Optimization of phenytoin therapy in adults with epilepsy in the Western Cape, South Africa.
OBJECTIVE: To assess the extent to which adults with epilepsy were optimized and individualized on phenytoin monotherapy in the Western Cape, South Africa and to estimate the average optimized dose and serum phenytoin concentration, and the therapeutic range for this patient group. METHODS: Patients...
| Publicado en: | Journal of Clinical Pharmacy & Therapeutics Vol. 24; no. 5; pp. 381 - 386 |
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| Autores principales: | , , , |
| Formato: | clinical trial research Journal Article |
| Publicado: |
Wiley-Blackwell
Oct99
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105975080&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105975080 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02694727 EV4 jtl: Journal of Clinical Pharmacy & Therapeutics issn: 02694727 maglogo: Y pubinfo: dt: Oct99 vid: 24 iid: 5 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 105975080 105975080 2009783384 10.1046/j.1365-2710.1999.00241.x NLM10583702 105975080 ppf: 381 ppct: 5 formats: fmt: @attributes: type: P tig: atl: Optimization of phenytoin therapy in adults with epilepsy in the Western Cape, South Africa. aug: au: Valodia PN Seymour MA Kies BM Folb PI sug: subj: Anticonvulsants Pharmacokinetics Epilepsy Drug Therapy Phenytoin Pharmacokinetics Adolescence Adult Aged Aged, 80 and Over Anticonvulsants Blood Anticonvulsants Therapeutic Use Clinical Trials Dose-Response Relationship, Drug Epilepsy Blood Female Individuality Male Middle Age Outpatients Phenytoin Blood Phenytoin Therapeutic Use Human Adolescent: 13-18 years Adult: 19-44 years Aged: 65+ years Aged, 80 & over Middle Aged: 45-64 years Female Male ab: OBJECTIVE: To assess the extent to which adults with epilepsy were optimized and individualized on phenytoin monotherapy in the Western Cape, South Africa and to estimate the average optimized dose and serum phenytoin concentration, and the therapeutic range for this patient group. METHODS: Patients were considered to be optimized on phenytoin if they were seizure-free or the best compromise was achieved between seizure reduction and side-effects. RESULTS: 538 (233 black and 305 coloured) adult people with epilepsy were treated at nine epilepsy clinics as outpatients. Of these patients, 332 (226 male and 106 female, 149 black and 183 coloured) were included in the data analysis as they were considered to have reliable phenytoin levels. Phenytoin doses and steady-state serum concentrations were predicted using the Michaelis-Menten equation. Patients attended a clinical pharmacokinetic service for 7.7+/-5.3 (range 1-22) months. The average optimized dose was 305.8 (range 100-500) mg/day and the average optimized level was 62.7+/-23.9 (range 15-133) micromol/l. Most patients (61.9%) were optimized in the therapeutic range 40-79 micromol/l; 21.1% were optimized above and 17% below this range. In 1.6% of patients serum concentrations above 120 micromol/l were required. Dosage adjustments were made in 47.0% of patients, increased in 31.9% and reduced in 15.1%. CONCLUSION: These findings indicate that many patients (47%) attending outpatient clinics were not optimized on phenytoin therapy. pubtype: Academic Journal doctype: clinical trial research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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