Summary
The dose‐plasma level relationship of DPH was determined in 700 patients divided into carefully defined groups. Equivalent dosages of DPH (5.1 mg/kg) were compared in each group. A highly significant (p < 0.001) linear dose (per meter2)‐plasma level relationship was observed in 21 adult males receiving their total daily dose each morning. Mean plasma DPH levels were similar in children of either sex, but larger doses were required to attain a plasma level equivalent to adult males. The mean plasma level achieved in adult females (25 to 45 years) was lower than that of adult males (p < 0.05). A significant increase (p < 0.001) in the mean plasma DPH level was observed in females over 65. There was no difference in the response of obese patients though they tended to receive inadequate dosages. The mean plasma level of patients receiving phenobarbital or primidone concurrently was similar to that of those receiving DPH alone, but individual differences were frequently observed. Consistent alterations in plasma DPH levels were not observed during pregnancy. Hence age, sex, and body size should always be fully considered in the clinical interpretation of data obtained by periodic monitoring of plasma DPH levels.
RÉsumé
La relation entre la dose de diphénylhydantoine (DPH) et son taux plasmatique fut étudiée chez 700 sujets, appartenant a des groupes soigneusement définis. Des doses équivalentes de DPH furent compareées dans chaque groupe (5.1 mg/kg). Une relation linéaire, très significative, entre la dose (par métre5) et le taux plasmatique fut observée chez 21 adultes de sexe masculin recevant leur dose quotidienne totale le matin. Les taux plasmatiques moyens de DPH étaient similaires chez les enfants des deux sexes, mais des doses plus élevées étaient requises pour atteindre un taux plasmatique équivalent à celui des adultes de sexe masculin. Le taux plasmatique moyen obtenu chez les adultes de sexe feminin (25–45 ans) était plus bas que celui des adultes de sexe masculin (p < 0.05). Un accroissement significatif (p < 0.001) du taux plasmatique moyen de DPH fut observe chez les femmes de plus de 65 ans. II n'y avait pas de différence dans la réponse chez les subjets obèses. Le taux plasmatique moyen chez les patients recevant à la fois du phénobarbital et de la primidone était analogue à ceux qui ne recevaient que de la DPH, bien que des différences individuelles furent fréquemment observés. Des changements significatifs du niveau plasmatique de DPH n'ont pas été observées durant la grossesse. Done l'âge, le sexe et le poids sont des facteurs de grande importance dans l'interprétation de données cliniques obtenues par l'évaluation périodique des taux plasmatiques de DPH.
RESUMEN
La relación dosis‐nivel en plasma de DPH se determineó en 700 enfermos divididos en grupos bien definidos. Dosis equivalentes de DPH (5,1 mg/kg) se compararon en cada grupo; en 21 adultos varones que recibían la dosis total cada mañana, se observó una relación linear dosis‐nivel en plasma (dosis por m2) muy significativa (p < 0.00...
Aerodigestive adverse effects (AD-AE) during intravenous pentamidine (IV-P) infusion for Pneumocystis jiroveci pneumonia prophylaxis are uncommon in retrospective chart review studies. We conducted a survey in patients on IV-P, which included 31 specific questions. Twenty-five patients were included in the analysis; AD-AE were observed in 22 (88%) with recurrence of symptoms in 88% participants with subsequent infusions. Five leading symptoms were congestion (48%), lip tingling (32%), nausea (28%), tongue tingling (24%), vomiting, and throat swelling (17%); multiple symptoms were reported in 72% of the patients. In conclusion, AD-AE of IV-P infusion are common, self-limited, and tend to be recurrent.
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