BACKGROUND Therapeutic drug monitoring of phenytoin by measurement of plasma concentrations is often employed to optimize clinical efficacy while avoiding adverse effects. This is most commonly accomplished by measurement of total phenytoin plasma concentrations. However, total phenytoin levels can be misleading in patients with factors such as low plasma albumin that alter the free (unbound) c...

We investigate the relationship between brain extracellular fluid free phenytoin concentration and plasma free phenytoin concentration in adults with acute brain injury. Daily cerebral microdialysate free phenytoin concentration was measured in eight adults with acute brain injury and compared to simultaneous measurement of plasma free phenytoin concentration. The group data revealed no signifi...

Esomeprazole is commonly prescribed proton pump inhibitor for gastritis and peptic ulcer disease. Most of the time in clinical practice, phenytoin and esomeprazole are prescribed for patients of generalized seizures with concomitant peptic ulcer. Hence there are chances of drug-drug interaction because of modulations of isoenzymes CYP2C9 and CYP2C19, are involved in metabolism of phenytoin and ...

Objective: To evaluate antioxidant effect of Virgin Coconut Oil (VCO) and Corn (CO) on germinal thickness (GT) in rats induced with phenytoin toxicity. Study design setting: An Experimental Longitudinal study was done at AL-Tibri Medical College Hospital Isra University Karachi Campus. Methodology: 28 male albino were selected divided into 4 groups each consisting 7 rats. Group A received norma...

Phenytoin, 5,5-diphenylhydantoin, is a widely used anticonvulsant agent with a variety of toxicities, including drug interactions. The formation of four oxidative metabolites, 4'-hydroxylated (4'-HPPH), 3'-hydroxylated (3'-HPPH), a catechol (3',4'-diHPPH), and the 3',4'-dihydrodiol form of phenytoin was examined in rat liver microsomes. In 11 cDNA-expressed rat P450 enzymes tested, CYP2C6 had t...

BACKGROUND & OBJECTIVES Simultaneous administration of phenytoin and isoniazid (INH) in tuberculous meningitis (TBM) or tuberculoma patients with seizures results in higher plasma phenytoin level and thus phenytoin intoxication. N-acetyltransferase 2 (NAT2) enzyme catalyses two acetylation reactions in INH metabolism and NAT2 gene polymorphism leads to slow and rapid acetylators. The present st...

Patients with large variations in phenytoin levels despite standard doses may prove to become difficult clinical problems. Our study of 34 head injury patients whose serum phenytoin levels were measured on day one and day five following intravenous loading and maintenance dose of phenytoin, showed 38.24% patients, to have therapeutic phenytoin levels on day one, while 20% were in toxic range. O...

The purpose of this investigation was to determine if administration of heparin causes displacement of an acidic drug from serum protein binding sites in vivo as has been suggested by several groups of investigators. Rats were injected and infused with phenytoin to produce steady-state serum concentrations of about 25 micrograms/ml. After 2 hr, some of the animals also received injections and i...

PURPOSE The pharmacokinetics of phenytoin is complicated by genetic and environmental differences. It is, therefore, important to monitor the serum concentrations in patients who receive phenytoin. Because most of the phenytoin in serum is bound to proteins, the level of serum albumin influences the amount of free phenytoin. MATERIALS AND METHODS We compared the measured and calculated free p...

introduction: different modalities have been used to achieve better results in wound healing among which are laser and pharmacological agents. to our knowledge, there is no investigation to compare phenytoin and laser together. in this study, we aimed to evaluate laser and phenytoin efficacy and compare their effect on wound healing. methods: we used 60 rats. the animals were divided into 4 gro...