Multiple drug interactions with phenytoin

D. J. Birkett; G. G. Graham; P. M. Chinwah; D. N. Wade; J. B. Hickie

doi:10.5694/j.1326-5377.1977.tb117733.x

Multiple drug interactions with phenytoin

D. J. Birkett, G. G. Graham, P. M. Chinwah, D. N. Wade, J. B. Hickie

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

Abstract

A 49-yr-old female with chronic alcoholism and epilepsy, treated with phenytoin, began to convulse when treatment with disulfiram (an inhibitor of phenytoin metabolism) was discontinued. The patient at this stage was resistant to the large doses of phenytoin, apparently owing to induction of the metabolism of this drug by chronic alcohol intake. Later, a small (30%) increase in dose resulted in about a 10-fold increase in plasma concentration of phenytoin and severe toxicity. The final dose of phenytoin required to maintain the plasma level within the therapeutic range suggested that the enzyme induction had decreased. The value of monitoring plasma concentrations of phenytoin is emphasized.

Original language	English
Pages (from-to)	467-468
Number of pages	2
Journal	Medical Journal of Australia
Volume	2
Issue number	14
DOIs	https://doi.org/10.5694/j.1326-5377.1977.tb117733.x
Publication status	Published - Oct 1977
Externally published	Yes

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AU - Chinwah, P. M.

AU - Wade, D. N.

AU - Hickie, J. B.

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N2 - A 49-yr-old female with chronic alcoholism and epilepsy, treated with phenytoin, began to convulse when treatment with disulfiram (an inhibitor of phenytoin metabolism) was discontinued. The patient at this stage was resistant to the large doses of phenytoin, apparently owing to induction of the metabolism of this drug by chronic alcohol intake. Later, a small (30%) increase in dose resulted in about a 10-fold increase in plasma concentration of phenytoin and severe toxicity. The final dose of phenytoin required to maintain the plasma level within the therapeutic range suggested that the enzyme induction had decreased. The value of monitoring plasma concentrations of phenytoin is emphasized.

AB - A 49-yr-old female with chronic alcoholism and epilepsy, treated with phenytoin, began to convulse when treatment with disulfiram (an inhibitor of phenytoin metabolism) was discontinued. The patient at this stage was resistant to the large doses of phenytoin, apparently owing to induction of the metabolism of this drug by chronic alcohol intake. Later, a small (30%) increase in dose resulted in about a 10-fold increase in plasma concentration of phenytoin and severe toxicity. The final dose of phenytoin required to maintain the plasma level within the therapeutic range suggested that the enzyme induction had decreased. The value of monitoring plasma concentrations of phenytoin is emphasized.

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Multiple drug interactions with phenytoin

Abstract

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