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Year : 1986  |  Volume : 18  |  Issue : 3  |  Page : 144-148

Correlation of serum total and free phenytoin levels with drug intake and seizure control

Correspondence Address:
S N Ahmad

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Source of Support: None, Conflict of Interest: None

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1. Sera of 92 epileptic patients, receiving phenytoin (3-7mg/kg/per day) alone/ in combination with phenobarbitone (1-2 mg/kg/day), were analysed for total and free phenytoin spectrophotometrically. 2. The respective means of total and free phenytoin in the phenytoin group were not significantly different from the phenytoin plus phenobarbitone group. 3. The relationshp between total and free phenytoin, in all patients, was curvilinear i.e. biphasic. The proportion of free phenytoin in patients with total phenytoin <20(g/ml was significantly (p<0.01) higher than those with total phenytoin <20 (g/ml 4. Compared to uncontrolled patients the controlled patients without toxicity showed no statistical differences in mean levels of total and free phenytoin; significantly higher proportion of free drug and a tendency to maintain higher levels of both free and total drug at a given dose, and a significant rise in these levels with dosage increment. 5. The mean total and free phenytoin levels in patients who developed toxicity were higher than the uncontrolled as well as controlled patients without toxicity.


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