Serum phenytoin level

Common Questions and Answers about Serum phenytoin level

dilantin

html In most patients maintained at a steady dosage, stable phenytoin serum levels are achieved. There may be wide interpatient variability in phenytoin serum levels with equivalent dosages. Patients with unusually low levels may be noncompliant or hypermetabolizers of phenytoin.
A few months ater starting Keppra(and stopping dilantin),my husband's VPA (ER) level was 121.For years,his level was steady-between 80 and 90.He had markedly increased hand tremors and somnolence.We were told by neurologist and pharmacist-still in therapeutic range-Keppra could not have caused the increased VPA level.Two months later,we returned to the neurologist at my (never marry a nurse) insistence.My husband now had leg cramps,was stuporous,very irritable,slept 14 to 16 hrs.
Markedly elevated homocyst(e)ine concentrations have been observed in patients with nutritional deficiencies of the essential cofactor vitamin B(12)) [27] and the cosubstrate folate. [28,29] Negative correlations between serum vitamin B(12)), folate, and vitamin B(6)) concentrations and plasma homocyst(e)ine concentrations have been observed in normal subjects.
Folic acid supplementation in folate-deficient patients with epilepsy changes the pharmacokinetics of phenytoin, usually leading to lower serum phenytoin concentrations and possible seizure breakthrough..." It however says that initiation of Folic acid and phenytoin together is beneficial. Since you can't go back and start all over again, you can take a small dose. It has been observed that as los as 1mg dose can perturb phenytoin’s levels, You may take doses lower than 1mg/day.
In these group of patients higher doses are needed.To find out serum or plasma level of the drug, blood samples are taken which is called monotoring of drug levels. The clinically effective serum level is usually 10-20 mcg/mL. Dosage should be individualized to provide maximum benefit. In some cases, serum blood level determinations may be necessary for optimal dosage adjustments.
Hi, is he on some other drugs too because other drugs might decrease the level of phenytoin by enhancing its metabolism via induction of enzymes and can lead to drug drug interction. “Drugs which may decrease phenytoin levels include: carbamazepine, chronic alcohol abuse, reserpine, and sucralfate. Moban® brand of molindone hydrochloride contains calcium ions which interfere with the absorption of phenytoin.
Your GGT level is the highest of the three, so perhaps the following will be helpful to you: Gamma-glytamyl transpeptidase is an enzyme which is found in hepatocytes and biliary epithelial cells. GGT may be high in liver disease. In particular it is a feature of biliary outflow obstruction rather than hepatocellular damage. * GGT (in men) = 11 - 50 i.u./l * GGT (in women) = 7 - 32 i.u./l Note reference ranges may vary between laboratories.
Can anyone tell me,if before treatment that they had a high Gamma GT enzyme level Doctors seem to be a bit perplexed as I have not drank any alcohol in twenty years, has anyone else had this enzyme with Hep C?
Serum concentrations may be reduced (enzyme induction); contraceptive failure may result; alternative contraceptive measures are recommended during therapy and for 1 month after modafinil is discontinued.
The GGT test helps to detect liver and bile duct injury both ALP and GGT are elevated in disease of the bile ducts and in some liver diseases, but only ALP will be elevated in bone disease. If the GGT level is normal in a person with a high ALP, the cause is most likely bone disease. GGT can also be used to screen for chronic alcohol abuse (it will be elevated in about 75% of chronic drinkers).
My mother-in-law is 77yrs. old she was poerated right parietal meningioma excisionwas on Eption.She is having high blood pressure. she was found post operative dizziness and 3 falls in the week. she was prescribed eptoin thrice a day. After 36 days of her operation Serum Phenytoin level was >40.Her Epyoin was stopped and Valprol started., but again she had a mild stroke. Her food intake food intake is very less since her surgery.
Recently was put on Ciprofloxacin for male issues and cr@p hit the fan about 20 days into to the 30 day use. Until I know otherwise this med nearly doubled my serum level from my normal "3.5" to 8 and 9. That was a wake up call to come here and read. I too suffer from short term memory loss but honestly at 15 I couldn't tell a joke to save my life so I've never been on par with many but I get by OK.
* Extra- and intrahepatic biliary obstruction * Hepatocyte injury of various causes (produces local cholestasis), including viral hepatitis * Space-occupying lesions (tumors, abcesses, granulomas) * Sepsis * Drugs (phenytoin) * Primary biliary cirrhosis Circulating ALP may also come from non-hepatic sources, and in those cases it doens not indicate hepatic disease: * Bone ALP is elevated when bone turnover is increased: Paget's disease of bone, hyperparathyroidism
partial bile duct obstruction, primary biliary cirrhosis (PBC), primary sclerosing cholangitis, adult bile ductopenia, and certain drugs such as androgenic steroids and phenytoin. Infiltrative diseases include sarcoidosis, other granulomatous diseases, and less often unsuspected cancer metastatic to the liver. Alkaline phosphatase levels also vary with age.
