Phenytoin

[angelique777]

If a rapid bolus of phenytoin is given to a patient what would most likely occur?

Choices

3rd degree HB

2nd degree HB

1st degree HB

SVT

Was curious to know your answer

I know it is contraindicated for sinus bradycardia, SA block, second or third degree AV block or Adams-Stokes syndrome. However what is more likely to occur if a rapid bolus of phenytoin is given?

Thanks for your time.

Angela

[shadowflightnurse]

My first instinct is that it would cause a heart block, probably 3rd degree. I know it used to be used for ventricular arrhythmias, so that's why I would say a significant block. It can also cause severe hypotension when given too fast.

[marikabw]

My Mosby's Pharm 21st ed book says "client's hx s/b reveiwed for conditions that contraindicate the use of phenytoin, such as a known sensitivity to the drug and impaired cardiac fct, b/c parenteral admin may affect ventricular automaticity & cause ventricular dysrhythmias" p359 it also recommends using fosphenytoin im b/c it has less tissue irritation than phenytoin.

epocrates online states adverse rex: v fib, hypotension, cardiovasc collapse, av condct abnormalities and tissue necrosis for IV's

cautions/contraindicated for IV's c/SA block, AV block 2/3degree, sinus brady, Adam Stokes

Were you giving this to Status epiliepticus?

[grambograham]

I'd probably say 3rd degree AV block.

[ghmccart]

why dont you just look it up and empower yourself