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MULTIPLE DRUG INTERACTIONS WITH PHENYTOIN
Author(s) -
Birkett Donald J.,
Graham Garry G.,
Chinwah Peter M.,
Wade Denis N.,
Hickie John B.
Publication year - 1977
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1977.tb117733.x
Subject(s) - phenytoin , pharmacology , drug , medicine , epilepsy , enzyme inducer , toxicity , drug interaction , drug metabolism , phenobarbital , therapeutic drug monitoring , metabolism , therapeutic index , disulfiram , anticonvulsant , anesthesia , chemistry , enzyme , biochemistry , psychiatry
A 49‐year‐old female with chronic alcoholism and epilepsy, treated with phenytoin, began to convulse when treatment with disulfiram (an inhibitor of phenytoin metabolism) was discontinued. The patient at this stage was resistant to the large doses of phenytoin, apparently owing to induction of the metabolism of this drug by chronic alcohol intake. Later, a small (30%) increase in dose resulted in about a tenfold increase in plasma concentration of phenytoin and severe toxicity. The final dose of phenytoin required to maintain the plasma level within the therapeutic range suggested that the enzyme induction had decreased. The value of monitoring plasma concentrations of phenytoin is emphasized.