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Updated multi-society guidance aligns with broader recommendations which prioritize individualized risk factors for aspiration and other complications, rather than dosing frequency alone

As the chart below shows, the arms race is accelerating

Nature (2024) 630(8017):5558

[iv] Phenytoins zero-order (saturable) pharmacokinetics and high degree of protein binding make it challenging to achieve a consistent and therapeutic drug level in hospitals unable to measure free phenytoin levels rapidly

This hormone helps manage appetite and blood sugar levels