Hurdles Faced by Healthcare Providers in Titrating Phenytoin Dosage in Long-Term Care

Medications are associated with development of adverse drug events (ADEs), some more than others, due to alteration in pharmacokinetics and dynamics with age. Phenytoin efficacy and toxicity relate to drug levels, interaction with cytochrome P450, hepatic function and albumin levels; phenytoin is largely protein bound. Our case illustrates the difficulties in dosing phenytoin in a long-term care resident.