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Serum Phenobarbitone Levels in Term and Near Term Neonates with Seizures
Sanober Wasim1, Amit Upadhyay, Monica Roy
1Department of Pediatrics, Lala Lajpat Rai Memorial Medical College, Meerut; and #Institute of Human Behavior and Allied Sciences, New Delhi; India. Correspondence to: Dr Amit Upadhyay, Head, Department of Pediatrics, LLRM Medical College, Meerut, India. au.llrm@gmail.com.
Objective:
To evaluate serum phenobarbitone levels in neonates with seizures and to evaluate the effect of repeated loading dose on serum phenobarbitone levels.
Methods:
In this prospective observational study conducted in a tertiary care centre of Northern India during 2011- 2012, 99 neonates admitted with seizureswere included.Serum phenobarbitone levels in neonates with seizures at 20 minutes and 12 hours after the first loading dose of phenobarbitone were measured.
Results:
Serum phenobarbitone levels [mean (SD)] at 20 min and 12 hours was 27.3 (28.4) ug/mL and 23 (19.1) ug/mL, respectively (P=0.07). The mean serum phenobarbitone levels 12 hours after the loading dose, and proportion of neonates with toxic levels increased with each loading dose of intravenous phenobarbitone.
Conclusion:
Monitoring of serum level of phonobarbitone may not be essential because seizure control in neonates appears to be independent of whether serum level is subtherapeutic, therapeutic or toxic range.
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