Always blame the other side of the family hehe. A good question about Gilbert's (pronounced jeelbear's since it's french ooh la la lol) and thyroid hormone. My mother hasn't started thyroxine yet so I can't say from any second hand experience on the matter yet. What I did find was that the UGT1A1 activity which is working at about 30% capacity in Gilbert's Syndrome is also one of the enzymes needed for glucuronidation of thyroxine. Interesting.
We finally settled on good old fashioned VPA (ER) and Dilantin-they provided the best control,the least somnolence,and (bonus) were cheapest.On our neurologist's advice ,we transitioned from phenytoin to Keppra,while continuing 2500 mg VPA daily.(He's always failed monotherapy.)We made the change as he was"sleeping his life away."Subsequent to completing the change,VPA level was 118 and LFTs were fine.Of note,his depakote levels have always been 70 to 90.This was in March.
Obviously, Adam was given yet another slightly different normal range. Again – discuss these differences with your doctor. * Some medications (phenytoin, phenobarbital, and rifampin) may contribute to vitamin D deficiency.
The Addison's Clinical Advisory Panel state that if a person is unwell, the diagnosis of adrenal insufficiency cannot be excluded by a serum cortisol level [Wass et al, 2009]. CKS therefore recommends seeking specialist advice in this situation.
I received blookwork results that showed that my alkaline phosphatase level is 153, my doctor said that high normal is 136. All other bloodwork and enzymes are fine. I am being sent for a gall bladder ultrasound and liver panel. Other than gallstones what else could be causing this? How far out of range am I, is 153 low or high? My doctor says not to worry on one hand but then on the other says that it could be a broad range of things. How common is it to get a high reading?
Elevated levels of serum GGT have been reported in a wide variety of clinical conditions, including pancreatic disease, myocardial infarction, renal failure, chronic obstructive pulmonary disease, diabetes, and alcoholism. High serum GGT values are also found in patients taking medications such as phenytoin and barbiturates. Here are some answers to your questions.
Six patients with HBV-related cirrhosis, viral breakthrough during LMV therapy and viral breakthrough or non-response during ADV therapy were treated daily with TDF plus LMV for at least 6 months. The HBV DNA level, alanine aminotransferase (ALT), the Child-Pugh score and serum creatinine were monitored. Genotypic LMV- or ADV-resistant mutations were measured in stored samples. 3. Results: In five of six patients, ADV-resistant mutations at rt181 or rt236 were detected during ADV therapy.
Comparison of phenytoin and carbamazepine serum concentrations measured by high-performance liquid chromatography, the standard TDx assay, the enzyme multiplied immunoassay technique, and a new patient-side immunoassay cartridge system. Therapeutic Drug Monitoring. 16(6):608-12, 1994 Dec.
2- I had my blood work done for (IGA, IGG , IGm and IGE ) immunoglobulin and came back with lower IGM level. Is the related to any herpes issue ? Thank you.
og 25-hydroxyvitamin D Low blood levels of 25-hydroxyvitamin D may mean that you are not getting enough exposure to sunlight or enough dietary vitamin D to meet your body’s demand or that there is a problem with its absorption from the intestines. Occasionally, drugs used to treat seizures, particularly phenytoin (Dilantin), can interfere with the production of 25-hydroxyvitamin D in the liver.
7 ( NHS normal range 3 - 20) Vit B12 = 285, ( second test 241) private Norm range = 191- 946 ( NHS norm range 140-600) Creatinine level of 114 ( second test 101), abnormal is above 110 Whit blood cell = 4.3, ( second test 4.7) Norm range 4 - 11 RBC = 11.9 , NHS Normal range 11.6 -14.6 Fasting glucose 5, Norm is above 6.2 TSH = 2 , ( second test 0.8) NHS normal range 0.35 - 5 Free t4 = 25.
It seems I may now have some sort of blood sugar problem as my blood sugar the last time they took it (without food or water) was 168. My thyroid level was 9.8 and my GI doctor has set me up for some further exploratory surgeries because he thinks I may have some sort of chronic pancreatitis, maybe a problem with my spleen, or liver. We are not sure at this time, but I did schedule the surgery time today, and then I had to schedule a time for some additional blood work too.
When the EMG was performed, did you also have a nerve conduction study (NCS)? Has the doctor checked your serum voltage-gated potassium channel antibodies test from Athena diagnostics? If not, I'd have your dr run it b/c it's a simple blood test (nothing to lose on that one). Be wary of thinking you have Lyme Disease unless you live in or have spent time in an endemic area.
What I've finally discovered from reading here, is the cause of the hair loss which was extreme over the last six months. I've slowed it down to a tolerable level using a hair product called Nioxin, that you can get at a beauty supply store. I have lost half the fullness of my hair-I'm not sure about regrowth as of yet; luckily, I have a lot of hair.
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