Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Phenytoin is an anti-convulsant drug commonly used to prevent seizures in patients with cerebral metastases. Phenytoin has complicated non-linear kinetics, is highly protein bound and has a small window between its therapeutic and toxic dose. This combination of factors means that small increases in dosage can all too quickly result in high plasma levels and toxic symptoms. Symptoms of phenytoin toxicity include: confusion, nystagmus, agitation, abnormal gait and hallucinations. This case report describes phenytoin toxicity in a patient receiving phenytoin 300 mg three times a day for a number of weeks. The patient was admitted to the unit for terminal care, where his phenytoin levels were found to be very high. Phenytoin was withheld until levels returned to within the normal range. During this time the patient became orientated and many of his symptoms resolved.
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PMID:A case of phenytoin toxicity in a patient with advanced lung cancer. 1716 67

A 61-year-old man had been receiving phenytoin(225mg/day)and valproate(600mg/day)for several years as the treatment for seizures. He was diagnosed with advanced gastric cancer,and S-1 plus cisplatin treatment was administered as neoadjuvant chemotherapy because bulky lymph node metastases were found at the time of the initial diagnosis. He complained of weakness of the lower extremities,light -headedness,and trembling of the upper extremities 2 months after the start of concomitant treatment with S-1 plus cisplatin. The serum phenytoin concentration increased to 21. 2mg/mL. Head computed tomography and magnetic resonance imaging did not reveal any intracranial lesion such as brain metastasis. Therefore, we diagnosed phenytoin toxicity due to concomitant use of S-1 and phenytoin,and the dose of phenytoin was then decreased to 150 mg. Although the weakness of the lower extremities improved,light -headedness remained. Phenytoin and valproate treatments were stopped,and he was able to walk 7 days after the termination of therapy. It is important to predict the timing of phenytoin toxicity due to S-1,and therapeutic drug monitoring should be performed in patients receiving S-1 plus cisplatin and phenytoin.
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PMID:Phenytoin toxicity in a patient receiving concomitant use of phenytoin and S-1 plus cisplatin chemotherapy for advanced gastric cancer. 2167 96