Therapy monitored by the measurement of phenytoin levels in patients with ventricular disorders of cardiac rhythm
Wierzchowiecki, M.; Masiakowski, J.; Dyderski, S.; Cieszyński, T.; Jankowiak, M.
Kardiologia Polska 30(9): 583-588
1987
ISSN/ISBN: 0022-9032 PMID: 3695063 Document Number: 290114
36 patients aged 42-72 with ventricular arrhythmias in a course of the ischemic heart disease underwent the study. Phenytoinum (Polfa) dose was 600 mg during first two days or 1,0 g during the first day of treatment and then, respectively 300 mg or 400 mg daily chronically, dependent to a body weight. Stationary serum drug concentrations were determined by means of a gas chromatography method. In the group of 21 patients treated with 300 mg daily dose of phenytoin mean stationary, serum drug concentration was 4,1 .+-. 2,6 .mu.g/ml. Reduction of ventricular premature beats was observed in 4 patients (19 per cent). In 22 patients treated with 400 mg/24 hours of phenytoin, its mean stationary serum concentration was 8,4 .+-. 4,5 .mu.g/ml and an improvement was observed in 13 of them (59 per cent). In patients of both groups with a good response to phenytoin administration, its mean stationary serum concentration was 8,9 .mu.g/ml in comparison with 5,5 .mu.g/ml in patients without any therapeutical effect. The study indicated the usefulness of phenytoin in the treatment of ventricular arrhythmias as well as a low bioavailability of Phenytonium (Polfa).