Treatment of phenytoin toxicity with repeated doses of activated charcoal.

A 38-year-old woman ingested at least 10 g of phenytoin and was managed using repeated doses of oral activated charcoal. The peak serum concentration of 52 micrograms/mL was reached within 42.5 hours of ingestion. Signs and symptoms of phenytoin toxicity had disappeared four days after ingestion. The serum phenytoin concentration was in the therapeutic range six days after ingestion. The clinical course of this patient was shorter than those of other conventionally treated patients with phenytoin overdoses. Multiple-dose activated charcoal may have a role in the treatment of phenytoin overdoses by limiting the amount of gastrointestinal absorption and by enhancing elimination.