Effective utilization of phenytoin by pharmacists at the critical care center

Abstract

Phenytoin (PHT), one of the antiepileptic drugs, exhibits nonlinear pharmacokinetics and its effective range is narrow (10~20 µg/mL). We examined the effect of prescription design by pharmacist on the administration of PHT, at the Trauma and Critical Care Center, Kyorin University Hospital. The number of cases which has been measured blood concentration in suitable administration time at before the support start and after the support began was 37 cases (71.2% of the measurement example) and 23 cases (74.2% of same). Among cases requiring multiple measurement, the patients who deviated from the effective range during treatment was before: 15 cases (75.0%) and after: 3 cases (33.3%) (p<0.05). Pharmacist prescription support was considered to maintain PHT concentration for cases requiring long-term administration (>13days) of PHT, which is frequently treated at a critical care centers such as status epilepticus, patients which other medicine is ineffective, and patients who continue to receive PHT from other hospitals.