{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:31:04Z","timestamp":1787729464649,"version":"build-2784847793"},"reference-count":12,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2013,12,30]],"date-time":"2013-12-30T00:00:00Z","timestamp":1388361600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Practice"],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>There are no published reports on pediatric phenytoin toxicity, resulting from the drug interaction between phenytoin and valproic acid.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case description:<\/jats:title>\n                    <jats:p>A 12-year-old patient with refractory epilepsy syndrome presented with phenytoin toxicity, following a concomitant treatment with phenytoin, valproic acid, and lamotrigine. The phenytoin concentration detected in the capsules used by the patient was in accordance with the prescribed dose and was appropriate for the age and weight of the patient. However, a supratherapeutic phenytoin serum concentration was observed (21.92 \u00b5g phenytoin\/mL of blood). Consequently, the phenytoin dose was reduced, and the patient was monitored; 24 hours later the patient did not present with any signs\/symptoms of toxicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>Despite the appropriate phenytoin concentration in the capsules, the patient presented with phenytoin toxicity. This toxicity likely resulted from the drug interaction between phenytoin and valproic acid that leads to phenytoin displacement from plasmatic proteins and inhibits phenytoin metabolism, thereby increasing the concentration of free drug in the serum.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0897190013515708","type":"journal-article","created":{"date-parts":[[2013,12,31]],"date-time":"2013-12-31T20:53:29Z","timestamp":1388523209000},"page":"214-216","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Drug Interaction Between Phenytoin and Valproic Acid in a Child With Refractory Epilepsy"],"prefix":"10.1177","volume":"27","author":[{"given":"Indira Valad\u00ea","family":"Carvalho","sequence":"first","affiliation":[{"name":"Department of Clinical Pathology, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata Cavalcanti","family":"Carnevale","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00edlia Berlofa","family":"Visacri","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priscila Gava","family":"Mazzola","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosiane","family":"de F\u00e1tima Lopes Ambr\u00f3sio","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo Conrado dos","family":"Reis","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Unit, Clinical Hospital, University of Campinas, Campinas, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel Alvarenga","family":"de Queiroz","sequence":"additional","affiliation":[{"name":"Pediatric Emergency Unit, Clinical Hospital, University of Campinas, Campinas, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Moriel","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology, Faculty of Medical Sciences, University of Campinas, Campinas, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2013,12,30]]},"reference":[{"issue":"1","key":"bibr1-0897190013515708","first-page":"34","volume":"26","author":"Botero GR","year":"2010","journal-title":"Acta Neurol Colomb"},{"key":"bibr2-0897190013515708","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2007.02.006"},{"key":"bibr3-0897190013515708","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2009.05.011"},{"key":"bibr4-0897190013515708","doi-asserted-by":"publisher","DOI":"10.2174\/157015910792246254"},{"key":"bibr5-0897190013515708","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.30.11.1233"},{"key":"bibr6-0897190013515708","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2005.02529.x"},{"key":"bibr7-0897190013515708","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(88)90054-X"},{"key":"bibr8-0897190013515708","unstructured":"Klasco RK. DRUGDEX\n                      \u00ae\n                      System. Greenwood Village, Colorado: Thomson Micromedex. http:\/\/www.micromedexsolutions.com\/micromedex2\/librarian\/. Accessed September 12, 2011."},{"key":"bibr9-0897190013515708","volume-title":"Intera\u00e7\u00f5es Medicamentosas de Stockley: refer\u00eancia r\u00e1pida","author":"Baxter K","year":"2010"},{"key":"bibr10-0897190013515708","unstructured":"Bul\u00e1rio da Ag\u00eancia Nacional de Vigil\u00e2ncia Sanit\u00e1ria (ANVISA) [homepage on the internet]. Brazil: ANVISA; 2003. http:\/\/www4.anvisa.gov.br\/base\/visadoc\/BM\/BM[26434-1-0].PDF. Accessed Septemeber 12, 2011."},{"key":"bibr11-0897190013515708","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-7843.2006.pto_309.x"},{"key":"bibr12-0897190013515708","unstructured":"Minist\u00e9rio da Sa\u00fade (Brazil), Secretaria de Aten\u00e7\u00e3o \u00e0 Sa\u00fade. Protocolo Cl\u00ednico e Diretrizes Terap\u00eauticas\u2014Epilepsia. 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Accessed July 13, 2013."}],"container-title":["Journal of Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0897190013515708","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0897190013515708","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0897190013515708","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:35:39Z","timestamp":1777509339000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0897190013515708"}},"subtitle":["A Case Report"],"short-title":[],"issued":{"date-parts":[[2013,12,30]]},"references-count":12,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2014,4]]}},"alternative-id":["10.1177\/0897190013515708"],"URL":"https:\/\/doi.org\/10.1177\/0897190013515708","relation":{},"ISSN":["0897-1900","1531-1937"],"issn-type":[{"value":"0897-1900","type":"print"},{"value":"1531-1937","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,12,30]]}}}