Case: 24 years old male is admitted to ICU with seizures requiring benzodiazepine drip. Phenytoin is ordered. Which one precaution should be directed to the nursing staff?
Answer: Phenytoin and benzodiazepine should not be given via the same IV line
Phenytoin is incompatible with any of the benzodiazepines. Precipitation is likely to occur if infusion occurs through the same intravenous line. This same principle applies to phenytoin with any other fluid or medication containing glucose or dextrose.
Fosphenytoin does not have this interaction.
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Reference:
Murphy A, Wilbur K. Phenytoin-diazepam interaction. Ann Pharmacother. 2003 May;37(5):659-63. doi: 10.1345/aph.1C413. PMID: 12708941.
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