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ACUTE EXPOSURE INFORMATION
- WITH THERAPEUTIC USE
- Dysrhythmias and hypotension have rarely occurred (estimated 1 adverse cardiac event per 200,000 administrations) with therapeutic administration of fosphenytoin. Propylene glycol is not used as a diluent in fosphenytoin (unlike phenytoin), a cardiac effect from its metabolites (largely phenytoin) is the presumed mechanism.
- WITH POISONING/EXPOSURE
- Toxic effects are rare at plasma concentrations less than 20 mcg/mL (80 mcmol/L), but are common in patients with plasma concentrations greater than 30 mcg/mL (120 mcmol/L).
- Common effects include nystagmus, ataxia, dysarthria, mild sedation and CNS depression. Ophthalmoplegia, hyperreflexia, mental status changes, hallucinations, and in severe cases, coma may also occur.
- Hypotension, bradycardia and asystole have resulted from intravenous overdoses of fosphenytoin (NO propylene glycol diluent).
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