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Serum Levels of Phenytoin in Children

  • H. Berlet

Abstract

Notwithstanding the satisfactory average relationship between drug dose and serum concentrations, individual levels of phenytoin (diphenylhydantoin, DPH) may vary greatly with a given dose per kg body weight (Janz et al., 1975; Remmer et al., 1969; Buchanan et al., 1972). This appears to hold especially for children (Borofsky et al., 1972; Buchanan et al., 1971), with very low elimination rates of the drug possibly accounting for occasional striking disparities between administered dose of DPH and high serum levels (Gauchel et al., 1973). These observations have prompted an evaluation of analytical data obtained from children treated with DPH for the control of epileptic seizures. Of particular interest were the relationship between oral DPH dose and serum levels, and daily fluctuations of serum DPH levels in children receiving DPH in divided daily doses.

Keywords

Elimination Rate High Serum Level Daily Fluctuation Fast Group Slow Group 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Bochner, F., Hooper, W. D., Tyrer, J. H., Eadie, M. J.: Effect of dosage increments on blood phenytoin concentrations. J. Neurol. Neurosurg. Psychiat. 35, 873 (1972).PubMedCrossRefGoogle Scholar
  2. Borofsky, L. G., Louis, S., Kutt, H., Roginsky, M.: Diphenylhydantoin: Efficacy, toxicity, and dose-serum level relationships in children. J. Pediat. 81, 995 (1972).PubMedCrossRefGoogle Scholar
  3. Buchanan, R. A., Allen, R. J.: Diphenylhydantoin (Dilantin®) and phenobarbital blood levels in epileptic children. Neurology (Minneap.) 21, 866 (1971).Google Scholar
  4. Buchanan, R. A., Kinkel, A. W., Goulet, J. R., Smith, T. C.: The metabolism of diphenylhydantoin (Dilantin®) following once-daily administration. Neurology (Minneap.) 22, 126 (1972).Google Scholar
  5. Dawson, K. P., Jamieson, A.: Value of blood phenytoin estimation in management of childhood epilepsy. Arch. Dis. Childh. 46, 386 (1971).PubMedCrossRefGoogle Scholar
  6. Dettli, L.: Pharmakokinetik bei repetierter Arzneimittelapplikation: Kumulationslehre. In: Klinische Pharmakologie und Pharmakotherapie (Eds. H. P. Kuemmerle, E. R. Garrett, K. H. Spitzy). München-Berlin-Wien: Urban und Schwarzenberg 1971.Google Scholar
  7. Gaudiel, F. D., Lehr, H. J., Gaudiel, G., von Harnack, G.-A.: Diphenylhydantoin bei Kindern. Dtsch. med. Wsdir. 98, 1391 (1973).CrossRefGoogle Scholar
  8. Houghton, G. W., Richens, A.: Inhibition of phenytoin metabolism by sulthiame in epileptic patients. Brit. J. clin. Pharmac. 1, 59 (1974).Google Scholar
  9. Janz, D., Beriet, H., Schmidt, D.: Comparison of gas-chromatographic and spectrophotometric determination of phenytoin in serum. In: Clinical Pharmacology of Anti-Epileptic Drugs (Eds. H. Schneider, D. Janz, C. Gardner-Thorpe, H. Meinardi, A. L. Sherwin, p. 56. Berlin, Heidelberg, New York: Springer 1975.Google Scholar
  10. Kutt, H., McDowell, F.: Management of epilepsy with diphenylhydantoin sodium. Dosage regulation for problem patients. J. Amer. med. Ass. 203, 969 (1968).CrossRefGoogle Scholar
  11. Remmer, H., Hirschmann, J., Greiner, I.: Die Bedeutung von Kumulation und Elimination für die Dosierung von Phenytoin (Diphenylhydantoin). Dtsch. med. Wschr. 94, 1265 (1969).Google Scholar
  12. Schneider, H.: Clinical and laboratory aspects of the routine spectrophotometric determination of anti-epileptic drugs in Bethel, Federal Republic of Germany. In: Methods of Analysis of Anti-Epileptic Drugs (Eds. J. W. A. Meijer, H. Meinardi, C. Gardner-Thorpe, E. van der Kleijn), ICS 286, 61, Amsterdam: Excerpta Medica, New York: American Elsevier Co., Inc. 1973.Google Scholar
  13. Shirkey, H. C.: Pediatric Therapy. St. Louis: CV Mosby Co. 1964.Google Scholar
  14. Svensmark, O., Kristensen, P.: Determination of diphenylhydantoin and phenobarbital in small amounts of serum. J. Lab. clin. Med. 61, 501 (1963).PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin-Heidelberg 1975

Authors and Affiliations

  • H. Berlet
    • 1
  1. 1.Institute of Pathochemistry and General NeurochemistryHeidelbergFederal Republic of Germany

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