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Panduan penyiapan dan pemberian terapi medikasi
Panduan penyiapan dan pemberian terapi medikasi
Phenytoin Sodium
Risiko Phlebitis sedang
Kejadian Kadang-kadang (1/100 – 1/1000 kejadian)
Disarankan pengawasan selama infus berlangsung.
Penyiapan
Sediaan
- 50 mg/mL
Rekomendasi Pengenceran (Konsentrasi)
<5 mg/ mL (100mg dalam 20cc atau lebih)
Pelarut
- NaCl 0.9%
Pemberian
Rekomendasi Akses
IV vena besar / CVC. Pre dan post pemberian bilas dengan NaCL 0,9%
Rekomendasi Durasi Pemberian
1 jam bila dilarutkan 100 mL
Stabilitas Obat Setelah Rekonstruksi
segera diberikan sampai dengan maksimal 4 jam setelah dilarutkan
Keamanan
pH
10-12.3
pH risiko tinggi (<4 / >9)
Osmolaritas Sebelum Pengenceran
3035 mOsm/kg
Osmolaritas tinggi (>900)
Harus melalui CVC
Harus melalui CVC
Osmolaritas Sesudah Pengenceran
100mg dalam 50cc NaCl 0,9% = 336 mOsm/kg
100mg dalam 100cc NaCL 0,9% = 312 mOsm/kg
100mg dalam 100cc NaCL 0,9% = 312 mOsm/kg
Osmolaritas rendah (<600)
Phlebitis
Ya
Kadang-kadang (1/100 – 1/1000 kejadian)
Disarankan pengawasan selama infus berlangsung.
Disarankan pengawasan selama infus berlangsung.
Inkompatibilitas
- Tidak boleh berinteraksi dengan obat lain (98% obat incompatibel)
Klasifikasi GHS
Acute Toxicity
Irritant
Health Hazard
Manifestasi GHS
H301 (18.6%): Toxic if swallowed [Danger Acute toxicity, oral]
H302 (81.4%): Harmful if swallowed [Warning Acute toxicity, oral]
H317 (82.5%): May cause an allergic skin reaction [Warning Sensitization, Skin]
H351 (77.8%): Suspected of causing cancer [Warning Carcinogenicity]
H360 (15.5%): May damage fertility or the unborn child [Danger Reproductive toxicity]
H361 (83%): Suspected of damaging fertility or the unborn child [Warning Reproductive toxicity]
H372 (18%): Causes damage to organs through prolonged or repeated exposure [Danger Specific target organ toxicity, repeated exposure]
H302 (81.4%): Harmful if swallowed [Warning Acute toxicity, oral]
H317 (82.5%): May cause an allergic skin reaction [Warning Sensitization, Skin]
H351 (77.8%): Suspected of causing cancer [Warning Carcinogenicity]
H360 (15.5%): May damage fertility or the unborn child [Danger Reproductive toxicity]
H361 (83%): Suspected of damaging fertility or the unborn child [Warning Reproductive toxicity]
H372 (18%): Causes damage to organs through prolonged or repeated exposure [Danger Specific target organ toxicity, repeated exposure]
Sumber
- https://www.ogbdexa.com/produk-sistem-saraf/phenytoin-sodium--injeksi-50-mg%2Fml
- http://doi.org/10.37573/9781585286850
- American Society of Health-System Pharmacists. 2021. ASHP® Injectable Drug Information: A Comprehensive Guide to Compatibility and Stability. 2021 Edition. eBook. American Society of Health-System Pharmacists. ISBN: 978-1-58528-690-4. doi.org/10.37573/9781585286850