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CCRN Critical Care Nursing

Category - Adult

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A patient taking Dilantin (phenytoin) for a seizure disorder is experiencing breakthrough seizures. A blood sample is taken to determine the serum drug level. Which of the following would indicate a sub-therapeutic level?

15 mcg/mL.
4 mcg/mL.
10 mcg/dL.
5 mcg/dL.

Explanation

Answer: B - The therapeutic serum level for Dilantin is 10 - 20 mcg/mL. A level of 4 mcg/mL is sub-therapeutic and may be caused by patient non-compliance or increased metabolism of the drug. A level of 15 mcg/mL is therapeutic. Choices C and D are expressed in mcg/dL, which is the incorrect unit of measurement.

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CCRN Critical Care Nursing

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