Therapeutic hypothermia decreases phenytoin elimination in children with traumatic brain injury

• Published in: Critical care medicine Vol. 41; no. 10; p. 2379
• Main Authors: Empey, Philip E, Velez de Mendizabal, Nieves, Bell, Michael J, Bies, Robert R, Anderson, Kacey B, Kochanek, Patrick M, Adelson, P David, Poloyac, Samuel M
• Format: Journal Article
• Language: English
• Published: United States 01.10.2013
• Subjects: Adolescent; Anticonvulsants - blood; Anticonvulsants - pharmacokinetics; Brain Injuries - metabolism; Brain Injuries - therapy; Child; Child, Preschool; Female; Humans; Hypothermia, Induced - adverse effects; Hypothermia, Induced - methods; Intensive Care Units, Pediatric; Male; Pennsylvania; Phenytoin - blood; Phenytoin - pharmacokinetics; Retrospective Studies; Trauma Severity Indices; Pennsylvania

Preclinical and clinical studies have suggested that therapeutic hypothermia, while decreasing neurologic injury, may also lead to drug toxicity that may limit its benefit. Cooling decreases cytochrome P450 (CYP)-mediated drug metabolism, and limited clinical data suggest that drug levels are elevat...