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Phenytoin: Therapeutic Indications and Adverse Effects

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Phenytoin: Therapeutic Indications and Adverse Effects

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Questions and Answers

What is the usual initial dose of phenytoin for acute indications?

100-200 mg/day PO

300-600 mg/day PO

200-500 mg/day PO

150-300 mg/day PO (correct)

What is the therapeutic range of total phenytoin in blood samples?

10-20 mg/L (correct)

30-40 mg/L

20-30 mg/L

5-10 mg/L

What is a common chronic adverse effect of phenytoin, occurring in 20% of patients?

Hirsutism

Folate deficiency

Coarsening of facial features

Gingival hyperplasia (correct)

At what phenytoin level can drug-induced seizures occur?

50 mg/L Signup and view all the answers

What is the therapeutic range of free phenytoin concentration in saliva samples?

1-2 mg/L Signup and view all the answers

What is the recommended action if a patient develops symptoms such as fever, rash, mouth ulcers, bruising, or bleeding while taking phenytoin?

Seek immediate medical attention Signup and view all the answers

Why is it important to maintain a patient on a specific manufacturer's product when treating epilepsy with phenytoin?

To ensure bioequivalence Signup and view all the answers

What is the approximate therapeutic equivalent of 100 mg of phenytoin sodium?

92 mg phenytoin base Signup and view all the answers

What is the recommended timing for taking a phenytoin level after initiating therapy?

At 7 days Signup and view all the answers

What is the indication for the use of intravenous phenytoin formulation?

Status epilepticus Signup and view all the answers

What is the percentage of plasma protein binding of phenytoin?

90% Signup and view all the answers

What is the effect of a decrease in protein binding on phenytoin's therapeutic activity?

Increased therapeutic activity Signup and view all the answers

What is the formula for calculating Cp adjusted, the adjusted phenytoin concentration?

Cp adjusted = Cp measured / (1 - a) * (albumin measured / albumin normal) + alpha Signup and view all the answers

What is the quoted half-life of phenytoin?

22 hours Signup and view all the answers

Why is it necessary to monitor plasma-phenytoin concentration?

Due to the narrow therapeutic index of phenytoin Signup and view all the answers