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Adverse events associated with intravenous phenytoin in children: a prospective study

Richard E Appleton1, Andrea Gill

  • 1The Roald Dahl EEG Unit, Department of Neurology, Royal Liverpool Children's Hospital (Alder Hey), Liverpool, UK. richard.appleton@rlch-tr.nwest.nhs.uk

Seizure
|August 14, 2003
PubMed

Insights

Intravenous phenytoin in children caused few adverse events like extravasation and hypotension, with all patients recovering fully. The study suggests infusion rates may influence side-effect occurrence.

Area of Science:

  • Pediatric Pharmacology
  • Clinical Pharmacy
  • Drug Safety

Background:

  • Intravenous phenytoin is used for pediatric seizure management.
  • Understanding its adverse effects in children is crucial for safe administration.

Purpose of the Study:

  • To evaluate the incidence and types of adverse side effects associated with intravenous phenytoin in pediatric patients.
  • To identify potential risk factors for adverse events.

Main Methods:

  • A prospective study involving 22 pediatric patients.
  • 100 doses of intravenous phenytoin were administered over 10 months.
  • Adverse events were monitored and recorded.

Main Results:

  • 27% of patients (6 out of 22) experienced adverse effects.
  • Observed side effects included extravasation, hypotension, and cardiac arrhythmia.
  • No cases of skin necrosis or 'purple glove syndrome' were reported.
  • All side effects resolved spontaneously and completely.

Conclusions:

  • Intravenous phenytoin appears to have a manageable side effect profile in children.
  • Excessive infusion rates or saline flushes may contribute to adverse events.
  • The overall frequency of side effects was lower than anticipated.

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