Ashley McCormick, PharmD, BCPS, BCCCP discusses the ESETT study on anticonvulsant medications for status epilepticus. Topics include ASM PK/PD properties, BZD dosing, seizure cessation rates, dosing scheme origins, medication safety, and more.
The ESETT trial evaluated antiepileptic medications' impact on status epilepticus treatment protocols and medication safety considerations.
PKPD considerations underscored the influence of drug properties on dosing predictability and patient safety for status epilepticus.
No significant differences in seizure cessation rates among medications prompted dosing protocol changes for status epilepticus treatment.
Operational aspects emphasized streamlined drug administration and dose uniformity for patient safety in emergency care settings.
Research directions highlight the need for IV push dosing studies and novel agents for enhancing status epilepticus treatment efficacy.
The podcast seamlessly transitions from clinical insights to personal experiences, showcasing a blend of professional expertise and casual discussions.
Deep dives
Key Insights on the ESET Trial in Neurocritical Care and Emergency Medicine
The ESET trial in neurocritical care and emergency medicine focused on benzodiazepine dosing, seizure cessation rates, and clinical outcomes. The trial assessed the impact of antiepileptic medications like levator acetate, phosphentatone, and valproate on patient care. Despite no statistically significant differences in cessation rates among these medications, ESET provided valuable insights into treatment protocols and medication safety considerations.
Exploring Pharmacokinetic Pharmacodynamic Properties of Anti-Seizure Medications
The podcast delves into the PKPD considerations with antiepileptic medications, highlighting factors like time to C-max and CSF penetration across medications such as phenytoin, valproic acid, and Keppra. The discussion underlines the nuances in drug properties and their influence on clinical outcomes, emphasizing the importance of dosing predictability and patient safety in pharmacological interventions for status epilepticus.
Clinical Implications and Practice Changes from the ESET Trial
The ESET trial's findings, though indicating no superior antiepileptic agent, prompted practice changes in dosing regimens and early treatment strategies for status epilepticus. By assessing medications like Keppra, levator acetate, and valproate, the trial contributed to a shift towards safer and predictable dosing practices, impacting patient outcomes and emergency care protocols.
Operational Considerations and Medication Safety in Mixed Adult-Pediatric Emergency Settings
Operational aspects and medication safety in mixed adult-pediatric emergency settings were highlighted, focusing on streamlined drug administration, dose uniformity, and caregiver communication. Emphasizing the importance of consistent dosing, the podcast addressed challenges in drug interactions, dosing precision, and patient-specific considerations in emergency care settings.
Future Directions and Implications for Antiepileptic Drug Research
Discussing potential research directions, the podcast explores the need for studies on IV push dosing, high-dose regimens, and novel agents like lacosamide and brivaracetam for status epilepticus treatment. By considering advancements in drug delivery systems and pharmacological properties, the conversation points towards refining antiepileptic drug choices and dosing strategies for improved efficacy.
Nature Adventures and Favorite Hikes in Colorado
Concluding on a lighter note, the podcast touches on outdoor activities and favorite trails in Colorado, highlighting family-friendly hikes like Bear Creek for nature enthusiasts and families. The conversation transitions from clinical insights to personal experiences, showcasing the podcast's dynamic approach in mixing professional expertise with casual discussions.
Exploring Technology and Logistics in Clinical Trials: Fun Facts from the ESA Trial
The ESA trial's innovative trial design and implementation strategies, including the use of an iPad protocol assist device and broslo tape for pediatric dosing, provided insights into logistical challenges and technological aids in emergency settings. The discussion sheds light on unique trial elements and practical tools used to streamline clinical trials in critical care research.
Addressing Challenges and Future Opportunities in Anti-Seizure Medication Research
Navigating the challenges and opportunities in antiepileptic medication research, the podcast uncovers the complexities of drug selection, dosing precision, and clinical trial logistics in emergency care settings. By identifying gaps in current treatment approaches and emphasizing the need for innovative research strategies, the conversation paves the way for future advancements in status epilepticus management.
Improving Clinical Outcomes through Enhanced Medication Safety Protocols
Accentuating the importance of medication safety protocols and preparedness in emergency care, the podcast underscores the significance of dose accuracy, drug administration consistency, and caregiver engagement in optimizing patient outcomes. Addressing challenges in operational efficiency and medication errors, the discussion advocates for standardized practices and enhanced safety measures in emergency pharmacological interventions.
Reflections on Emergency Medicine Practice and Research Alignment
Reflecting on the alignment between emergency medicine practice and research findings, the podcast explores the implications of ESET trial results on clinical protocols and treatment guidelines. By bridging gaps between research evidence and real-world emergency care practices, the conversation underscores the importance of evidence-based decision-making and continuous improvement in patient management.
Outdoor Adventures and Recreational Insights in Colorado's Wilderness
Transitioning to a casual exchange, the podcast explores outdoor recreational experiences and favorite hiking trails in Colorado, highlighting the region's natural beauty and family-friendly nature activities. From snowy escapades to adventurous hikes, the conversation injects a personal touch into professional discourse, showcasing the balance between expertise and leisure in the podcast narrative.
Special Guest: Ashley McCormick, PharmD, BCPS, BCCCP
Ashley McCormick joins to discuss the April Trial of the Week “Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus” the ESETT study, published in NEJM in 2019.
We set the scene by reviewing ASM PK/PD properties and discussing if there was a standard of care first-line treatment. Then we do a deep dive into the ESETT trial of the week. Did the 75kg dose cap influence results? How appropriate was the BZD dosing? How does this % of seizure cessation compare to other studies? Where did this dosing scheme come from? Trial fun facts, medication safety considerations, and much, much more.
