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A simplified phenytoin regimen for preeclampsia
M J Lucas1, R T DePalma, M T Peters
1Department of Obstetrics & Gynecology, University of Texas Southwestern Medical Center, Dallas 75235-9032.
American Journal of Perinatology
|March 1, 1994
Summary
A universal phenytoin dosing regimen is feasible for mild preeclampsia, similar to magnesium sulfate protocols. Serum levels remained therapeutic for 24 hours with a supplemental oral dose.
Area of Science:
- Obstetrics and Gynecology
- Pharmacology
- Clinical Pharmacy
Background:
- Preeclampsia management often involves magnesium sulfate.
- Alternative anticonvulsant dosing strategies require investigation.
Purpose of the Study:
- To evaluate the feasibility of a universal phenytoin dosing scheme for mild preeclampsia.
- To compare phenytoin administration to magnesium sulfate protocols.
Main Methods:
- 14 patients received a 1g IV phenytoin loading dose; serum levels measured for 32 hours.
- 14 patients received an additional 500mg oral phenytoin dose; serum levels measured.
- Maternal weight's effect on serum phenytoin levels analyzed.
Main Results:
- Average serum phenytoin levels dropped below 10 micrograms/mL at 12 hours post-IV dose.
- Supplemental oral phenytoin maintained therapeutic levels for 24 hours.
- Maternal weight significantly impacted serum levels only at extreme ranges.
Conclusions:
- A universal phenytoin dosing scheme is feasible for mild preeclampsia.
- Phenytoin can be administered using a universal dosing strategy comparable to magnesium sulfate.