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?

<p>50 mg/L (C)</p> Signup and view all the answers

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

<p>1-2 mg/L (C)</p> 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?

<p>Seek immediate medical attention (C)</p> 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?

<p>To ensure bioequivalence (B)</p> Signup and view all the answers

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

<p>92 mg phenytoin base (C)</p> Signup and view all the answers

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

<p>At 7 days (B)</p> Signup and view all the answers

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

<p>Status epilepticus (B)</p> Signup and view all the answers

What is the percentage of plasma protein binding of phenytoin?

<p>90% (C)</p> Signup and view all the answers

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

<p>Increased therapeutic activity (B)</p> Signup and view all the answers

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

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

What is the quoted half-life of phenytoin?

<p>22 hours (B)</p> Signup and view all the answers

Why is it necessary to monitor plasma-phenytoin concentration?

<p>Due to the narrow therapeutic index of phenytoin (A)</p> Signup and view all the answers

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