Intravenous Phenytoin: A Loading Scheme for Desired Concentrations
Authors: Klaus U. Blaser
Journal: Annals of Internal Medicine (1989)

Brief Reports15 June 1989Intravenous Phenytoin: A Loading Scheme for Desired ConcentrationsKlaus U. Blaser, MD, Samuel Vozeh, MD, Hans Landolt, MD, Gilbert Kaufmann, MD, Jorma Romppainen, MD, Otmar Gratzl, MDKlaus U. Blaser, MDSearch for more papers by this author, Samuel Vozeh, MDSearch for more papers by this author, Hans Landolt, MDSearch for more papers by this author, Gilbert Kaufmann, MDSearch for more papers by this author, Jorma Romppainen, MDSearch for more papers by this author, Otmar Gratzl, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-110-12-1029 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptPhenytoin is used for maintenance therapy and in acute situations, such as the treatment of status epilepticus and seizure prophylaxis after neurosurgery (1, 2). The recommended serum concentration to control generalized seizures is between 40 and 80 μmol/L (1). However, to reach this concentration range, 2 to 6 weeks are needed if therapy is started with the maintenance dose. An initial loading dose is therefore required in acute situations to rapidly achieve therapeutic serum concentrations.Relatively little is known about the dose-serum concentration relationship of phenytoin during intravenous...References1. RallSchleifer TL. Drugs effective in the therapy of epilepsies. In: Gilman AG, Goodman LS, Rail W, Murad F, eds. The Pharmacological Basis of Therapeutics. New York: Macmillan Publishing Company; 1985:446-72. Google Scholar2. NorthPenhallHaniehHannChallenFrewin JRACRD. Postoperative epilepsy: a double-blind trial of phenytoin after craniotomy. Lancet. 1980;1:384-6. CrossrefMedlineGoogle Scholar3. CranfordLeppikPatrickAndersonKostick RIBCB. Intravenous phenytoin: clinical and pharmacokinetic aspects. Neurology. 1978;28:874-80. CrossrefMedlineGoogle Scholar4. VozehUematsuAaronsMaitreLandoltGratzl STLPHO. Intravenous phenytoin loading in patients after neurosurgery and in status epilepticus: a population pharmacokinetic study. Clin Pharmacokinet. 1988;14:122-8. CrossrefMedlineGoogle Scholar5. EarnestMarxDrury MJL. Complications of intravenous phenytoin for acute treatment of seizures: recommendations for usage. JAMA. 1983;249:762-5. CrossrefMedlineGoogle Scholar6. SheinerRosenbergMarathe LBV. Estimation of population characteristics of pharmacokinetic parameters from routine clinical data. J Pharmacokinet Biopharm. 1977;5:445-79. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: From the University Hospital (Kantonsspital), Basel, Switzerland. For current author addresses, see end of text. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByPhenytoin Loading Doses in Adult Critical Care Patients: Does Current Practice Achieve Adequate Drug Levels?Rapid i.v. loading with phenytoin with subsequent dose adaptation using non-steady-state serum levels and a Bayesian forecasting computer program to predict maintenance dosesThe Population Approach: Rationale, Methods, and Applications in Clinical Pharmacology and Drug DevelopmentPhenytoin reduces suxamethonium-induced myalgiaManagement of epilepsyEvaluation of population (NONMEM) pharmacokinetic parameter estimatesSingle-Dose Phenytoin InfusionDenson G. Fujikawa, MD 15 June 1989Volume 110, Issue 12Page: 1029-1031KeywordsAttentionEpileptic seizuresHospital medicineNeurosurgeryProphylaxisStatus epilepticusSurgical intensive care units Issue Published: 15 June 1989 PDF DownloadLoading ...