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1990;46(3):341-7. doi: 10.1016/0163-7258(90)90022-t.Clin Otolaryngol Allied Sci. Type: Anticonvulsants Dosage Forms: capsules 50, 100, 200, 300 125/5 mL IM/IV; Common Trade Names: Dilantin, Phenytek; Adult Dosing Status epilepticus. 0000016760 00000 n
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Loading dose: 15-20mg/kg IV; if ineffective, can give 10mg/kg IV 20 min after first dose [Oral loading dose of phenytoin in the treatment of serial seizures, prevention of seizure recurrence and rapid drug substitution]. 1984 Jun;47(6):642-4. doi: 10.1136/jnnp.47.6.642.Clin Pharmacokinet. Oral loading may be associated with a slightly higher incidence of nausea and vomiting, and although it achieved therapeutic levels within a few hours, its peak effect is not apparent until 8-12 hours following administration. 1000 mg given as 400 mg initially, 300 mg two hours later and 300 mg two hours after that) to ensure optimal oral absorption. Identical twins in the study had a similar ratio and plasma level-time course profile. Loading doses of phenytoin (Dilantin) are used to rapidly attain therapeutic drug concentrations. 0000008944 00000 n
For a 1 gm dose, that would be 400 mg, then 300 mg, then 300 mg administered every 2 hours (4 hour total administration time).Who has time for three doses spanned over 4+ hours in a busy ED?If you’re still uncomfortable giving a large single dose, there is also support for two-dose oral loading (which still cuts 2 hours off the ED stay compared to 3 doses).ALiEM is your digital connection to the cooperative world of EM. Because its molecular weight is different than that of phenytoin, one milligram of fosphenytoin does not equal one milligram of phenytoin. Dilantin oral loading dose. 0000002317 00000 n
The loading dose should be followed by maintenance doses of oral or intravenous DILANTIN every 6 to 8 hours. 0000004119 00000 n
\\ Corrected\;phenytoin\;(equation\;1) = \frac{(Measured\;phenytoin)}{0.25 * Albumin + 0.1}
©2020 - ClinCalc LLC. Because phenytoin has demonstrated some saturable and erratic oral absorption beyond 400 mg, the use of large oral loading doses is controversial. Normal maintenance dosage is then instituted 24 hours after the … 0000022902 00000 n
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Normal maintenance dosage is then instituted 24 hours after the loading dose, with frequent serum level determinations.
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To avoid confusion, fosphenytoin doses are reported as "mgPE" (milligrams of phenytoin equivalents). In patients with hypoalbuminemia, a corrected equation must be used to account for reduced phenytoin protein binding. 0000017600 00000 n
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Over a period of nine months twenty-five epileptic patients were treated with the oral loading dose of phenytoin. 1992 Apr;17(2):185-91. doi: 10.1111/j.1365-2273.1992.tb01070.x.Clin Pharmacokinet. 0000007047 00000 n
Press 'Calculate' to view calculation results. Plasma DPH levels of more than 10 mug/ml were achieved within 16 to 38 hr in the children given loading doses and within 5 days in the conventionally dosed children. 0000011881 00000 n
Divided daily dosage: The recommended starting dose for adult patients who have received no previous treatment is one 100-mg DILANTIN (extended phenytoin sodium capsule, USP) by mouth three times daily. Fosphenytoin (Cerebyx) is a more water-soluble prodrug form of phenytoin that allows for faster IV infusion and less risk of extravasation injury. 1995 Nov;29(5):341-69. doi: 10.2165/00003088-199529050-00004.Br J Clin Pharmacol. These loading doses may be given on initiation of therapy, or in response to a subtherapeutic drug level in patients at high risk for seizure activity. 0000018689 00000 n
General. 0000012123 00000 n
[Article in Serbian] Sokić D, Janković SM. 0000010125 00000 n
1975;60:13-26. doi: 10.1111/j.1600-0404.1975.tb01383.x.Pharmacol Ther. 0000016998 00000 n
Unable to load your delegates due to an errorClin Pharmacol Ther. 0000005774 00000 n
For most adults, the satisfactory maintenance dosage will be one capsule three to four times a day. If the patient requires an oral dose, bioavailability will be less than 1 (depending upon absorption, first pass metabolism etc. The loading dose is generally 10–20 mg/kg10. %PDF-1.3
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These loading doses may be given on initiation of therapy, or in response to a subtherapeutic drug level in patients at high risk for seizure activity. Kane SP. Common Questions and Answers about Dilantin oral loading dose. This calculator uses the average of the following correction equations. $$\\ Corrected\;phenytoin = \frac{(Measured\;phenytoin)}{0.2 * Albumin + 0.1}$$
We strive to reshape medical education and academia in their evolution beyond the traditional classroom.We aim to disrupt how medical providers and trainees can gain public access to high-quality, educational content while also engaging in a dialogue about best-practices in EM and medical education.ALiEM is not endorsed by, sponsored by, or affiliated with the University of California San Francisco or any institution.We frequently give 500 mg now and 500 mg more in 2 hours at discharge.