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dc.contributor.authorSelioutski, Olga
dc.contributor.authorGrzesik, Katherine
dc.contributor.authorVasilyeva, Olga N.
dc.contributor.authorHilmarsson, Ágúst
dc.contributor.authorFessler, A. James
dc.contributor.authorLiu, Lynn
dc.contributor.authorGross, Robert A.
dc.date.accessioned2018-01-02T13:04:14Z
dc.date.available2018-01-02T13:04:14Z
dc.date.issued2017-11
dc.date.submitted2017
dc.identifier.citationEvaluation of phenytoin serum levels following a loading dose in the acute hospital setting 2017, 52:199 Seizureen
dc.identifier.issn10591311
dc.identifier.doi10.1016/j.seizure.2017.10.006
dc.identifier.urihttp://hdl.handle.net/2336/620420
dc.descriptionTo access publisher's full text version of this article click on the hyperlink belowen
dc.description.abstractPURPOSE: Due to the complex pharmacokinetic profiles of phenytoin (PHT) and fosphenytoin (FOS), achieving sustained, targeted serum PHT levels in the first day of use is challenging. METHODS: A population based approach was used to analyze total serum PHT (tPHT) level within 2-24h of PHT/FOS loading with or without supplementary maintenance or additional loading doses among PHT-naïve patients in the acute hospital setting. Adequate tPHT serum level was defined as ≥20μg/mL. RESULTS: Among 494 patients with 545 tPHT serum levels obtained in the first 2-24h after the loading dose (LD), tPHT serum levels of either
dc.description.sponsorshipClinical & Translational Science Institute (CTSI) of the University of Rochesteren
dc.language.isoenen
dc.publisherW.B. Saundersen
dc.relation.urlhttp://linkinghub.elsevier.com/retrieve/pii/S1059131117305411en
dc.rightsArchived with thanks to Seizureen
dc.subjectFlogaveikien
dc.subjectLyfhrifafræðien
dc.subjectLyfjaskömmtunen
dc.subjectLyfjagjöfen
dc.subjectNEU12
dc.subject.meshPhenytoinen
dc.subject.meshStatus Epilepticusen
dc.subject.meshPharmacokineticsen
dc.titleEvaluation of phenytoin serum levels following a loading dose in the acute hospital settingen
dc.typeArticleen
dc.contributor.department[ 1 ] Univ Rochester, Sch Med & Dent, Dept Neurol, Strong Epilepsy Ctr, Rochester, NY 14642 USA [ 2 ] Univ Rochester, Sch Med & Dent, Dept Biostat, Rochester, NY USA [ 3 ] Univ Rochester, Sch Med & Dent, Dept Pharm, Rochester, NY USA [ 4 ] Landspitali Univ Hosp, Reykjavik, Icelanden
dc.identifier.journalSeizureen
dc.rights.accessNational Consortium - Landsaðganguren
html.description.abstractPURPOSE: Due to the complex pharmacokinetic profiles of phenytoin (PHT) and fosphenytoin (FOS), achieving sustained, targeted serum PHT levels in the first day of use is challenging. METHODS: A population based approach was used to analyze total serum PHT (tPHT) level within 2-24h of PHT/FOS loading with or without supplementary maintenance or additional loading doses among PHT-naïve patients in the acute hospital setting. Adequate tPHT serum level was defined as ≥20μg/mL. RESULTS: Among 494 patients with 545 tPHT serum levels obtained in the first 2-24h after the loading dose (LD), tPHT serum levels of either <or≥20μg/mL were observed along wide and overlapping cumulative dose ranges. Among those receiving 15-20mg/kg and 20-55mg/kg weight-based loading dose, 63% and 51% respectively did not attain tPHT serum level of ≥20μg/mL even within the first 6h of treatment. For the 393 available concomitant free and total serum PHT levels, correlation was weak, r=0.36. CONCLUSION: Close laboratory surveillance and PHT/FOS dose adjustments are recommended to ensure adequate and sustained tPHT serum levels early in treatment. Free serum PHT level is the preferred method of drug monitoring.


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