 |
|
Severe Soft-Tissue Injury Following Intravenous Infusion of PhenytoinPatient and Drug Administration Risk Factors
Robert F. Spengler, ScD;
Janet B. Arrowsmith, MD;
David J. Kilarski, MS;
Clyde Buchanan, MS;
Larry Von Behren, MD;
Donald R. Graham, MD
Arch Intern Med. 1988;148(6):1329-1333.
Abstract
• From April 8, 1982, through June 1984, 11 patients in a single hospital experienced 17 episodes of limb edema and discoloration after the intravenous (IV) administration of phenytoin sodium (Dilantin). One patient required a below-the-elbow amputation; all other patients recovered. No single drug lot was implicated. A case-control study was performed using three controls for each case; controls received IV infusions of phenytoin and were hospitalized close in time to the case patients. Compared with controls, patients with reactions were more often female and elderly and had underlying cardiovascular disease. Affected patients also received phenytoin through an IV catheter smaller than 20 gauge (50% vs 6%), at a rate greater than 25 mg/min (63% vs 19%), and in two or more IV infusions of phenytoin given "IV push" at the same site (81% vs 24%). High-risk patients require careful monitoring and stricter guidelines for the IV administration of phenytoin.
(Arch Intern Med 1988;148:1329-1333)
Author Affiliations
From the Epidemiology Program Office, Centers for Disease Control, Atlanta (Drs Spengler and Arrowsmith); the Division of Epidemiologic Studies, Illinois Department of Public Health, Springfield (Dr Spengler); the Division of Epidemiology and Surveillance, Food and Drug Administration, Rockville, Md (Dr Arrowsmith); the Pharmacy Department, St John's Hospital, Springfield, Ill (Messrs Kilarski and Buchanan); Southern Illinois University, School of Medicine, Springfield (Dr Von Behren); and Springfield (Ill) Clinic (Dr Graham). Dr Spengler is now with the Vermont Department of Health, Burlington.
Footnotes
Accepted for publication Dec 28, 1987.
The opinions expressed in this article are those of the authors and not necessarily those of the Food and Drug Administration.
Reprints not available.
 CiteULike  Connotea  Delicious  Digg  Facebook  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Pearls & Oy-sters: Soft-tissue necrosis as a result of intravenous leakage of phenytoin
Twardowschy et al.
Neurology 2009;73:e94-e95.
FULL TEXT
Purple glove syndrome following intravenous phenytoin administration
Chokshi et al.
Vasc Med 2007;12:29-31.
ABSTRACT
Extravasation Injury of the Upper Extremity by Intravenous Phenytoin
Edwards and Bosek
Anesth. Analg. 2002;94:672-673.
ABSTRACT
| FULL TEXT
Prospective study of local cutaneous reactions in patients receiving IV phenytoin
O'Brien et al.
Neurology 2001;57:1508-1510.
ABSTRACT
| FULL TEXT
Data vs Opinion, Phenytoin vs Fosphenytoin: The Saga Continues
Labiner
Arch Intern Med 1999;159:2631-2632.
FULL TEXT
Guidelines for Nonemergency Use of Parenteral Phenytoin Products: Proceedings of an Expert Panel Consensus Process
Meek et al.
Arch Intern Med 1999;159:2639-2644.
ABSTRACT
| FULL TEXT
Incidence and clinical consequence of the purple glove syndrome in patients receiving intravenous phenytoin
Coplin et al.
Neurology 1999;53:1611-1611.
FULL TEXT
Pediatric Use of Intravenous and Intramuscular Phenytoin: Lessons Learned
Wheless
J Child Neurol 1998;13:S11-S14.
ABSTRACT
Severe Soft-Tissue Injury Following Intravenous Infusion of Phenytoin
WEINSTEIN
Arch Intern Med 1989;149:1905-1905.
ABSTRACT
|
