Premium
Pharmacist Impact on Posttraumatic Seizure Prophylaxis in Patients with Head Injury
Author(s) -
Brophy Gretchen M.,
Tesoro Eljim P.,
Schrote Gretchen L.,
Garnett William R.
Publication year - 2002
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.22.3.251.33547
Subject(s) - phenytoin , medicine , dosing , pharmacist , traumatic brain injury , epilepsy , anesthesia , clinical pharmacy , anticonvulsant , pharmacokinetics , emergency medicine , pharmacology , pharmacy , nursing , psychiatry
Phenytoin is the most commonly administered antiepileptic agent for the prevention of early (≤ 7 days) posttraumatic seizures. Use of the agent, however, requires strict monitoring due to its narrow target range and nonlinear pharmacokinetics. The impact of a clinical pharmacist participating in the care of patients with head injury on posttraumatic seizure prophylaxis with regard to phenytoin dosing and monitoring, cost avoidance, and patient outcome, was measured retrospectively. Parameters from time periods before (BP) and after (AP) a clinical pharmacist participated in patient care were compared. The average number of days that phenytoin was given was 13.4 (BP) and 7.6 (AP), and the duration of phenytoin prophylaxis was 7 days or less in 35% and 65% of patients, respectively. The average number of phenytoin levels drawn from each patient was 10.3 (BP) and 3.4 (AP). Seizures occurred in 4.7% (BP) and 1.5% (AP) of patients. A cost savings of approximately $28,000 was observed for the AP group. A clinical pharmacist reduced the use of posttraumatic seizure prophylaxis and associated costs without jeopardizing patient outcomes.