Safety of Intravenous Push Levetiracetam Compared to Intravenous Piggyback at a Tertiary Academic Medical Center: A Retrospective Analysis.
Drug Saf
; 45(1): 19-26, 2022 01.
Article
in En
| MEDLINE
| ID: mdl-34716562
ABSTRACT
INTRODUCTION:
Medication administration via intravenous push presents multiple potential advantages; however, there may be an increased risk of adverse drug reactions. In 2020, Brigham and Women's Hospital changed levetiracetam intravenous administration to intravenous push (IVP).OBJECTIVE:
The purpose of this analysis was to compare the safety profile of IVP to intravenous piggyback (IVPB) levetiracetam administration.METHODS:
This institutional review board-approved, single-center, pre-post analysis was performed between 1 November, 2019 and 30 May, 2020. The electronic health record was used to identify all administrations of intravenous levetiracetam greater than 1000 mg in patients ≥ 18 years old. The major safety outcomes included hypotension, bradycardia, drug-induced sedation, and intravenous site reactions such as phlebitis and infiltration. The major efficiency outcome was the time from pharmacy order verification to first-dose administration.RESULTS:
A total of 498 administrations in 162 patients were included in theanalysis:
252 administrations in 84 patients in the IVP group and 246 administrations in 78 patients in the IVPB group. The incidence of bradycardia was 7 vs 3 (3.2% vs 1.5%, p = 0.34); hypotension 10 vs 6 (5.2% vs 3.5%, p = 0.44); sedation 21 vs 36 (19.3% vs 27.9%, p = 0.12); and peripheral IV site reactions 0 vs 1 (0% vs 0.6%, p = 0.39) in the IVP vs IVPB groups, respectively. The median time between order verification and first-dose administration was significantly reduced in the IVP vs IVPB group (23.5 vs 55 min, p < 0.001).CONCLUSIONS:
Intravenous push levetiracetam administration of doses up to 4000 mg was associated with a similar incidence of cardiovascular, sedation, and infusion site-related adverse events compared to IVPB and resulted in a significant reduction in time to first-dose administration. Intravenous push levetiracetam in doses as high as 4000 mg may be considered safe with appropriate monitoring.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Bradycardia
/
Hypotension
Type of study:
Observational_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Female
/
Humans
Language:
En
Journal:
Drug Saf
Journal subject:
TERAPIA POR MEDICAMENTOS
/
TOXICOLOGIA
Year:
2022
Document type:
Article
Affiliation country:
Estados Unidos