Phenytoin questions

[jamesbt]

Hi All,

I wonder whether anyone has any information on phenytoin concerning when to take levels and what those levels represent. I know it can take weeks for steady state to occur, so when we take a level, does this represent what the level was days ago, or at that time?
Also, is there a specific time when to take levels, e.g. immediately before a dose,or actually it doesnt matter when you take it.

also know that there is a specific formula we use to calxulate the actual level if there is abnormal albumin, but cannot find it for the life of me! Any help would be really appreciated,

Thanks

James

[Shwampa]

Here's a whole chapter from:

Applied Clinical Pharmacokinetics
By Larry A. Bauer
Date June 24, 2008
Format Paperback, 840 pages
ISBN 0071476288 / 9780071476287

http://www.mhprofessional.com/downlo.../BauerCh10.pdf

[jamesbt]

Thanks thas a very detailed piece of information.
While covering the neurology ward, I come across a few things I just cannot find guidelines to. Another situation was where the dose of valproate was being tapered and stopped in a patient adn the query was how quickly this could be done?
I dont know if therre are any neurology of epilepsy experienced pharmacists out there who know about how to taper any of the antiepileptics?

Help would be very much appreciated.
Thanks