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- Title
Correlation of Serum Phenytoin Levels With the Occurrence of Adverse Drug Reactions in Patients With Epilepsy in a Tertiary Care Hospital of Northern India.
- Authors
Adil, Mohd; Pukhta, Muzaffar Ahmad; Farhat, Samina; Nazir, Tauseef
- Abstract
Background Phenytoin is the most commonly used anti-epileptic drug (AED) in our set up due to its cost-effectiveness and easy availability. Significant fluctuations in serum phenytoin levels leading to toxicities or treatment failures make it an ideal candidate for therapeutic drug monitoring (TDM). Methods Patients of age =18 years who were put on phenytoin were enrolled in Data was analysed using SPSS version 20.0. Chi square test, Kruskal Wallis test were used to analyse the data. Relationship of serum phenytoin levels versus ADRs was analysed using Mann-Whitney test. Results A total of 105 patients enrolled in the study, twenty patients (19%) had normal or therapeutic serum phenytoin levels. Thirty-nine patients (37.2%) had sub therapeutic serum phenytoin levels, while forty-six patients (43.8%) had toxic serum phenytoin levels. A total of 91 ADRs of 20 different types were reported by 48 patients of the study population. The most common organ system involved was neurological (49.4%) followed by gastrointestinal (26.4%), Skin/Connective Tissue (19.8%) and Haematological (4.4%). ADRs were present in 5.13% of the patients with sub therapeutic levels of phenytoin against the 82.60% of the patients with toxic levels of phenytoin. ADRs were present in 40% of the patients with serum phenytoin levels in normal or therapeutic range. There was a statistically significant relationship between serum phenytoin levels and the proportion of ADRs (p<0.001). ADRs were most common in the age group of 21-40 years (53.6%) and least common in the age group of 61-80 years (33.3%). There was, however, no statistically significant relationship between age and ADRs (p=0.376). Conclusion The TDM of phenytoin should adopt a multi-disciplinary approach with active involvement of neuro-physicians, pharmacologists, pharmacists and other technical staff for improving the overall management of epilepsy. TDM data will provide the clinicians with greater insight into the factors determining the patient's response to drug therapy.
- Subjects
INDIA; DRUG side effects; PEOPLE with epilepsy; PHENYTOIN; DRUG monitoring; TERTIARY care
- Publication
JK Practitioner, 2022, Vol 27, Issue 4, p55
- ISSN
0971-8834
- Publication type
Article