Advertisment Polium-B
Indian Journal of Critical Care Medicine
An open access publication of ISCCM™ 
Users online: 1040 
     Home | Login 
  About Current Issue Archive Search Instructions Online Submission Subscribe Etcetera Contact  
  Navigate Here 
 »   Next article
 »   Previous article
 »   Table of Contents

 Resource Links
 »   Similar in PUBMED
 »  Search Pubmed for
 »  Search in Google Scholar for
 »Related articles
 »   Citation Manager
 »   Access Statistics
 »   Reader Comments
 »   Email Alert *
 »   Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded534    
    Comments [Add]    

Recommend this journal


Year : 2008  |  Volume : 12  |  Issue : 1  |  Page : 24--27

Variability of serum phenytoin levels in critically ill head injured patients in intensive care unit

Department of Critical Care Medicine, Lokmanya Hospitals, Chinchwad, Pune, India

Correspondence Address:
Lalitha V Pillai
Department of Critical Care Medicine, Lokmanya Hospitals, Chinchwad, Pune - 411 033
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-5229.40946

Rights and Permissions

Patients with large variations in phenytoin levels despite standard doses may prove to become difficult clinical problems. Our study of 34 head injury patients whose serum phenytoin levels were measured on day one and day five following intravenous loading and maintenance dose of phenytoin, showed 38.24% patients, to have therapeutic phenytoin levels on day one, while 20% were in toxic range. On day five, 23% patients were in toxic and 29.41% were in therapeutic range. Only 21% patients remained in the therapeutic range during the monitoring period. This study shows that there is a wide variability of phenytoin levels in the ICU patients with a difference of more than 100% between the highest and lowest phenytoin level in individual cases (in four patients the difference exceeded 500%) raising concern about the safety of the drug. Hence it is recommended that intensive care unit patients receiving phenytoin therapy should have periodic serum phenytoin obtained even in absence of seizures or classic signs phenytoin toxicity.


Print this article     Email this article

Online since 7th April '04
Published by Wolters Kluwer - Medknow