In patients who are elderly, or have pre-existing cardiac disease, give phenytoin over 60 minutes. 10-16 years: Usual range, 6-7 mg/kg/day IV/PO divided two to three times daily; Anticonvulsant (Nonemergent) Children and adolescents. 2 0 obj Neither GlobalRPh Inc. nor any other party involved in the preparation of this document shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material. %PDF-1.5 2.2.5. The product is still suitable for use. Ensure ECG, blood pressure and respiratory function are monitored throughout the duration of the infusion. Phenytoin is 100% bioavailable by the IV route. For this reason, plasma phenytoin concentrations may increase modestly when IM or IV fosphenytoin sodium injection is substituted for oral phenytoin sodium therapy.

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PURPOSE . Phenytoin sodium is related to the barbiturates in chemical structure, but has a five-membered ring. endstream endobj 362 0 obj <>/Size 338/Type/XRef>>stream A faint yellow coloration may develop, however this has no effect on the potency of the solution.The loading dose should be followed by maintenance doses of 100 mg orally or intravenously every 6-8 hours.In the pediatric population, a loading dose of 15-20 mg/kg of phenytoin sodium intravenously will usually produce plasma concentrations of phenytoin within the generally accepted therapeutic range (10-20 mcg/mL). Get concise advice on drug therapy, plus unlimited access to CE. Considerations for PO to IV Dose Conversions.

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trailer Draw phenytoin concentrations at least 2 hours after completion of IV administration and 4 hours after IM administration. Prior to the administration, the patency of the IV catheter should be tested with a flush of sterile saline. Initial loading dose of phenytoin for status epilepticus. b�X>�7���#̶'��m��t���w_v���٪�/�� PLEASE READ THE CAREFULLY BEFORE ACCESSING OR USING THIS SITE. 5�V��߮\���Tv�G �,qZ���YT�n;Z��rm�I+h��M3��\����u���v�&��䳇^Q��'�>����z�]^Ƣ�$�Bɢ)�Bɢ�þ��ű��N��E2���M�$��v���CM�\��Hf)�)��Wfy���x˸����˯b�|r�+�8��`�\-k5��pc�=���u�fgփv�Om�y�=�׏0����� �,��|>�/���Ƒ`al� ?�ְ�n����7Z��+�֠G�~oΰ��`K��^�a_;w�Y����W{�Z��A�j����#4�� 4 (Class I, Level B) 1.4.2. pharmacist for any questions about appropriate conversion doses. If intramuscular administration is required, compensating dosage adjustments are necessary to maintain therapeutic plasma levels. B. The purpose of this policy is to implement a program that enables our hospital pharmacists to convert IV medications to the enteral (PO or via feeding tube) route of administration when appropriate. 0000008088 00000 n TA����f"D���o�@;����������� �C�Ҁ$���KZ�$���,7����1D�QP�-�f 4 (Class I, Level B) 1.5. Each injection of parenteral Phenytoin Sodium Injection should then be followed by a flush of sterile saline through the same catheter to avoid local venous irritation due to the alkalinity of the solution.Phenytoin Sodium Injection can be given diluted with normal saline. When returned to oral administration, the dose should be reduced by 50% of the original oral dose for one week to prevent excessive plasma levels due to sustained release from intramuscular tissue sites.Monitoring plasma levels would help prevent a fall into the subtherapeutic range.

0000007361 00000 n Get concise advice on drug therapy, plus unlimited access to CE. If the undiluted parenteral Phenytoin Sodium Injection is refrigerated or frozen, a precipitate might form: this will dissolve again after the solution is allowed to stand at room temperature. If the patient has not already received phenytoin then give: Phenytoin sodium IV 18mg/kg (see Table 1 below). 0 or IV mucositis). (The IV maintenance dose should never be given qd in a single dose).As non-emergency therapy, Phenytoin Sodium Injection should be administered more slowly as either a loading dose or by intermittent infusion. Serum blood level determinations are especially helpful when possible drug interactions are suspected.When treatment with oral phenytoin is not possible, IV phenytoin can be substituted for oral phenytoin at the same total daily dose. <> Adminstration should commence immediately after the mixture has been prepared and completed within 1 hour.

An intramuscular dose 50% greater than the oral dose is necessary to maintain these levels. The chemical name is For doses of more than 300 mg and/or infusion rates of 50 mg/min (pediatric: 1mg/kg/min) the patient should be on a cardiac monitor with rate, rhythm, and blood pressure display . 3 0 obj Intravenous (IV) to Enteral (PO) Conversion of Medications Hospital Policy . endstream endobj 339 0 obj <>/Metadata 51 0 R/AcroForm 340 0 R/Pages 48 0 R/StructTreeRoot 53 0 R/Type/Catalog/Lang(EN)>> endobj 340 0 obj <>/Encoding<>>>>> endobj 341 0 obj <>/ColorSpace<>/Font<>/ProcSet[/PDF/Text/ImageC/ImageI]/ExtGState<>>>/Type/Page>> endobj 342 0 obj <> endobj 343 0 obj <> endobj 344 0 obj [/Indexed 359 0 R 255 360 0 R] endobj 345 0 obj <> endobj 346 0 obj <>stream
Patient has had an NPO order for greater than two days. N.B. Conversion to Monotherapy: ... is 100% bioavailable by both the IM and IV routes. 0000010551 00000 n H�\��n�0��~;�`Ii0r�.9��vwY��l���}��ja���H*��|^T��0�cU����I���25_���slU�E����2��������ߞ���{�Sn���x��5���/�q��=�Ei!�Ӛx���'׳*��&i��:�ϣ� %���� 1 0 obj