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The clinical value of free phenytoin levels
- Source :
- Annals of Neurology. 18:90-93
- Publication Year :
- 1985
- Publisher :
- Wiley, 1985.
-
Abstract
- The relationship between total and free phenytoin levels and drug toxicity was studied in 80 patients. Twenty-four were taking phenytoin alone. Drug toxicity was assessed by a "blind" rater using an eight-point standardized scoring system. The mean free phenytoin fraction was 0.076 in patients taking phenytoin alone or phenytoin and carbamazepine and 0.11 in patients taking valproic acid (p less than 0.001). The free fraction did not change with the total level over the range tested (6.7 to 39.9 micrograms/ml total phenytoin). There was a strong correlation between free and total levels (r = 0.84). Both free (r = 0.59) and total (r = 0.49) phenytoin levels were positively correlated with the toxicity score. Only total phenytoin levels showed a weak positive correlation with decreasing seizure frequency. Our results suggest that routine free phenytoin level monitoring is not necessary in most clinical situations.
- Subjects :
- Adult
Phenytoin
medicine.medical_specialty
Adolescent
Gastroenterology
Internal medicine
otorhinolaryngologic diseases
medicine
Humans
heterocyclic compounds
Drug toxicity
Valproic Acid
Epilepsy
business.industry
digestive, oral, and skin physiology
Carbamazepine
Middle Aged
nervous system diseases
stomatognathic diseases
Neurology
Free fraction
Anesthesia
Toxicity
Clinical value
Neurology (clinical)
Free phenytoin
business
medicine.drug
Subjects
Details
- ISSN :
- 15318249 and 03645134
- Volume :
- 18
- Database :
- OpenAIRE
- Journal :
- Annals of Neurology
- Accession number :
- edsair.doi.dedup.....9d5576bdf708d9d6e9b5a534974e1a77