Phenytoin Intoxication: A Narrative Review of the Pharmacokinetic Parameters Influencing Toxicity Wening Wulandari (a*), Vidiya Gunarsih (a), Windy Setiyanti (a)
Department of Pharmacy, Faculty of Health Sciences, Jenderal Soedirman University
Abstract
This narrative review discusses the pharmacokinetic parameters of phenytoin and their impact on toxicity. Phenytoin is a cornerstone anticonvulsant medication used to treat seizures that stabilize the electrical activity of neurons in the brain. However, its complex and often unpredictable pharmacokinetic profile causes severe and life-threatening symptoms when taken in excessive long-term administration. Phenytoin toxicity is primarily caused by the drugs pharmacokinetic profile within the body, encompassing its absorption, distribution, metabolism, and excretion parameters. Several other factors can also influence the drugs fate within the body, including age, genetics, liver function, kidney function, interaction with other medications, and the patient nutritional status. The review examines clinical manifestations of phenytoin toxicity and provides strategic recommendations aimed at optimizing its therapeutic use to mitigate the risk of adverse effects. This article analysis was carried out using primary literature from the last ten years collected from Google Scholar, PubMed, and Cochrane online databases, with the exclusion of review articles and meta-analyses. The review concludes that a thorough understanding of the pharmacokinetic parameters influencing phenytoin toxicity is crucial for both clinicians and patients for preventing and managing intoxication, ultimately leading to improved phenytoin therapy.
