Neurology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text (PDF)
Right arrow Correspondence:
Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Correspondence are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Dodson, W. E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Dodson, W. E.
NEUROLOGY 1982;32:42
© 1982 American Academy of Neurology

Nonlinear kinetics of phenytoin in children

W. Edwin Dodson, M.D.

Edward Mallinckrodt Department of Pediatrics and the Department of Neurological Surgery and Neurology (Neurology) and the Division of Clinical Neuropharmacology, Washington University School of Medicine, and the Division of Pediatric Neurology. St. Louis Children's Hospital, St. Louis, MO.

The nonlinear kinetics of phenytoin were evaluated in 54 children by measuring phenytoin concentrations at steady state at three or more doses. There was good correlation between phenytoin doses and concentrations when a nonlinear kinetic model was used (r = 0.896). Increasing age was associated with a reduction in the apparent Vmax. The apparent Km was influenced primarily by drug interactions. Phenobarbital increased the Km and Vmaxfor phenytoin. Carbamazepine reduced both Km and Vmax. Valproic acid reduced the Km. The low Km (< 2.6 mg per liter) found in 28% of patients makes titration of the phenytoin dose to therapeutic levels difficult.

Address correspondence and reprint requests to Dr. Dodson, St. Louis Children's Hospital. 500 South Kings highway, P.O. Box 14871, St. Louis, MO 63178.

This work was supported by grants from the National Foundation-March of Dimes; Public Health Service Research Grant No. RR-36 from the General Clinical Research Center Branch; NIH Mass Spectrometry Resource Grant No. RR-00954; and NIH Career Academic Development Award No. 1-K07 NS11074.

Accepted for publication June 17, 1981.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1982 by AAN Enterprises, Inc.