From the Guidelines
Levetiracetam (Keppra) is the most suitable antiepileptic medication for administration through a Percutaneous Endoscopic Gastrostomy (PEG) tube due to its availability as an oral solution and favorable pharmacokinetics. According to the study published in the Annals of Emergency Medicine 1, levetiracetam can be loaded orally with a dose of 1,500 mg, and it is also available in an intravenous formulation, but the oral solution is more suitable for PEG tube administration. Other antiepileptic medications that can be administered through a PEG tube include valproic acid (Depakene), carbamazepine (Tegretol), and lamotrigine (Lamictal), but their administration may require more caution and specific considerations, such as using liquid formulations or properly crushing tablets, and avoiding extended-release formulations.
When administering antiepileptic medications through a PEG tube, it is essential to follow certain guidelines to ensure safe and effective delivery:
- Use liquid formulations when available, such as levetiracetam and valproic acid solutions
- Properly crush tablets that are approved for crushing, but avoid crushing extended-release formulations
- Dilute the medication with 15-30 mL of water before administration
- Flush the tube with 15-30 mL of water before and after medication delivery to prevent clogging
- Temporarily stop enteral feeding for at least 1-2 hours before and after administering certain medications, such as phenytoin, to prevent drug-nutrient interactions
- Consult with a pharmacist about specific formulations and potential interactions to ensure proper administration and therapeutic drug levels.
The study published in the Annals of Emergency Medicine 1 provides valuable information on the administration of antiepileptic medications, including loading doses and routes of administration, which can be applied to the administration of these medications through a PEG tube. However, it is crucial to consider the specific characteristics of each medication and the individual patient's needs to ensure safe and effective treatment.
From the Research
Antiepileptic Medications for PEG Tube Feeding
- The following antiepileptic medications can be administered through a Percutaneous Endoscopic Gastrostomy (PEG) tube:
- These medications have been studied for their efficacy in treating various types of seizures, including generalized tonic-clonic, tonic, and clonic seizures, as well as absence seizures 6.
- The use of PEG tube feeding for antiepileptic medication administration has been shown to improve seizure control and quality of life in patients with refractory epilepsy 4.
- It is essential to note that the choice of antiepileptic medication for PEG tube feeding should be based on individual patient needs and medical history, as well as the specific characteristics of the medication, such as its formulation and bioavailability 2, 3.