Phenytoin-induced encephalopathy in a child

Abstract

Phenytoin is a commonly used antiepileptic medication in the pediatric age group, but it has a narrow therapeutic range. Various adverse effects have been reported commonly. We report a relatively rare case of encephalopathy in a child from overdose of injectable phenytoin due to ignorance of the previous treatment. Scrutiny of medical records and history is of utmost importance while administering such medications.

Lack of narrow therapeutic index awareness leading to increased risk of acute phenytoin toxicity in a child with traumatic brain injury

“…However therapeutic index is narrow which makes it potential drug to cause toxicity due to errors in prescribing, dispensingor administration and/ or increase in doses and/or change in brands/formulations of the drug [1,2]. Acute overdosealtered physiological state in disease conditions, inter-individual variability, drug interactions, and genetic mutations in the cytochrome P450 enzyme can be factors precipitating toxicity [3][4][5][6].…”

Effects of Antiepileptic Drug Levels on Clinical Outcomes in Pediatric Patients Using Pharmacokinetics Approach

“…2 Obat antiepilepsi (OAE) pada anak yang sering digunakan dan termasuk dalam golongan indeks terapi sempit adalah asam valproat, fenitoin, dan fenobarbital. [3][4][5] Penggunaan obat antiepilesi dalam jangka waktu panjang dapat menyebabkan risiko efek toksik dan efek samping, bergantung pada kadar obat dalam darah. Kadar asam valproat, fenitoin, dan fenobarbital yang berada di bawah kisaran terapi dapat menghasilkan sedikit efek terapi, sedangkan kadar obat yang berada di atas kisaran terapi dapat menyebabkan efek toksik yang signifikan, seperti hepatotoksik pada penggunaan asam valproat, nistagmus lateral pada penggunaan fenitoin dan efek sedasi, ataksia pada penggunaan fenobarbital.…”