ABSTRACT
A single 18 mg/kg dose of oral phenytoin capsules or suspension (mean dose, 1.3 g) was given to 44 patients with recent seizures and no detectable serum phenytoin level. Mean serum phenytoin levels after loading for patients receiving capsules were 6.8 micrograms/mL at two hours, 9.7 micrograms/mL at three to five hours, 12.3 micrograms/mL at six to ten hours, and 15.1 micrograms/mL at 16 to 24 hours. Mean levels for patients receiving suspension were slightly, but not significantly, lower than for patients receiving capsules. No seizures occurred during an eight-hour observation period after loading. Drug toxicity was minimal. Single-dose, 18 mg/kg oral phenytoin loading provides rapid therapeutic levels and is well tolerated.
Subject(s)
Phenytoin/administration & dosage , Seizures/drug therapy , Administration, Oral , Adult , Aged , Capsules , Drug Administration Schedule , Epilepsy/blood , Epilepsy/drug therapy , Female , Humans , Male , Middle Aged , Phenytoin/blood , Prospective Studies , Random Allocation , Seizures/blood , Status Epilepticus/blood , Status Epilepticus/drug therapyABSTRACT
Hypoglycemia must be considered in any patient with an acute change of mental status or in a patient who shows a focal neurological deficit. Treatment with high IV glucose concentrations can save the patient from grave irreversible neurological sequelae and death.
