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IJAPGR OCT-DEC 2015
Monitoring Serum Concentrations of Phenytoin in Epileptic Patients
Ramjan Shaik*, ShobhaRani R H, Nalini P
Phenytoin has complex pharmacokinetic profile with wide inter-individual variation. Due to its wide fluctuations, dosage must be carefully monitored which otherwise can lead to adverse reactions or loss of therapeutic efficacy. This study aimed at monitoring serum concentrations of phenytoin and to determine the therapeutic range in which there is seizure control and to monitor the adverse drug reactions caused due to phenytoin. Blood samples were collected from patients after steady-state concentration of phenytoin was reached. Serum phenytoin concentrations were measured using chemiluminescent enzyme immunoassay method (CLIA). From 93 patients, a total of 114 samples were collected among whom male patients were 41 (44.1%). Wide variability in serum concentrations of phenytoin was observed which ranged from 2.4 – 30 µg/ml. Phenytoin concentrations were subjected for analysis with various independent variables such as age, gender, weight, co-administered drugs, alcohol and it was observed that there is no effect of these variables on the serum concentrations of phenytoin. There were no major toxicities due to phenytoin except giddiness, nystagmus, headache, mild gingival hyperplasia and mild thrombophlebitis. In conclusion, dosage adjustment of phenytoin was not required since therapeutic benefit was observed in all the patients even at concentration 2.4 µg/ml, without major toxicities.
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