2025 Southeastern Residency Conference

TITLE: Feasibility and Impact of a Pharmacist-Driven Fosphenytoin Dosing and Monitoring Program 
AUTHORS: Tristan Underwood, Vince Buttrick, Erik Turgeon 
OBJECTIVE: Describe the benefits of implementing a pharmacist-driven fosphenytoin dosing and monitoring program.  
BACKGROUND: Fosphenytoin requires careful monitoring due to its narrow therapeutic range and complex pharmacokinetics. Studies have demonstrated that pharmacist-directed dosing programs can improve dosing accuracy, optimize serum levels, and reduce adverse events. The purpose of this study was to evaluate the impact of a pharmacist-driven fosphenytoin dosing and monitoring program on adherence to FDA approved fosphenytoin dosing and recommended lab monitoring for the treatment of seizures. 
METHODS: Data was collected for adult patients admitted to the hospital who received at least one dose of fosphenytoin between July 2023 – July 2024 and November 2024 – March 2025. The intervention was a pharmacist-driven, hospital-wide fosphenytoin dosing and monitoring program that included a fosphenytoin order panel and an automatic in-basket message notifying pharmacy of phenytoin levels. The primary endpoint was to compare adherence to FDA approved fosphenytoin dosing and recommended lab monitoring in the pre-implementation and post-implementation groups. The secondary endpoints included frequency of re-current seizures and number of fosphenytoin related pharmacist interventions. 
RESULTS: In progress.
CONCLUSIONS: In progress.