@entity1167 following intravenous XXXX loading.

@entity1 @entity410 @entity66 @entity649 @entity26 @entity409 @entity56 @entity3174 @entity1167 @entity551 @entity1168
Two @entity1 , aged 44 and 68 years, presented with generalized @entity410 either witnessed or highly suspected. Both @entity1 had laboratory-proven subtherapeutic anticonvulsant serum levels. The @entity1 differed with regard to risk; one @entity1 had existing @entity66 , and the other was free of such risk factors except @entity409 . An apparently appropriate dose of intravenous @entity3174 was initiated in each case, and the @entity1 were monitored appropriately and given supplemental @entity26 . @entity1168 , @entity551 , @entity649 , and, ultimately, @entity1167 occurred in both. The criteria proposed by Earnest et al. should be implemented for each @entity410 case that requires a decision on the urgent need for therapeutic anticonvulsant levels, whether by mechanical infusion, manual intravenous push, or oral loading. The mechanical infusion is the easiest method to standardize and monitor. The manual intravenous push has a greater possibility of inadvertent overdosage during some small time frame, as well as more local symptoms by some reports. Record et al. have recommended oral loading in selected @entity1 . Careful consideration must be made of the choice of environment in which intravenous loading is done (e.g., emergency department, intensive care unit), as dictated by @entity1 parameters, nursing staff levels, and planned disposition. The crucial factors contributing to the deterioration of both @entity1 in the two cases presented were the concentration of @entity3174 manually infused and the possibility that their high-risk status made them poor candidates for manual intravenous @entity3174 . Dose and a @entity56 were doubtful factors in these cases.
