(39) A 55- year old man begins taking phenytoin a seizure disorder that devel;oped following cerebral infections. At a dose of 300mg daily , his serum phenytoin concentration is 12 micrograms( normal therapeutic range is 10-20) and breakthrough seizures occur. AT a dose of 400 mg daily, serum phenytoin concentration is 28 microgram/mL and he has a symptom of toxicity, including ataxia and somnolence. Which of the following best explains the large increase in the patients serum phenytoin concentration?          (A) Accidental ingestion of excess medication (B) Age-related decrease in cytochrome P450-enzyme activity (C) Age-related decrease in liver cell mass (D) Decreased glucuronidation in the liver (E) Saturation of an enzyme pathway that metabolizes phenytoin

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Substance Abuse

Substance abuse refers to the use of illegal drugs in excessive quantities, as well as the misuse of legal substances such as prescription or over-the-counter pharmaceuticals or alcohol for purposes other than those intended. Drug addiction, also known as substance use disorder, is a disease that affects the brain and behavior of a person. It leads to a failure to control the use of any drug or prescription, legal or illegal.