Plasma level distribution, effect and toxicity of antiepileptic drugs among Ethiopian epileptics

Ethiop Med J. 1990 Jan;28(1):23-30.


Plasma phenytoin and phenobarbitone levels were estimated in 123 adult Ethiopian epileptics by gas-liquid chromatography. Thirty four (38.2%) of the patients on phenytoin, and 52 (52%) of those on phenobarbitone, had plasma levels in the conventional therapeutic ranges of 10-20 micrograms/ml and 10-30 micrograms/ml respectively. Of the 89 patients who were taking phenytoin either singly or combined with phenobarbitone, motor disturbances (ataxia and nystagmus) were seen in 31 (34.8%) and dysmorphic and idiosyncratic side effects including gum hypertrophy, hirsutism, acne and skin rash in 37 (41.6%). Subnormal serum calcium levels were noted in 15 (30.6%) and high alkaline phosphatase was found in 13 (26.5%). Phenobarbitone was found to be an effective anticonvulsant (78.1% seizure control rate), with adverse effects of sedation and intellectual depression. Seizure control was achieved in 77.1% of patients on a single drug as opposed to 55.6% on combination of phenytoin and phenobarbitone (p less than 0.05). The overall seizure control rate was 66%.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Drug Therapy, Combination
  • Epilepsy / drug therapy*
  • Ethiopia
  • Female
  • Humans
  • Male
  • Phenobarbital / blood
  • Phenobarbital / pharmacokinetics*
  • Phenobarbital / toxicity
  • Phenytoin / blood
  • Phenytoin / pharmacokinetics*
  • Phenytoin / toxicity


  • Phenytoin
  • Phenobarbital