Related Experiment Video

Updated: Feb 8, 2026

Isolation of the Side Population in Myc-induced T-cell Acute Lymphoblastic Leukemia in Zebrafish
09:06

Isolation of the Side Population in Myc-induced T-cell Acute Lymphoblastic Leukemia in Zebrafish

Published on: May 4, 2017

7.0K

Fosphenytoin Population Pharmacokinetics in the Acutely Ill Pediatric Population

Brady S Moffett1,2, Mindl M Weingarten1,2, Lindsay R Schmees1,2

  • 1Department of Pharmacy, Texas Children's Hospital, Houston, TX.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|June 22, 2018
PubMed

Insights

A loading dose of 20 mg/kg followed by 6 mg/kg every 8 hours is recommended for phenytoin (fosphenytoin) in pediatric patients. Dose adjustments are necessary for reduced kidney function and phenobarbital use impacts clearance.

Area of Science:

  • Pharmacokinetics
  • Pediatric Pharmacology
  • Clinical Pharmacy

Background:

  • Phenytoin is a critical anti-seizure medication.
  • Optimizing phenytoin dosing in pediatric patients is essential for effective seizure control.
  • Fosphenytoin offers an improved safety profile for intravenous phenytoin administration.

Purpose of the Study:

  • To characterize the pharmacokinetics of phenytoin in pediatric patients receiving fosphenytoin.
  • To establish optimal loading and maintenance dosing regimens for fosphenytoin in children.
  • To identify factors influencing phenytoin pharmacokinetics in the pediatric population.

Main Methods:

  • Retrospective population pharmacokinetic analysis using NONMEM v7.3.
  • Inclusion of pediatric patients (<19 years) treated with fosphenytoin for seizures.
  • Simulation to determine optimal dosing strategies.

Main Results:

  • Analysis of 536 pediatric patients.
  • Developed a two-compartment pharmacokinetic model incorporating fat-free mass, serum creatinine, and phenobarbital use.
  • Simulations indicated a 20 mg/kg loading dose followed by 6 mg/kg every 8 hours as an effective regimen.
  • Recommended dose reductions for patients with impaired renal function.

Conclusions:

  • A 20 mg/kg loading dose and 6 mg/kg every 8-hour maintenance dose is a suitable empiric strategy for achieving therapeutic phenytoin concentrations.
  • Fat-free mass is a key covariate for dosing.
  • Concomitant phenobarbital use may increase phenytoin clearance, necessitating dose consideration.
  • Fosphenytoin dose reduction is advised in pediatric patients with compromised kidney function.
Abstract

More Related Videos

Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis05:56

Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis

Published on: August 29, 2025

583
Author Spotlight: Analyzing Bone Marrow Microenvironment in Murine Hematological Malignancies06:33

Author Spotlight: Analyzing Bone Marrow Microenvironment in Murine Hematological Malignancies

Published on: November 10, 2023

1.9K

Related Concept Videos

Analysis of Population Pharmacokinetic Data01:12

Analysis of Population Pharmacokinetic Data

Analysis of population pharmacokinetic data involves studying the behavior of drugs within diverse populations to understand their pharmacokinetic parameters. Traditional pharmacokinetic methods typically involve collecting samples from a few individuals and estimating these parameters. While these methods are commonly used, they have limitations in capturing the variability in drug response among individuals or heterogeneous populations. Population pharmacokinetics is employed to address these...
758
Conservation of Small Populations02:04

Conservation of Small Populations

Small population sizes put a species at extreme risk of extinction due to a lack of variation, and a consequent decrease in adaptability. This weakens the chances of survival under pressures such as climate change, competition from other species, or new diseases. Large populations are more likely to survive pressures such as these, as such populations are more likely to harbor individuals that have genetic variants that are adaptive under new stresses. Small populations are much less...
17.4K
What is Population Genetics?01:25

What is Population Genetics?

A population is composed of members of the same species that simultaneously live and interact in the same area. When individuals in a population breed, they pass down their genes to their offspring. Many of these genes are polymorphic, meaning that they occur in multiple variants. Such variations of a gene are referred to as alleles. The collective set of all the alleles within a population is known as the gene pool.
64.8K
Population Growth00:57

Population Growth

Population size is dynamic, increasing with birth rates and immigration, and decreasing with death rates and emigration. In ideal conditions with unlimited resources, populations can increase exponentially, which plots as a J-shaped growth rate curve of population size against time. This type of curve is characteristic of newly-introduced invasive species, or populations that have suffered catastrophic declines and are rebounding.
28.7K
What are Populations and Communities?00:30

What are Populations and Communities?

Overview
38.0K
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
266