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Related Experiment Videos

Phenytoin elimination in newborns.

B F Bourgeois, W E Dodson

    Neurology
    |February 1, 1983
    PubMed
    Summary

    Phenytoin (PHT) elimination half-life (t50%) in infants varies significantly with age and concentration. PHT levels may decrease with constant doses due to these factors in newborns.

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    Area of Science:

    • Pharmacokinetics
    • Neonatal Medicine
    • Clinical Pharmacology

    Background:

    • Phenytoin (PHT) is commonly used to treat seizures in infants.
    • Understanding PHT elimination is crucial for optimizing therapeutic drug monitoring in neonates.

    Purpose of the Study:

    • To determine the apparent half-life (t50%) of phenytoin (PHT) in a cohort of infants.
    • To investigate the influence of postnatal age and initial PHT concentration (Ci) on PHT elimination.

    Main Methods:

    • Measured PHT apparent half-life (t50%) 30 times in 16 infants (2-36 days old) with seizures.
    • Analyzed the relationship between t50%, postnatal age, and initial PHT concentration (Ci).

    Main Results:

    • During the first week of life, PHT t50% ranged widely from 6 to 140 hours.
    • After the first week, PHT elimination became concentration-dependent, with t50% decreasing as postnatal age increased.
    • Controlling for Ci, average t50% decreased threefold from the first week (57.3 ± 48.2 hours) to the fourth week (19.7 ± 1.31 hours).

    Conclusions:

    • Both age-related changes and concentration-dependent PHT elimination contribute to decreasing PHT levels in newborns receiving constant doses.
    • These findings highlight the importance of individualized dosing and therapeutic drug monitoring for phenytoin in the neonatal population.

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