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La perfusión de fenitoína en la preeclampsia severa y la infusión de fenitoína en la preeclampsia severa
Lancet (London, England)
|June 20, 1987
Resumen
Las altas dosis intravenosas de fenitoína sódica proporcionaron efectivamente una profilaxis anticonvulsiva para pacientes con preeclampsia y eclampsia. El tratamiento demostró un buen perfil de seguridad con niveles terapéuticos plasmáticos de fenitoína mantenidos durante todo el período de estudio.
Área de la Ciencia:
- Obstetricia y Ginecología.
- Farmacología Farmacología.
- Neurología Neurología.
Sus antecedentes:
- La preeclampsia y la eclampsia son trastornos hipertensivos graves en el embarazo.
- La profilaxis anticonvulsiva es crucial para el manejo de estas condiciones y la prevención de las convulsiones.
- La fenitoína es un medicamento anticonvulsivo de uso común.
Objetivo del estudio:
- Evaluar la eficacia y seguridad de la administración intravenosa de dosis altas de fenitoína sódica para la profilaxis anticonvulsiva en pacientes con preeclampsia y eclampsia.
- Para controlar los niveles plasmáticos de fenitoína durante y después de la infusión en esta población de pacientes.
Principales métodos:
- El sodio de fenitoína intravenoso se administró como una infusión de dosis alta (8-18 mg/kg).
- El estudio incluyó a 2 pacientes con eclampsia y 24 pacientes con preeclampsia de moderada a severa.
- Los niveles plasmáticos de fenitoína se midieron a los 30 min, 6 h, 12 h y 24 h después de la infusión.
Principales resultados:
- No se observaron efectos secundarios maternos o neonatales importantes.
- Los niveles plasmáticos de fenitoína se mantuvieron dentro del rango terapéutico (7-20 mg/l) a los 30 min y 6 h en todos los pacientes.
- Los niveles terapéuticos se mantuvieron a las 12 horas en 21 pacientes y a las 24 horas en 19 pacientes después de una segunda dosis.
Conclusiones:
- La administración intravenosa de altas dosis de fenitoína sódica es una opción segura y efectiva para la profilaxis anticonvulsiva en la preeclampsia y la eclampsia.
- El fármaco logra y mantiene concentraciones plasmáticas terapéuticas en esta población obstétrica.
- Investigaciones adicionales pueden explorar regímenes de dosificación óptimos y resultados a largo plazo.
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