Practical management of therapeutic diphenylhydantoin concentrations in children.
OBJECTIVE
Development of easy, practical methods for the management and optimisation of therapeutic diphenylhydantoin (DPH) concentrations in children.


METHODS
Investigation of DPH concentration profiles and pharmacokinetic parameters in children with poorly controlled epilepsy. Subsequent determination of individual-specific DPH maintenance dosage and volume of distribution data suitable for use in routine therapeutic concentration management procedures.


METHODS
Department of Paediatrics and Child Health and Department of Pharmacology, University of Stellenbosch, Tygerberg Hospital.


METHODS
Children of both sexes between the ages of 4 and 12 years with poorly controlled epilepsy receiving DPH as sole medication.


RESULTS
In all subjects evaluated epilepsy was unsatisfactorily controlled because of inadequate DPH dosage regimens. Individual-specific maintenance dosage and volume of distribution data could be calculated for all individuals participating in the trial. The calculated data were suitable for use in routine management procedures and in no instance was it necessary to recalculate parameters in a 12-month follow-up period subsequent to evaluation.


CONCLUSIONS
Therapeutic DPH concentration profiles can be managed satisfactorily in children in individual-specific DPH pharmacokinetic parameters are derived and skillfully applied.
Smit
A
A
Department of Paediatrics and Child Health, University of Stellenbosch, Tygerberg, W Cape.
Schoeman
J F
JF
Seifart
H I
HI
Parkin
D P
DP
D000927:Anticonvulsants / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D016903:Drug Monitoring; D004827:Epilepsy / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D010672:Phenytoin / Q000008:administration & dosage* / Q000097:blood / Q000493:pharmacokinetics*
D000927:Anticonvulsants; D010672:Phenytoin