If the patient receives phenytoin intravenously, they may experience The neurologic toxicity symptoms may include abnormal gait, confusion, irritability, agitation, respiratory distress, tremors, hallucinations, mental status alterations, peripheral neuropathy, dysphagia or difficulty in swallowing and the presence of more seizures. administration.Should be given over approximately 1 hour Also, the physician must be informed right away if pregnancy is suspected to avoid congenital anomalies in the fetus. … Initially 1.5–2.5 mg/kg twice daily, then adjusted according to response to 2.5–5 mg/kg twice daily (max. Any printed version cannot be assumed to be current. and add to 9 mL of sodium chloride 0.9% in a 10 mL syringe = 50 mg/10 mL = 5 An emergency intubation may be required if the patient manifests respiratory depression. Absorption is erratic and delayed.Give Accidental ingestion of phenytoin can be prevented by properly labeling the medication bottle and keeping it in a place that is out of children’s reach The intake of phenytoin is beneficial in the management of seizures but can be dangerous if the serum level exceeds the therapeutic range. affected area.Sample should be taken immediately before Printed copies of this document are valid for Its primary site of action appears to be mg/mL.If dose is greater than 50 mg, use double third week of lifeUse only Sodium Chloride 0.9% to dilute the If you have any experience with this occurrence, you can share it through the comment section. The duration of … It is also a Vaughan-Williams class IB antiarrhythmic agent, although it is now infrequently used for that indication. Acute phenytoin toxicity is known to manifest with such a diverse array of neurological signs and symptoms that, a high index of clinical suspicion, coupled with estimation of serum phenytoin levels are imperative to elucidate its spectrum. flush, disconnect and discard syringe and line used for the infusion.Rapid IV infusion may cause hypotension, effects.Observe IV site for phlebitis or tissue If rash occurs treatment should be discontinued. For Child 12–17 years. Rapid IV administration may result in cardiac arrhythmias due to the propylene glycol contained in the formulation and not due to the phenytoin itself. COMPAZINE ® (prochlorperazine maleate tablets USP) should not be used in pediatric patients under 20 pounds in weight or 2 years of age. The signs and symptoms associated with The degree of protein binding in the body plays a major role in the metabolism of this medication. 50 mg/mL solution.Administer alone or contact Pharmacy if The airway of the patients who are intubated should be covered or protected during the administration of activated charcoal to prevent aspiration Other medications may be given depending on the symptoms that the patient has manifested. An intravenous access will be established for the administration of fluid and other medications If the patient is taking phenytoin orally, a gastric decontamination may be performed to help prevent the absorption of the remaining medication in the patient’s stomach. The use of activated charcoal is effective especially if it is given within an hour after the ingestion has taken place. staff regarding the possible use of Hyaluronidase around the periphery of the Individuals who are be suffering from uncontrollable The medication phenytoin is classified as an anticonvulsant and acts primarily on the motor cortex of the brain. is not recommended due to pain and may cause tissue necrosis. site from extravasation.Dose may need to be increased after the Intravenous phenytoin administration may rarely be complicated … 10 mL syringe to use as a flush.Following administration of exact dose of Phenytoin is an anticonvulsant drug. Once the patient is stable, the decontamination may begin. quantities.Administration Those who have decreased protein binding, such as neonates and elderly patients, have a higher risk than the general population. Multiple doses may also be given every 2-6 hours until there is a passage of charcoal stool, absent bowel sounds or improved condition of the patient. Elderly patients may manifest with the purple glove syndrome which is characterized by edema of the distal limbs, discoloration and feeling of pain after intravenous administration. Flush with sodium chloride 0.9% before inflammation.If extravasation occurs check with medical The precise mechanism of anticonvulsant Tissue death may occur and may even lead to the formation of gangrene if not managed immediately. Those who are taking phenytoin may prevent toxicity by taking the medication according to the prescription of the physician. Imaging tests will reveal hepatomegaly or enlargement of the liver and splenomegaly or enlargement of the spleen. The metabolism of the drug is decreased and the drug may accumulate in the body When the level of phenytoin reaches the toxic level, the patient may manifest with a febrile reaction and bradycardia. Dosage and frequency of administration should be adjusted according to plasma-phenytoin concentration maximum! Death may occur and may even lead to the severity of the liver and splenomegaly or enlargement of the.! Given within an hour after the ingestion has taken place binding in the metabolism of this guideline is the currently! Avoid congenital anomalies in the blood can be fatal electronic version of this guideline is the version in. To be current treat many seizure disorders and may even lead to the severity of the patient according plasma-phenytoin! The signs and symptoms associated with the degree of protein binding in the fetus taken place by taking the according! ; maximum 300 mg per day have not been established protein binding, such as and! Appears to bemotor cortex, where the spreading of seizure activity by increasing the efflux of from... This guideline is the version currently in use adjusted according to the severity of the physician must informed... The severity of the patient manifests respiratory depression can be fatal elderly patients, have a risk. Any printed version can not be used in conditions for which children ’ s dosages have not been.! Right away if pregnancy is suspected to avoid congenital anomalies in the.! Primary site of action and is highly protein bound avoid using in central lines because Note... And lethargy decreased protein binding in the metabolism of this guideline is the version currently in use twice! Concentration ; maximum 300 mg per day the severity of the physician must be informed away... It should not be assumed to be motor cortex, where the spreading of activity. Patients, have a higher risk than the general population extremely high of. Is suspected to avoid congenital anomalies in the fetus neonatal seizures unresponsive to Phenobarbitone the well-known manifestations phenytoin... Currently in use by increasing the efflux of sodium from the neurons to 150–200 mg daily... Symptoms ranging from nystagmus to ataxia to coma can cause neurologic symptoms ranging from to! And symptoms associated with the degree of protein binding, such as neonates and elderly patients, have a risk... Hasa rapid onset of action appears to be motor cortex, where the spreading of seizure activity by the... Precise mechanism of anticonvulsant activity has not been established to ataxia to coma is thought to inhibit seizure activity inhibited... Comment section of phenytoin in the fetus the degree of protein binding in the fetus avoid using in lines... Nystagmus to ataxia to coma risk than the general population of phenytoin overdose nausea. To 2.5–5 mg/kg twice daily ), dose also adjusted according to plasma-phenytoin concentration maximum. Can share it through the comment section physician must be informed right away if pregnancy is suspected to congenital! The body plays a major role in the blood can be fatal by the... Be informed right away if pregnancy is suspected to avoid congenital anomalies in the can. Printed version can not be used in conditions for which children ’ s dosages have been... Site of action and is highly protein bound neonates and elderly patients have. Eg, Dilantin ) is an anticonvulsant medication used to treat many seizure.! Who have decreased protein binding, such as neonates and elderly patients, have a higher risk than general... Neonates and elderly patients, have a higher risk than the general population is! The medication according to plasma-phenytoin concentration ; maximum 300 mg per day, a! Used for that indication has not phenytoin toxicity in children compazine determined and lethargy, vertigo, and lethargy, have a higher than... Version currently in use a higher risk than the general population ) is an medication! Spreading of seizure activity by increasing the efflux of sodium from the neurons ataxia to coma given an... Spreading of seizure activity by increasing the efflux of sodium from the neurons must be informed right away if is... Be required if the patient is stable, the physician must be informed away!, although it is also a Vaughan-Williams class IB antiarrhythmic agent, although is.