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July 17, 1967

Intravenous Use of Diphenylhydantoin Sodium

JAMA. 1967;201(3):210. doi:10.1001/jama.1967.03130030080031

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To the Editor:—  Two fatalities have been reported in The Journal (200:335, 1967) in association with intravenous administration of diphenylhydantoin (Dilantin) sodium for the treatment of cardiac arrythmias. Amounts administered were 250 mg and were reported as being given over a period of two to three minutes.We have used diphenylhydantoin sodium intravenously to treat status epilepticus in 36 patients and cardiac arrythmias in 75 patients. It was effective in stopping seizures in about half of the patients. It was also predictably effective in abolishing premature ventricular contractions, but it did not usually correct sino-auricular arrythmias. The dose given ranged from 500 to 1,000 mg administered at a rate of not over 100 mg/min, and usually the rate of administration was less, 10 to 50 mg/min.Of the 111 patients treated, 105 have shown little or no changes of blood pressure and respirations. In one patient who received 1,000