5 EN two hours prior and after the dose of phenytoin and flushing the tube with 60 mL of water, therapeutic phenytoin serum concentrations were achieved with only modest increase in doses
This reduces drug absorption and consequent plasma concentration 2 hour
Panel 2: Techniques for administering drugs via enteral feeding tubes 23
If your child receives tube feedings with such a product, give the phenytoin at least 1 hour before or 2 hours after feeding
If this drug is given through a feeding tube, stop tube feeding for 2 hours before giving this drug
reported decreased serum phenytoin concentrations associ-ated with enteral tube feeding; minimal effect has been re-ported in most studies involving healthy volunteers
Dosing
Also, be aware of drug/nutrient interactions that can inhibit absorption of PO phenytoin doses…especially tube feeds! In particular, phenytoin seems to like binding
Phenytoin LVH recommendation: Hold tube feeds 2 hours before and 2 hours after medication administration
After all medications are administered, flush tube with 15 to 30 mL of water
, An order is written for (phenytoin) Dilantin 500 mg IM q3-4h prn for pain The doctor may adjust the dose as needed
It’s possible that you’ll need to stop tube feedings for 1 to 2 hours before and after taking these medications
4)Verify that residual volume is less than 200 mL
Restart tube feeding 2 hours after giving
Only hold the feeding by 30 minutes or more when separation is indicated to avoid altered drug bioavailability
500 mL of IV fluid consists of 50 g of dextrose
before 40 It is recommended that administration of phenytoin be separated from feeding by 1-2 Feeding-tube location was in the small bowel in 26 of 32 Phenytoin comes as an extended-release (long-acting) capsule, a chewable tablet, and a suspension (liquid) to take by mouth
Flush feeding tube with water before, between each medication when administering multiple medications, and after medication administration
Interventions 1
Phenytoin (Dilantin) has specific administration requirements to ensure optimal absorption and avoid potential interactions
However if seizures are controlled at 9 mcg/mL or side effects are present at 12 mcg/mL, a patient specific therapeutic range should be considered
Feeding tubes and enteral nutrition may decrease absorption of phenytoin suspension by up to 80% via protein binding, poor solubility, or binding to feeding tubes
Chan
If this medicine (Dilantin Infatabs) is given through a feeding tube, stop tube feeding for 2 hours before giving this medicine (Dilantin Infatabs)
5-4 hours afterward
The nurse is providing medications to a patient who is currently receiving continuous tube feeding via gastrostomy tube