DIPHENYLHYDANTOIN AND PHENOBARBITAL TOXICITY. THE ROLE OF LIVER DISEASE.

摘要: Diphenylhydantoin and phenobarbital often are tolerated less well in patients who have liver disease than intact individuals, can take the usual diphenylhydantoin doses of 4-6 mg/kg 1-2 without evidence toxicity. The dose-related signs toxicity such as nystagmus, ataxia, mental changes may occur with 4 or and/or 2 daily. This has been commented upon by Roseman1and Sparberg,2among others, but no explanations offered. Several mechanisms might be involved this manifestation. One explanation that cerebral metabolic derangement enhances brain's susceptibility to pharmacologic agents given ordinarily innocuous dosages.3Second, blood-brain barrier altered. Third, apparent low tolerance related impairment detoxification liver. paper deals