Ramsay R E, Wilder B J, Uthman B M, Garnett W R, Pellock J M, Barkley G L, Leppik I E, Knapp L E
International Center for Epilepsy, University of Miami, FL 33136, USA.
Epilepsy Res. 1997 Oct;28(3):181-7. doi: 10.1016/s0920-1211(97)00054-5.
Fosphenytoin (Cerebyx), is a water soluble prodrug that is rapidly and completely converted to phenytoin. This study reports the injection-site tolerance and safety of intramuscular fosphenytoin (> 10 mg/kg doses) in 60 patients requiring a phenytoin loading dose. Patients received injections at single or multiple sites with volumes ranging from 4 to 30 ml per injection site. The majority of patients had no irritation (erythema, swelling, tenderness, bruising) or complaints of discomfort related to fosphenytoin injection either after injection (95%) or at follow-up (88%). Irritation, when reported, was mild in all cases. Forty of 60 patients (67%) reported transient side effects, primarily involving the central nervous system, such as nystagmus, dizziness or ataxia, which are commonly associated with phenytoin therapy. All patients received prescribed doses; no patient had an injection(s) stopped due to intolerance or side effects. No serious adverse events occurred with intramuscular fosphenytoin. In this study, intramuscular fosphenytoin was demonstrated to be a safe and well tolerated, and in many instances, a preferable alternative to other means of phenytoin loading.
磷苯妥英（Cerebyx）是一种水溶性前体药物，可迅速且完全转化为苯妥英。本研究报告了60例需要苯妥英负荷剂量的患者肌肉注射磷苯妥英（剂量>10mg/kg）时的注射部位耐受性和安全性。患者在单个或多个部位接受注射，每个注射部位的注射体积为4至30毫升。大多数患者在注射后（95%）或随访时（88%）没有出现与磷苯妥英注射相关的刺激（红斑、肿胀、压痛、瘀伤）或不适主诉。当有刺激报告时，所有病例均为轻度。60例患者中有40例（67%）报告了短暂的副作用，主要涉及中枢神经系统，如眼球震颤、头晕或共济失调，这些副作用通常与苯妥英治疗有关。所有患者均接受了规定剂量的药物；没有患者因不耐受或副作用而停止注射。肌肉注射磷苯妥英未发生严重不良事件。在本研究中，肌肉注射磷苯妥英被证明是安全且耐受性良好的，并且在许多情况下，是苯妥英负荷其他给药方式的更好选择。
