In 1949 the neurosurgical service of Massachusetts General Hospital asked the department of pharmacy to see if it would be possible to prepare diphenylhydantoin (Dilantin) sodium (called Epanutin or Epimal in some countries) for intramuscular or intravenous use in the handling of postoperative convulsions when the patient was unconscious and the use of oral medication was not possible. It was felt dangerous to use enough sodium phenobarbital intravenously or intramuscularly to suppress the convulsions because of its severe depressant effect on respiration. A patient after brain operation is very sensitive to sedatives given in enough strength to stop his convulsions. The fact that diphenylhydantoin sodium does not suppress the respiration or add to the impairment of consciousness in the doses ordinarily used to control convulsions suggested that it would be an ideal substance to use parenterally.
In 1950 a preparation was prepared in the pharmacy department in accordance with the
Murphy JT, Schwab RS. DIPHENYLHYDANTOIN (DILANTIN) SODIUM USED PARENTERALLY IN CONTROL OF CONVULSIONSA FIVE-YEAR REPORT. JAMA. 1956;160(5):385–388. doi:10.1001/jama.1956.02960400043010
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