Purpose: This study was designed to measure the brain penetration of phenyt
oin (PHT) after intravenous (i.v.) administration of either standard PHT or
fosphenytoin (FPHT), a PHT prodrug. The study was formulated to answer the
question whether the time required for FPHT to be converted to PHT in the
bloodstream would delay the accumulation of PHT in brain.
Methods: Four rats were sampled at Various times after intravenous infusion
of 30 mg/kg PHT i.v. or 30 mg/kg PHT equivalents of FPHT i.v. PHT was meas
ured in serum, protein-free ultrafiltrate, and in brain, by using high-perf
ormance liquid chromatography.
Results: Although the initial PHT-free fraction was significantly higher fo
r FPHT-treated rats than it was for PHT-treated rats, brain PHT levels were
significantly reduced after infusion of FPHT.
Conclusions: When FPHT is used for treatment of generalized status epilepti
cus, it should be anticipated that lower initial brain PHT levels will be a
chieved than are typically found with standard PHT.