Phenytoin is one of the most difficult drugs to dose

Phenytoin is one of the most difficult drugs to dose.

This is because phenytoin metabolism depends on the dose. Higher doses take longer to metabolize, so doubling the dose can more than double the serum concentration.

Loading doses help get to therapeutic levels faster. Give 15 to 20 mg/kg PO or IV...about 1000 mg for most adults.

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