Publication:

Plasma phenytoin concentration in epileptic patients with adequate seizure control in a North-Eastern tertiary care hospital in India

Background In this study, estimation of plasma phenytoin level was done on epileptic patients with adequate seizure control. Since, no such study reporting on phenytoin estimation on seizure-free period in the north-eastern part of India was undertaken; hence rationale of adequate seizure control with phenytoin is yet to be ascertained. This retrospective study is being done to obtain a satisfactory clinical outcome with minimal adverse effects in our setting regarding the target plasma level of phenytoin.

Methods The patients from the Neurology Department were enrolled for this study. Blood samples were taken and the plasma extracted was used for the phenytoin estimation using HPLC.

Results Results showed that the majority of the study population exhibited total plasma phenytoin levels within the recommended therapeutic range (10-20 μg/ml).

Conclusions The study findings showed that patients with adequate seizure control exhibited plasma phenytoin concentration within the recommended therapeutic level, which is the safe level of the drug in blood. However, some variations in the plasma phenytoin level are suggestive of the inter-individual differences in pharmacokinetics after phenytoin therapy. Hence, monitoring of phenytoin treatment is necessary to ensure dosage delivery is at therapeutic levels and to avoid any untoward toxicity.