IV fosphenytoin in obese patients
- 1 February 2017
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurology Clinical Practice
- Vol. 7 (1), 45-52
- https://doi.org/10.1212/cpj.0000000000000322
Abstract
Background: Previous studies evaluated the disposition of IV phenytoin loading doses and found that obese patients had increased drug distribution into excess body weight, larger volumes of distribution, and longer half-lives when compared to their nonobese counterparts. We assess the safety and efficacy of fosphenytoin loading doses in patients with different body mass indices (BMIs). Methods: A retrospective chart review was conducted in 410 patients who received fosphenytoin. Patients were divided into 2 groups: BMI Results: The median dose of fosphenytoin administered was 19 mg/kg (interquartile range 15–20). The most frequently encountered adverse event was hypotension, which occurred in 39% of the cohort. Using a Bonferroni adjustment for multiple comparisons, there were no differences in adverse events between the 2 groups. The need for additional antiepileptic loading doses was not different between the 2 groups (p = 0.07). Conclusions: The incidence of adverse events and the need for repeat loading antiepileptic medications was similar between the 2 groups. From our findings, the patients in our study did not receive empiric loading dose adjustments and the current method of loading fosphenytoin achieves similar outcomes, regardless of the patient's BMI.Keywords
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