A 45-year-old woman on ICU is receiving IV phenytoin for status epilepticus. She develops purple discolouration and pain at the IV site, followed by t...

Question

A 45-year-old woman on ICU is receiving IV phenytoin for status epilepticus. She develops purple discolouration and pain at the IV site, followed by tissue necrosis. What is the cause of this extravasation injury?

Accepted Answer

Purple glove syndrome from propylene glycol in the phenytoin formulation, combined with the high pH

Answer

Allergic reaction to phenytoin

Answer

The high alkalinity (pH ~12) of IV phenytoin causing tissue necrosis on extravasation

Answer

Thrombophlebitis from the diluent

Answer

Infection at the IV site

uk-fficm MCQ (SBA): Phenytoin Extravasation

A 45-year-old woman on ICU is receiving IV phenytoin for status epilepticus. She develops purple discolouration and pain at the IV site, followed by tissue necrosis. What is the cause of this extravasation injury?