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Dilantin Toxicity


This is for patients with unintentional overdose...not suicidal ones



Inclusion Criteria

  • Dilantin toxicity secondary to unintentional overmedication
  • Unsteady gait
  • CBC, chem-7, dilantin level, and toxicology consult on ALL patients
  • IV access and cardiac monitor
  • Charcoal if indicated

Exclusion Criteria

  • Suicide attempt or gesture
  • Multiple acute co-ingestants
  • Significant inebriation or intoxication
  • Unstable vital signs
  • Arrhythmmias
  • Other acute comorbidities or complicating illnesses
  • Dilantin level greater than 35 µ/cc

Potential Interventions

  • Cardiac monitoring
  • Serial dilantin levels
  • Repeat charcoal if needed
  • Initial bed rest, then advance activity as tolerated

Discharge Criteria

Home

    • Steady gait
    • Understanding of discharge instructions
    • Poison center or toxicology consult completed

Admit

    • Persistent symptoms after 24 hours
    • Increasing dilantin level after second dose of charcoal
    • Unstable vital signs or clinical condition
    • Physician discretion based on other complications or comorbidities


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