dr.joandr.joan عضو ماسي
تم تعديل 2009/08/03 في أدوية الطوارئ Emergency drugs
Phenytoin :
Trade names: Epanutin, Dilantin
Class: anticonvulsant , antiarrhythmic
Pregnancy: (Category D)
acts in the motor cortex of the brain to reduce the spread of electrical
discharges from the rapidly firing epileptic foci in this area. Also activity of centers in the brain stem responsible for the tonic phase of grand mal seizures
· Chronic epilepsy.
· Premature ventricular contractions.
· Tachycardia.
by mouth, initially 3–4 mg/kg daily or 150–300 mg daily (as a single dose or in 2 divided doses) increased gradually as necessary; usual dose 200–500 mg daily; CHILD initially 5 mg/kg daily in 2 divided doses, usual dose range 4–8 mg/kg daily (max. 300 mg)
By intravenous injection : status epilepticus, 15 mg/kg at a rate not exceeding 50 mg per minute, as a loading dose; maintenance doses of about 100 mg should be given thereafter at intervals of every 6–8 hours; rate and dose reduced according to weight; CHILD 15 mg/kg as a loading dose (neonate 15–20 mg/kg at rate of 1–3 mg/kg/minute)
Prophylaxis of convulsion : 4-7 mg/kg/day, divided into 2 doses.
Ventricular arrhythmias , by intravenous injection via caval catheter " Central Line", 3.5–5 mg/kg at a rate not exceeding 50 mg/minute, with blood pressure and ECG monitoring; repeat once if necessary.
· Hypersensitivity.
Side effects:
§ Drowsiness,
§ ataxia,
§ dizziness,
§ measles-like rash,
§ gingival hyperplasia,
§ Hirsutism (excessive hair growth) ,and
§ hypoglycemia.
N.B :
Rapid I.V. administration Hypotension & arrhythmia.
Nursing considerations:
· I.V. phenytoin may forms a precipitate, so flush tubing by saline (not dextrose) before & after administration.
· Assess for hypersensitivity.
· If a pregnant woman takes this drug, tell her not to breast-feed her baby.
· Obtain liver & kidney function studies.
· Monitor serum drug levels on a routine basis.
· During I.V. therapy, monitor B.P. for signs of hypotension .
· Take e food to minimize GI upset.
· If the patient is diabetic, monitor for signs of hypoglycemia.
· Oral hygiene to minimize bleeding from the gum.
· Report any excessive growth of hair.