal replacement therapy
  • Hemodialysis
  • Intensive care

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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