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Ethotoin Use in Pediatric Seizure Patients

BARBARA H. KORBERLY, PHARMD; THOMAS J. MRAZIK, PHARMD; LEONARD J. GRAZIANI, MD
Am J Dis Child. 1981;135(12):1139-1140. doi:10.1001/archpedi.1981.02130360043015.
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Ethotoin (Peganone), 3-ethyl, 5-phenylhydantoin, reportedly had less anticonvulsant activity in epileptic patients than the two more commonly used anticonvulsants, phenytoin sodium and phenobarbital.1 Phenytoin, an effective drug for treatment of generalized seizures other than absence, has several side effects, including gingival hyperplasia and hirsutism, which may reduce patient acceptance and compliance, especially in children and adolescents. Phenobarbital, with comparative anticonvulsant activity to phenytoin, is reported to cause behavioral disturbance, especially hyperactivity, in up to 42% of pediatric patients who receive the drug.2 By contrast, ethotoin has minimal side effects,1 but since its introduction in 1956 for the control of generalized seizures other than absence, it has not been studied extensively in epileptic children.3-5 These previous studies did not report therapeutic blood levels for ethotoin, and the dosage that was used ranged from 500 mg to 5 g daily.

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