AI Article Synopsis
- - A 52-year-old man with late-onset epilepsy experienced toxicity after being prescribed phenytoin, even at standard doses, leading to his hospitalization for assessment after a seizure.
- - Despite inconclusive tests, therapeutic drug monitoring (TDM) identified elevated phenytoin levels, suggesting possible genetic factors that affect drug metabolism, though genetic testing wasn't performed.
- - The patient's condition improved after tapering off phenytoin and switching to valproate, highlighting the importance of TDM and awareness of adverse drug reactions in epilepsy treatment.
Article Abstract
Adverse drug reactions to commonly prescribed medications such as phenytoin, used for seizures, often go undetected due to various factors. This case report highlights a 52-year-old male diagnosed with late-onset epilepsy who was prescribed phenytoin. Despite the standard dosage, the patient experienced toxicity symptoms and a seizure, prompting admission for assessment. Laboratory tests and imaging were inconclusive, leading to a therapeutic drug monitoring (TDM) consultation, which revealed elevated phenytoin levels. Genetic testing for CYP2C9 polymorphisms was not feasible but noted as significant, especially in populations with higher prevalence. Phenytoin was tapered, leading to the patient's gradual recovery upon discontinuation and transition to valproate. The Naranjo scale predicted potential adverse drug responses (ADRs). This case underscores the significance of TDM, genetic considerations in drug metabolism, and the need to be vigilant in treating epilepsy to prevent such adverse events.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10977159 | PMC |
| http://dx.doi.org/10.1155/2024/2888895 | DOI Listing |
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