What is normal Dilantin level range?
The therapeutic ranges for most adults have been established at 10.0-20.0 mcg/mL for total phenytoin (bound plus unbound) and 1.0-2.0 mcg/mL for free phenytoin (unbound only).
What is a high Dilantin level?
Twenty to 30 mg/L: Nystagmus. Thirty to 40 mg/L: Ataxia, slurred speech, tremor, nausea, and vomiting. Forty to 50 mg/L: Lethargy, confusion, hyperactivity. Greater than 50 mg/L: Coma and seizures.
What indicates phenytoin toxicity?
Signs and symptoms of phenytoin toxicity typically correspond to the serum level, and progress from occasional mild nystagmus at 10-20 mcg/mL (the therapeutic range) to coma and seizures at levels above 50 mcg/mL (see Presentation and Workup). Treatment is supportive (see Treatment and Medication).
What is serum phenytoin?
Intravenous phenytoin sodium is effective for status epilepticus and can be used as the initial drug to manage recurrent seizures if they are widely spaced. This drug also may prevent seizures initially in high-risk patients with head trauma.
Why is my Dilantin level low?
2. 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.
What happens if Dilantin level is too high?
Dilantin, or phenytoin, toxicity happens when you have high levels of Dilantin in your body that become harmful. Dilantin is a medicine that is used to prevent and treat seizures. Dilantin toxicity can lead to a coma.
What are symptoms of high Dilantin levels?
Symptoms
- Coma.
- Confusion.
- Staggering gait or walk (early sign)
- Unsteadiness, uncoordinated movements (early sign)
- Involuntary, jerky, repeated movement of the eyeballs called nystagmus (early sign)
- Seizures.
- Tremor (uncontrollable, repeated shaking of the arms or legs)
- Sleepiness.
How do you interpret phenytoin levels?
Toxic phenytoin levels are defined as greater than 30 µg/mL. Lethal levels are defined as greater than 100 µg/mL. The reference range of free phenytoin is 1-2.5 µg/mL. In patients with renal failure associated with hypoalbuminemia, free phenytoin levels may be more accurate than total phenytoin levels.
What are the indications of an abnormal phenytoin serum level?
Total phenytoin levels (mcg/mL) and typical corresponding signs and symptoms are as follows:
- Lower than 10 – Rare.
- Between 10 and 20 – Occasional mild nystagmus.
- Between 20 and 30 – Nystagmus.
- Between 30 and 40 – Ataxia, slurred speech, nausea, and vomiting.
- Between 40 and 50 – Lethargy and confusion.
What are the symptoms of too much Dilantin?
What can increase phenytoin level?
Carbamazepine, phenobarbital, valproic acid, sodium valproate can either increase or decrease phenytoin levels.
Why Dilantin levels are low?