Pharmacokinetic testing reveals biphasic plasma concentration curves during phenytoin administration, suggesting critical timing considerations for managing status epilepticus and cardiac arrhythmias.
Oral and intravenous phenytoin tolerance tests showed distinctive biphasic curves with a fall in plasma phenytoin to very low levels after an initial peak and a rise to a secondary peak one to four hours later. It is suggested that this pattern should be borne in mind when intravenous phenytoin is being used, as in the control of status epilepticus or cardiac arrhythmias.
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A. Handley (1970) studied this question.
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