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Timing of maintenance phenytoin therapy after intravenous loading doseJ J Riviello Jr et al. Pediatr Neurol. 1991 Jul-Aug. AbstractThe specific timing of maintenance phenytoin therapy in children has not been addressed. Prevention of a subtherapeutic phenytoin level is important for seizure control. We devised a protocol using an 18 mg/kg loading dose of phenytoin with serial levels (obtained after 2,6,12 hours) and analyzed the results in 20 consecutive patients. A therapeutic level (greater than 10 micrograms/ml) was present in all patients at 2 hours, in 16 of 20 at 6 hours, and in 10 of 20 at 12 hours. The patients were divided into 2 groups by the 12-hour levels: group I: therapeutic level; and group II: subtherapeutic level. The mean 2-hour level in group I was 22.7 micrograms/ml versus 15.6 micrograms/ml in group II (P less than 0.001). The mean decline in plasma concentration in individual patients was 0.7 micrograms/ml/hr in group I versus 1.02 micrograms/ml/hr in group II (P less than 0.05). We now use the 2-hour level to decide the timing of maintenance phenytoin therapy and have devised an equation to estimate the duration of the therapeutic range. Phenytoin can be administered at 12 hours when the 2-hour level is satisfactory or earlier when the 2-hour level indicates that a subtherapeutic level will occur. Similar articles
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How effective is phenytoin?Phenytoin is highly effective for seizures and is one of the most commonly used seizure medicines in North America. It is best used for partial-onset seizures, which begin in one area of the brain.
Why is phenytoin taken at night?Why Is Phenytoin Given At Night? Phenytoin is commonly administered in the evening or at night. So that by the morning, there is sufficient concentration of the drug in the tissues and blood. This would reduce the risk or chances of a morning epileptic seizure.
What is the best time to take phenytoin?You'll usually take phenytoin once or twice a day. You can take it with or without food. If you take it twice a day, try to space your doses evenly through the day.
How does phenytoin stop seizures?Phenytoin is used to control certain type of seizures, and to treat and prevent seizures that may begin during or after surgery to the brain or nervous system. Phenytoin is in a class of medications called anticonvulsants. It works by decreasing abnormal electrical activity in the brain.
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