رجل عمره ٥٥ سنة بعد نوبات صرع متكررة، والطبيب كتب فينيتوين وريدي بجرعة تحميل. عنده كانيولا في ظهر اليد، والضغط ١٣٢/٨٠، والنبض ٨٤. الممرض يجهز الدواء. أي إجراء صحيح؟

A 55-year-old man after recurrent seizures is prescribed an IV phenytoin loading dose. He has a cannula in the back of his hand; BP 132/80, HR 84. The nurse is preparing the drug. Which action is correct?

1. Dilute it in glucose because that is safer
2. Dilute in saline only and infuse slowly on a monitor
3. Give it as a rapid push so the seizure stops sooner
4. Mix it with the other drugs in the same bag

Answer: B) Dilute in saline only and infuse slowly on a monitor. Phenytoin precipitates in glucose and is diluted only in saline. Rapid infusion causes hypotension and arrhythmia, so it is given slowly (no faster than 50 mg/min in adults) with monitoring, and the site is watched because it is irritant.