Division of Developmental and Reproductive Medicine, University of Liverpool, Liverpool, UK.
Arch Dis Child. 2011 Sep;96(9):883-4. doi: 10.1136/adc.2011.215269. Epub 2011 May 19.
Phenytoin is used to treat acute tonic-clonic seizures in children who have not responded to a benzodiazepine. In the UK, the loading dose of phenytoin is 18 mg/kg. There is limited evidence on whether this loading dose will achieve the desired levels in paediatric patients. Intravenous loading doses of phenytoin were retrospectively and prospectively audited over 19 months. Doses were normalised for weight and compared with the serum phenytoin concentrations. Errors in dose calculations and adverse events were recorded. Serum phenytoin concentrations were measured on 31 occasions in 27 children (24 retrospective and 10 prospective) between 60 and 180 (median, 153) min after completion of the loading dose. Serum phenytoin concentrations were within the therapeutic range (10-20 μg/ml) on 24 occasions. No errors in dose calculations or adverse effects were identified. A phenytoin loading dose of 18 mg/kg gave serum concentrations within the recommended therapeutic range in most children.
苯妥英钠用于治疗苯二氮䓬类药物治疗无效的急性强直阵挛性发作的儿童。在英国，苯妥英钠的负荷剂量为 18mg/kg。对于该负荷剂量是否能达到儿科患者所需的水平，证据有限。对 19 个月内的静脉负荷剂量进行了回顾性和前瞻性审核。剂量按体重归一化，并与血清苯妥英钠浓度进行比较。记录了剂量计算错误和不良事件。在负荷剂量完成后 60 至 180 分钟（中位数 153 分钟），对 27 名儿童（24 名回顾性和 10 名前瞻性）的 31 次血清苯妥英钠浓度进行了测量。在 24 次测量中，血清苯妥英钠浓度在治疗范围内（10-20μg/ml）。未发现剂量计算错误或不良反应。18mg/kg 的苯妥英钠负荷剂量可使大多数儿童的血清浓度在推荐的治疗范围内。
