OBJECTIVE To present a case report and literature review of phenytoin-induced purple glove syndrome (PGS). CASE SUMMARY A 54-year-old African American male presented to our hospital's emergency department (ED) following a seizure episode, cardiac arrest, and loss of consciousness. On arrival to the ED, the patient's total phenytoin level was subtherapeutic at 4.1 mcg/mL and his corrected tota...

BACKGROUND Genetic polymorphisms are known to influence outcomes with phenytoin yet effects in the Middle East and North Africa region are poorly understood. OBJECTIVES The objective of this systematic review was to evaluate the impact of genetic polymorphisms on phenytoin pharmacokinetics and clinical outcomes in populations originating from the Middle East and North Africa region, and to ch...

Current guidelines recommend against the use of phenytoin following aneurysmal subarachnoid hemorrhage (aSAH) but consider other anticonvulsants, such as levetiracetam, acceptable. Our objective was to evaluate the risk of poor functional outcomes, delayed cerebral ischemia (DCI) and delayed seizures in aSAH patients treated with levetiracetam versus phenytoin. Medical records of patients with ...

Dear Editor: With interest we read the article by Ashrafi et al. about a 14-year-old female who is regarded to have developed Leigh syndrome (LS) after traumatic brain injury (TBI) (1). We have the following comments and concerns: We do not agree with the notion that traumatic brain injury was the precipitating factor for LS. The patient had a history of hypoacusis, which is a typical clinical ...

Oxidative stress and reactive oxygen species (ROS) such as hydrogen peroxide (H2O2), which is detoxified by catalase, are implicated in fetal death and birth defects, but embryonic levels of catalase are only about 5% of adult activity, and its protective role is unknown. Our approach involved the use of mice genetically modified to either: (1) express low levels of endogenous catalase (acatala...

OBJECTIVE Antiepileptic drugs (AEDs) may have adverse effects on bone mineral density (BMD) and metabolism. We previously reported biochemical evidence of increased bone turnover in premenopausal women with epilepsy on phenytoin monotherapy compared with those on carbamazepine, lamotrigine, and valproate. We therefore hypothesized that rates of bone loss would be higher in young women treated w...

Phenytoin is a commonly used anti-epileptic drug. Adverse reactions including fever, skin reactions and lymphadenopathy are well known but atypical reactions can also occur. A patient is described with a lag time of only 4 days between onset of phenytoin and the development of a syndrome with acute lung injury and renal failure. The symptoms mimicked a renopulmonary syndrome, and resolved compl...

Saliva carbamazepine and phenytoin samples were used to monitor treatment in 35 children aged between 2 and 14 years during a 2-year period. All phenytoin levels and over half the carbamazepine levels that were above the therapeutic range were associated with adverse effects. Dose and carbamazepine saliva levels were significantly related but no such relationship was found for phenytoin. There ...

1. Abstract 2. Basic principle for corporal drug movement 2.1. Membrane transporters 2.2. Cardiac output distribution 2.3. Gastrointestinal-blood cycling 2.4. Drug distribution throughout the splanchnic organs 2.5. Efflux transportation, blood flow fraction, and drug recycling 3. Phenytoin 3.1. Michaelis-Menten consideration 3.2. Hepatic, intestinal, and renal contribution to phenytoin clearanc...