Clinical situation	Rationale	Strength of recommendation	References
Suspected noncompliance	Determine probable cause of seizures.	C	1, 8
Suspected drug toxicity	Decrease drug dosage to achieve nontoxic level.	C	1, 8
Increase phenytoin (Dilantin) dosage	Nonlinear kinetics may result in toxic level.	C	1, 9
Renal failure	Decreased drug protein binding may render “therapeutic” level toxic.	C	8, 9
Pregnancy	Decreased drug protein binding may render “therapeutic” level toxic.	C	8, 9