Thrombocytopenia and L.E. cells after oxyphenbutazone.
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Biomedical subjects
Publications and source records attributed to A J Handley.
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Oral and intravenous phenytoin tolerance tests showed distinctive biphasic curves with a fall in plasma phenytoin to very low levels after an initial peak and a rise to a secondary peak one to four hours later. It is suggested that this pattern should be borne in mind when intravenous phenytoin is being used, as in the control of status epilepticus or cardiac arrhythmias.
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Serum phenytoin concentrations in outpatients and inpatients with epilepsy have been contrasted. Individual patients were receiving prescriptions ranging from 100 to 300 mg. of sodium phenytoin daily, but the two groups were comparable in respect of dosage, age, and sex distribution. Whereas the mean phenytoin concentration among 14 inpatients was 28 mug./ml. that among 15 outpatients was only 15.7 mug./ml. When the supervision of a further 12 outpatients was changed to include more frequent visits and regular provision of blood samples their mean serum concentration of phenytoin rose from 17.5 to 27.7 mug./ml.The results indicate that failure to follow dosage instructions is a factor of major importance among epileptic patients whose response to treatment is inadequate or erratic.
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