2 0 obj endobj Patients receiving phenytoin must be monitored for signs of phenytoin toxicity. By continuing to use our website, you are agreeing to In contrast, we observed no such risk with amoxicillin, an antibiotic with similar indications but not expected to interact with phenytoin (adjusted OR 1.12, 95% CI 0.64, 1.98). Pharmacodynamic interactions and interactions of unknown mechanism Clozapine Co-administration with clozapine, a drug with the potential to cause agranulocytosis, must be avoided. m,q��w�݈�T&�i�f�o���|s-���`��Զ��sx���z9�WR�����\]��3�Q\�&{�e�A�A���K��A��v��6��W��`Z[t��O'[��@�4pɎ��{S�ZNI���1j�ZFi`|_Z"[c�(��^~�{�i_��ςU��|s>�����O'�56`�a���`��_��"q2��i-�J}�i������#����Hv58��#L�-|��l������r�u?H Acute hepatic failure following administration of trimethoprim-sulfamethoxazole has rarely been seen, and only 4 cases have been well documented pathologically. Serologic studies for hepatitis B and C were negative. This conclusion is consistent with the time relationship of administration of TMP-SMZ and the clinical course, as well as with the transaminase increase and the histologic picture of massive centriacinar necrosis.
Drug levels may assist in ruling out phenytoin toxicity as a differential diagnosis. Her overall condition was good, her cognitive functions were improving, and she was alert and oriented. The patient developed renal and hepatic insufficiency and died 26 days after admission.A complete autopsy was done 24 hours after death. Massive hepatic necrosis following exposure to phenytoin and trimethoprim-sulfamethoxazole is a rare occurrence and to the best of our knowledge has not been reported previously.
The patient's alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, total bilirubin, and γ-glutamyltransferase levels were markedly elevated at this time (The patient was treated for possible urosepsis with ceftriaxone (1 g intravenously every 8 hours). The liver weighed 2080 g. The capsule was shrunken and had focal petechiae. of trimethoprim+sulfamethoxazole the half-life of phenytoin increased by 39% and its clearance decreased by 27%.
Blood culture was negative.
The most striking gross findings were submassive hepatic necrosis, duodenal ulcer with hemorrhage, and hemorrhage into the right basal ganglia. The patient was lethargic. There was no evidence of pulmonary embolism or venous thrombosis. Urinalysis showed 15 to 30 white blood cells with 1+ protein. Her blood pressure was 220/120 mm Hg. Additionally, as a precaution, TMP-SMZ, DPH, and cimetidine were discontinued, although the patient displayed no signs of an allergic reaction or eosinophilia. The patient complained of slurred speech and difficulty with movement on the left side. Phenytoin: pharmacokinetics and clinical therapeutics.Hepatic injury associated with diphenylhydantoin therapy: a clinicopathologic study of 20 cases.Update of hepatotoxicity due to classes of drugs in common clinical use: non-steroidal drugs, anti-inflammatory drugs, antibiotics, antihypertensives, and cardiac and psychotropic agents.Adverse reactions to trimethoprim-sulfamethoxazole in patients with the acquired immunodeficiency syndrome.Hepatic necrosis and trimethoprim-sulfamethoxazole.Terminal hepatic failure following a small dose of sulfamethoxazole-trimethoprim.Fulminant liver failure and pancreatitis associated with the use of sulfamethoxazole-trimethoprim.Fulminant hepatic failure in a child as a potential adverse effect of trimethoprim-sulphamethoxazole.The liver as a target for chemical-chemical interactions.Fatal liver necrosis and diphenylhydantoin sensitivity.Toxic hepatic necrosis associated with taking dilantin, tridione, and phenobarbital: report of a case.Diphenylhydantoin fatal hepatic necrosis: a review of literature and report of a case treated exchange transfusion.Shaun S. Tan, MBChB, Sharon Saw, PhD, Ka Lip Chew, MBBS, Cindy Wang, BSc, Anastacia Pajarillaga, BSc, Candy Khoo, BSc, Weixuan Wang, BSc, Zahidah Mohamed Ali, BSc, Zhixin Yang, BSc, Chan Yiong Huak, PhD, Paul Tambyah, MBBS, Roland Jureen, MD, Sunil K Sethi, MBBSRichard L. Haspel, MD, PhD, J. Louise Jones, BSC, MBChB, PhD, FRCPath, Hasan Rizvi, MBBS, MBA, FRCPath, Martin Young, BSc, MBBS, MRCOG, FRCPathIrene Maria Beune, MD, Stefanie Elisabeth Damhuis, MD, Wessel Ganzevoort, MD, PhD, John Ciaran Hutchinson, MBBS, PhD, Teck Yee Khong, MD, Eoghan E. Mooney, MB, FRCPath, Neil James Sebire, FRCPath, MD, Sanne Jehanne Gordijn, MD, PhDRidin Balakrishnan, MD, Kamaljeet Singh, MD, Malini Harigopal, MD, Susan Fineberg, MD Bactrim must not be given concomitantly with dofetilide (see 4.5 Interactions).
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