How to Prepare Phenytoin & Saline
Phenytoin, also known by the brand name Dilantin, is an anticonvulsant medication used to treat epilepsy or seizures due to head injury. It is used in a hospital or emergency room setting by a nurse following a doctor's order. According to Michael L. Schlicher in MedSurg Nursing, phenytoin lacks solubility and tends to precipitate in solution so it must be diluted correctly to ensure safe administration via continuous infusion.
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Things You'll Need
- Doctor's order for phenytoin dosage
- Phenytoin
- Saline solution in IV bag
- Micron in-line filter
Instructions
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1
Calculate how much of the phenytoin to mix with the saline according to the doctor's order. Intravenous infusions of phenytoin last two to four hours but not to exceed 50 mg per minute. For example, your doctor has ordered a phenytoin drip of 250 mg per hour. You will need 500 ml of normal saline and 500 mg of phenytoin for a two-hour drip at 500 mg divided by 120 minutes or 4.16 mg per minute.
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Use normal saline, that is, 0.9 percent sodium chloride IV solution, to avoid possible precipitation and a micron in-line filter as a precaution. Mix the phenytoin and saline in a 1:1 concentration in the saline bag, so mix 500 mg phenytoin with 500 ml saline. A faint yellow color is normal.
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Check the solution for possible crystalline formation. Mark the bag carefully. Document what you've done and double check your calculations with another nurse or the pharmacy.
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Tips & Warnings
Frequently monitor the solution during infusion to check for precipitation. (see References 1,2)
Phenytoin is a powerful, dangerous drug with serious side effects and interactions with many other medications. Only licensed nurses should prepare and administer it under a doctor's orders and supervision. (see References 1)
References
Resources
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