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NEUROLOGY 1982;32:1401
© 1982 American Academy of Neurology

Efficacy of phenobarbital monotherapy in treatment of neonatal seizures—relationship to blood levels

Peter Gal, Pharm. D., Jamie Toback, Pharm.D., Henry R. Boer, M.D., M.P.H., N. V. Erkan, M.D. and Thomas J. Wells, M.D., M.P.H.

Area Health Education Center (Dr. Gal) and the Department of Neonatal Medicine (Dr. Boer), Moses H. Cone Memorial Hospital, Greensboro, NC, and the Department of Clinical Pharmacy (Dr. Toback), Crawford W. Long Memorial Hospital, Atlanta, GA, and the Department of Neonatology (Dr. Erkan), Georgia Baptist Medical Center, Atlanta, GA, and the Bureau of Maternal and Child Health (Dr. Wells), UT.

Seventy-one neonates were observed for the relationship between phenobarbital plasma concentrations and elimination of seizures. Sixty neonates (85%) had seizures controlled by phenobarbital alone. Effective plasma concentrations were 10.1 to 46.4 mg per liter. Although 36 neonates had seizures controlled by phenobarbital concentrations below 20 mg per liter, 7 neonates required levels above 30 mg per liter. We recommend that plasma phenobarbital concentrations should equal or surpass 40 mg per liter before additional anticonvulsants are used for neonates with seizures.

Address correspondence and reprint requests to Dr. Gal, Moses H. Cone Memorial Hospital, 1200 N. Elm Street, Greensboro, NC 27420.

Accepted for publication May 4, 1982.




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