OBJECTIVE There has been growing interest in newer anti-epileptic drugs (AEDs) for seizure prophylaxis in the intensive care setting because of safety and monitoring issues associated with conventional AEDs like phenytoin. This analysis assessed the cost-effectiveness of levetiracetam versus phenytoin for early onset seizure prophylaxis after neurosurgery and traumatic brain injury (TBI). MET...

OBJECTIVE The aim of the study is to determine: 1) the frequency of patients admitted for phenytoin toxicity and their economic burden; 2) the clinical symptoms and signs of intoxication; 3) the causes or risk factors of intoxication, and 4) the ways to prevent phenytoin toxicity. METHODS Retrospective review of hospital ICD coded database between 1987 and 1998. All patients with phenytoin in...

About 20-30% of patients with epilepsy continue to have seizures despite carefully monitored treatment with antiepileptic drugs. The mechanisms explaining why some patients' respond and others prove resistant to antiepileptic drugs are poorly understood. It has been proposed that pharmacoresistance is related to reduced sensitivity of sodium channels in hippocampal neurons to antiepileptic drug...

A 43-year-old woman sought advice about the treatment of her sea-sickness. A sea-kayaking enthusiast, she suffers disturbing motion sickness in big seas. The usual remedies have either been ineffective or made her drowsy. A scuba-diving instructor recommended that she try taking pheny-toin the night before going kayaking, and she wonders whether there is any evidence to support this recommendat...

BACKGROUND The duration of action of vecuronium is reduced in patients receiving phenytoin. In this study, the authors examined, simultaneously, the influence of phenytoin on both the pharmacokinetics and the pharmacodynamics of vecuronium. METHODS This study was approved by the institutional review board of the University of California, San Francisco, and patients gave written informed conse...

Many cytochrome P450 isoforms are known to be drug-inducible. The anticonvulsant phenytoin has been reported to be an inducer of human CYP2B6, CYP3A4, and murine CYP2C29. However, the molecular mechanism mediating phenytoin induction remains unclear. Herein, we used in vivo and in vitro gene reporter assays of the Cyp2c29 promoter to delineate the phenytoin-response activity to a phenytoin-resp...

SIR, We were interested to read the comparative study of phenytoin and gold in rheumatoid arthritis (RA) by Richards et al,' prompted by the work of Macfarlane et al, who had shown improvements in clinical and laboratory tests and suggested that phenytoin may, therefore, have properties of a second line drug.2 Richards et al found phenytoin to have significant beneficial effects on haemoglobin ...

1. Summary statement of the proposal for inclusion, change or deletion Phenytoin base (as EpanutinR) is available as 50mg chewable tablets and an oral suspension of strength 30mg/5ml, and are proposed for addition to the Model List of Essential Medicines, for use in the management of epilepsy in children. It is at least as effective as carbamazepine, phenobarbitone and sodium valproate in the m...

This study assessed the value of introducing the measurement of free phenytoin levels in a public hospital. After publicising the availability and purpose of the assay, free phenytoin levels were determined either (a) on the doctor's request or (b) when the total level was requested and the patient's record showed evidence of factors predisposing to an elevated unbound fraction. Total phenytoin...

The effect of 'Mentat', a herbal preparation, was studied on pharmacokinetics of single and multiple doses of phenytoin in rabbits. No significant effect was found after single oral dose of 'Mentat' on single dose kinetics of phenytoin. However, 'Mentat' administration for 7 days increased the steady state kinetic parameters. Peak plasma phenytoin concentration, area under the implasma concentr...