Plasma level distribution, effect and toxicity of antiepileptic drugs among Ethiopian epileptics.
Plasma phenytoin and phenobarbitone levels were estimated in 123 adult Ethiopian epileptics by gas-liquid chromatography. Thirty four (38.2%) of the patients on phenytoin, and 52 (52%) of those on phenobarbitone, had plasma levels in the conventional therapeutic ranges of 10-20 micrograms/ml and 10-30 micrograms/ml respectively. Of the 89 patients who were taking phenytoin either singly or combined with phenobarbitone, motor disturbances (ataxia and nystagmus) were seen in 31 (34.8%) and dysmorphic and idiosyncratic side effects including gum hypertrophy, hirsutism, acne and skin rash in 37 (41.6%). Subnormal serum calcium levels were noted in 15 (30.6%) and high alkaline phosphatase was found in 13 (26.5%). Phenobarbitone was found to be an effective anticonvulsant (78.1% seizure control rate), with adverse effects of sedation and intellectual depression. Seizure control was achieved in 77.1% of patients on a single drug as opposed to 55.6% on combination of phenytoin and phenobarbitone (p less than 0.05). The overall seizure control rate was 66%.
Bekele
G
G
Department of Internal Medicine, Faculty of Medicine, Addis Ababa University, Ethiopia.
Abebe
Y
Y
T'Haimanot
R
R
D000293:Adolescent; D000328:Adult; D002648:Child; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000188:drug therapy*; D005002:Ethiopia; D005260:Female; D006801:Humans; D008297:Male; D010634:Phenobarbital / Q000097:blood / Q000493:pharmacokinetics* / Q000633:toxicity; D010672:Phenytoin / Q000097:blood / Q000493:pharmacokinetics* / Q000633:toxicity
D010672:Phenytoin; D010634:Phenobarbital