Guidelines for nonemergency use of parenteral phenytoin products - Proceedings of an expert panel consensus process

This document summarizes the proceedings of an expert panel consensus proce ss addressing the nonemergency use of parenteral phenytoin products for man agement of seizures in pediatric and adult patients. The algorithm and cons ensus statements developed by the expert panel emphasize strategies for low ering the probability of adverse events associated with the use of parenter al phenytoin products. Specific patient characteristics are defined to guid e administration and monitoring of parenteral phenytoin therapy. The algori thm provides a decision pathway for the selection of the product and the ro ute of administration of phenytoin sodium or fosphenytoin sodium after it h as been determined that a parenteral phenytoin product is appropriate. Key factors covered in the algorithm include a list of patient characteristics and considerations necessary to prevent parenteral phenytoin adverse effect s during selection of administration route and recommendations for monitori ng of parenteral phenytoin therapy once it has been initiated. Situations r equiring rapid attainment of high phenytoin concentrations, such as in the management of acute seizures, are not addressed in these guidelines.