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A complex pattern of disposition of phenytoin in severe intoxication
Author(s) -
Pruitt Albert W.,
Zwiren Gerald T.,
Patterson Joseph H.,
Dayton Peter G.,
Cook Clarence E.,
Wall Monroe E.
Publication year - 1975
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1002/cpt1975181112
Subject(s) - phenytoin , metabolite , urine , chemistry , disposition , albumin , pharmacokinetics , toxicity , pharmacology , plasma concentration , distribution (mathematics) , endocrinology , medicine , chromatography , biochemistry , epilepsy , psychology , social psychology , mathematical analysis , mathematics , psychiatry , organic chemistry
A 5‐year‐old child developed phenytoin (diphenylhydantoin, DPH) toxicity after receiving 500 mg of the drug daily for 3 weeks. Plasma, urine, and duodenal fluid were collected for assay of DPH and its metabolites. The peak plasma concentration of DPH was 108 µg/ml, and the decline in plasma level did not fit first‐order kinetics. The para‐hydroxy, meta‐hydroxy, and dihydrodiol metabolites of DPH were measured in urine; duodenal aspirate contained both DPH and the para‐hydroxy metabolite. Plasma pH may affect distribution of DPH since in vitro binding of DPH to human albumin increased as pH increased.