English

Abstract

CONTEXT: Mankind exhibits epilepsy as one of the common neurologic disorders. Standard drug therapy of this disease provides control of seizures in more than 80% of patients. Effective, specific treatment by Anti-Epileptic Drugs becomes absolutely essential for successful treatment in human subjects. Epilepsy especially Grand-Mal variant is typically treated with Phenytoin. Unique point about our study is focused on the estimation of serum phenytoin sodium concentration and to correlate it with some of the important biochemical markers that assess the hepatic function. AIMS: 1. It may help to assess whether the epileptic patient receiving phenytoin on an out-patient basis requires an additional dose when monitoring shows suboptimal levels. 2. Should the maintenance dose be reduced, stopped or adjusted to minimize the dose related adverse effects without sacrifice of seizure control. 3. Study also provides an estimation of out-patient compliance. 4. Rational designing of dosing regimen, prediction of future drug concentration and assessment of functional impairment due to disease may be possible. 5. Failure to provide adequate control in maximal tolerated dose by phenytoin after confirming compliance may give a clue to substitute another drug. METHODS AND MATERIALS: Thirty seven patients suffering from grand mal epilepsy who attended the neurology OPD of Basaveshwar Teaching and General Hospital were selected for the study. Two patients received 100mg, 25 patients 200mg and 10 patients received 300mg of Dilantin Sodium (Parke Davis) capsule daily at night between 9-10pm. The period of the exposure to the drug varied from 1-5 years. Ten healthy volunteers of same age group who were not receiving any drugs were the control for the study. 10ml of blood was collected from each patient between 9-10am. 2ml of serum was extracted from each sample; serum phenytoin level was measured using UV Spectrophotometer, Bausch and Lomb 21 by the method of Dill. 5ml of blood was collected to measure the following biochemical parameters: Serum AST, Serum ALT, Serum ALP, Instrument - Ciba Corning Blood gas 288 system and other biochemical parameters are measured by Technicon-RA-XT Auto Analyser. CONCLUSION: The present study summarizes its findings in patients of grand-mal epilepsy receiving phenytoin therapy. Elevation of serum alkaline phosphatase levels in comparison to the control group. Other parameters such as serum aspartate transaminase and alanine transaminase were within normal limits and there was no significant correlation.