A faint yellow coloration may develop, however this has no effect on the potency of the solution.Maintenance dose (started 18-24h after load): 6 mg/kg ibw IV/PO in divided doses q8 to 12h. Phenytoin is 100% bioavailable by the IV route. All target IV medications will be reviewed by the pharmacist for potential IV to enteral conversion upon initiation of therapy. %���� The drug should be injected slowly intravenously at a rate not exceeding 1-3 mg/kg/min or 50 mg per minute, whichever is slower.Continuous monitoring of the electrocardiogram and blood pressure is essential. endobj 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. There are many drug interactions with phenytoin (consult the BNF Appendix 1 or your clinical pharmacist). PLEASE READ THE CAREFULLY BEFORE ACCESSING OR USING THIS SITE. Patients eligible for IV to enteral conversion will be identified by an audit of … in therapeutic range? Give mini loading dose of 10 mg/kg either IV or PO to ensure adequate seizure protection Phenytoin concentrations increase disproportionately with dose; toxicity may occur if the maintenance dose is increased by more than 25–50mg per day. Get concise advice on drug therapy, plus unlimited access to CE.
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The rate of administration for IV phenytoin should be no greater than 50 mg per minute in adults and 1-3 mg/kg/min (or 50 mg per minute, whichever is slower) in pediatric patients.Serum concentrations should be monitored and care should be taken when switching a patient from the sodium salt to the free acid form. Contact clinical pharmacist for assistance when An intramuscular dose 50% greater than the oral dose is necessary to maintain these levels. x��=k�7��]���_�j���4���m]�c'��v�N���Uv?Ȳf�Z�h"i����# �_ࣻ�{w���FI �����v�9G��͋�y�����r�������_�7��w���ywx������z�]���ߣo_���}�����""N�����g"J���7e'i�g2���������2�;=�Dw��ϟ�r������ϾS�~}����� �AR*R�9��G���et��Ʒ���p�����ùד�l��8K3'i����m�q��eeڽXW�W���g�!z�>����~��?�D?�?�����v�� If intramuscular administration is required, compensating dosage adjustments are necessary to maintain therapeutic plasma levels. Pharmacist's Letter includes: ... Pharmacist's Letter includes: 12 issues every year, with brief articles about new meds and hot topics; 300+ CE courses, including the popular CE-in-the-Letter; Posology. %PDF-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. Because there is approximately an 8% increase in drug content with the free acid form over that of the sodium salt, dosage adjustments and serum level monitoring may be necessary when switching from a product formulated with the free acid to a product formulated with the sodium salt and vice versa.0409–1844–32 Carpuject® with Luer Lock 50 mg/mL-2 mL; Box of 10To prevent needle-stick injuries, needles should not be recapped, purposely bent, or broken by hand.The authors make no claims of the accuracy of the information contained herein; and these suggested doses and/or guidelines are not a substitute for clinical judgment.
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. &ڝ��w$i��[`�7����XIA�(�=2�5 ��y��uD�4����'��r�>��/`�~���/�ك�{�ɭ?j� q���Kt��{^��8���h�A�Dh�_M��>��E;���X��ըyR¤���Ѷ�� "k���'����3I��.i�ˢ�V �rUD���g��U��p&"�sD�~Jq�t�������n+���!2;[t���?�|�*Jz[njg5W;L�{q�a��+�n5ܿGo@���(�q1�t�-`���"��a The product is still suitable for use. Phenytoin capsules are approximately 90% bioavailable by the oral route. 100mg phenytoin sodium (capsules/injection) = 90 mg phenytoin base9,10 (suspension) Suspension (90mg/5mL) is available for NG administration or those with swallowing problems. The addition of parenteral Phenytoin Sodium Injection to dextrose and dextrose-containing solutions should be avoided due to lack of solubility and resultant precipitation.Treatment with Phenytoin Sodium Injection can be initiated either with a loading dose or an infusion:Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.The diluted infusion mixture (Phenytoin Sodium Injection plus normal saline) should not be refrigerated. pharmacist for any questions about appropriate conversion doses. <> 5�V��߮\���Tv�G �,qZ���YT�n;Z��rm�I+h��M3��\����u���v�&��䳇^Q��'�>����z�]^Ƣ�$�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��