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Phenytoin may accumulate in the cerebral cortex over long periods of time which can cause atrophy of the cerebellum. The degree of atrophy is related to the duration of phenytoin treatment and is not related to dosage of the medication. [23] Phenytoin is known to be a causal factor in the development of peripheral neuropathy. [24]
The level of digoxin for treatment is typically 0.5-2 ng/mL. [8] Since this is a narrow therapeutic index , digoxin overdose can happen. A serum digoxin concentration of 0.5-0.9 ng/mL among those with heart failure is associated with reduced heart failure deaths and hospitalizations. [ 9 ]
Severe symptoms are usually due to acute elevation of the plasma sodium concentration to above 157 mmol/L [10] (normal blood levels are generally about 135–145 mmol/L for adults and elderly). [10] Values above 180 mmol/L are associated with a high mortality rate, particularly in adults. [ 11 ]
[3] [4] Systemic manifestations occur at the time of skin manifestations and include a high number of eosinophils in the blood, liver inflammation, and interstitial nephritis. However, a subgroup of patients may become hypothyroid as part of an autoimmune thyroiditis up to 2 months after the initiation of symptoms.
Taiwanese, Japanese, and Malaysian individuals expressing the CYP2C9*3 [47] variant of CYP2C9, which has reduced metabolic activity compared to the wild type (i.e. CYP2c9*1) cytochrome, have increased blood levels of phenytoin and a high incidence of SJS (as well as SJS/TEN and TEN) when taking the drug.
This medication has many already established neurological side effects. However, glove syndrome is a rare, with prevalence ranging from 1.7% to 5.9%, but has very serious adverse effect that may lead to limb amputations. This may occur due to the administration of phenytoin with or without extravasation.
Elevated levels of the alkaline phosphatase enzyme are reported among those who have obesity. A study reported there were higher serum levels of alkaline phosphatase in obese than in the non-obese. With elevated alkaline phosphatase levels, there is an increase in disproportionate intracellular fat depots and thereby releasing itself into the ...
The symptoms of DRESS syndrome usually begin 2 to 6 weeks but uncommonly up to 8–16 weeks after exposure to an offending drug. Symptoms generally include fever, an often itchy rash which may be morbilliform or consist mainly of macules or plaques, facial edema (i.e. swelling, which is a hallmark of the disease), enlarged and sometimes painful lymph nodes, and other symptoms due to ...