Fosphenytoin
Pro-drug: phenytoin ester
IV/IM administration
Clinical uses
Adverse effects
Less common than with phenytoin. Many of the side effects of the latter are
thought to be related to the carrier substance.
- severe cardiovascular adverse effects have been reported in patients
receiving IV preparation
- asystole, VF
- hypotension
- bradycardia
- heart block
- majority of side effects occur within 30 minutes of infusion
Committee
on Safety of Medicines recommendations:
Monitor heart rate, blood pressure and respiratory function for the duration
of the infusion.
Continue to observe the patient for at least 30 minutes after the end of the
infusion
Hypotension may occur with recommended doses and rates of infusion. A reduction
in infusion rate of discontinuation of therapy may be necessary
A lower loading dose and/or infusion rate, and a lower or less frequent
maintenance dose may be required in the elderly and those with renal or hepatic
impairment. A 10-25% reduction in dose or rate is advised
| 
