Neurology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Correspondence:
Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Correspondence are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Uthman, B. M.
Right arrow Articles by Ramsay, R. E.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Uthman, B. M.
Right arrow Articles by Ramsay, R. E.
NEUROLOGY 1996;46:24S-28S
© 1996 American Academy of Neurology

Intramuscular use of fosphenytoin

An overview

Basim M. Uthman, MD, B. J. Wilder, MD and R. Eugene Ramsay, MD

From the Neurology Service, Department of Veterans Affairs Medical Center, Gainesville, FL (Dr. Uthman); Department of Neurology, University of Florida College of Medicine, Gainesville, FL (Dr. Uthman and Dr. Wilder); and Departments of Neurology and Psychiatry and the International Center for Epilepsy, University of Miami, FL (Dr. Ramsay).
Address correspondence and reprint requests to Dr. Basim M. Uthman, Neurology Service (127), Department of Veterans Affairs Medical Center, 1601 SW Archer Road, Gainesville, FL 32608.

Abstract.

Phenobarbital, diazepam, lorazepam, and phenytoin are all currently used for the treatment of acute seizures, including status epilepticus.None of these drugs is considered ideal. Fosphenytoin is a new phenytoin prodrug that fulfills many of the properties of an ideal anticonvulsant drug. The safety, tolerance, and pharmacokinetics of intramuscularly administered fosphenytoin have been evaluated in three clinical trials involving patients requiring loading or maintenance doses of phenytoin. These investigations demonstrated that fosphenytoin is rapidly and completely absorbed after injection into muscle and is quickly converted to produce therapeutic phenytoin plasma concentrations within 30 min of administration. Plasma concentrations of phenytoin achieved with IM fosphenytoin exceeded those associated with an equimolar dose of oral phenytoin. IM fosphenytoin was well tolerated both locally and systemically. Only mild and transient reactions occurred at the injection site. The most common systemic adverse events reported--somnolence, nystagmus, dizziness, and ataxia--are side effects commonly seen with phenytoin and tended to be mild. Preexisting seizure disorders remained stable. Combination treatment with IV diazepam or lorazepam to attain rapid seizure control and IM fosphenytoin to maintain the anticonvulsant effect theoretically offers many advantages for control of acute seizures and should be studied.

NEUROLOGY 1996;46(Suppl 1): S24-S28






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1996 by AAN Enterprises, Inc.