Become familiar with the indications, interactions, and side effects. Anticonvulsant phenytoin is a medication used to treat epilepsy.
Other names for this medication:
Despite the fact that phenytoin first appeared in literature in 1946, it took decades for the mechanism of action to be clarified. Although several scientists were convinced that phenytoin altered sodium permeability, it wasn’t until the 1980’s that this phenomenon was linked to voltage-gated sodium channels. More specifically, phenytoin prevents seizures by inhibiting the positive feedback loop that results in neuronal propagation of high frequency action potentials.,, Nearly all voltage-gated sodium channel subtypes are targeted by phenytoin, which is frequently referred to as a non-specific sodium channel blocker.
If you have any queries regarding the dosage calculation process, consult your physician or pharmacist. If you're not sure if you got the right medicine, ask your pharmacist. Despite feeling fine, keep taking phenytoin. Different phenytoin products are absorbed by the body in different ways and cannot be substituted for one another. Even if you experience side effects like unusual changes in behavior or mood, you should not stop taking phenytoin without first consulting your doctor. Discolored capsules should not be taken. Never take it in larger or smaller amounts or more frequently than directed by your doctor. Make sure you get the phenytoin product that was prescribed for you each time you receive a dose of medication. Ask your doctor or pharmacist to explain any instructions on your prescription label that you do not understand, and carefully follow them. Ask your doctor when you should take phenytoin if you are receiving formula or supplements through a feeding tube. If you need to switch from one phenytoin product to another, your doctor may need to adjust your dose. Your seizures might become more severe if you stop taking phenytoin abruptly. Extended-release (long-acting) capsules, chewable tablets, and a suspension (liquid) for oral administration are the three forms of phenytoin available. Additionally, phenytoin is used to manage irregular heartbeat. Phenytoin may help control your condition but will not cure it. Before each use, thoroughly shake the liquid to evenly distribute the medication. Do not split, chew, or crush the extended-release capsules; rather, swallow them whole. Phenytoin should be taken daily at or near the same time(s). Follow the prescription for phenytoin exactly. When using this medication to treat your condition, discuss the risks with your doctor. Two or three times a day is the typical dosage for the chewable tablet and suspension. One to four times a day is the typical dosage for the extended-release capsules. Ask your doctor or pharmacist for more details if you believe this medication should be used for something else. Unless your doctor tells you otherwise, continue your normal diet. To ensure that you take the right dosage of medication, use an accurate measuring device. The chewable tablets can be thoroughly chewed before being swallowed, or they can be taken whole without being chewed. You'll need to give yourself some time in between eating and taking phenytoin. Your doctor will probably decrease your dose gradually. Your doctor will start you on a low dose of phenytoin and gradually increase it, not more frequently than once every 7 to 10 days.
Never take two doses at once to make up for missed ones. Skip the missed dose and carry on with your regular dosing schedule, though, if it is almost time for the subsequent dose. As soon as you realize you missed a dose, take it.
Call 911 right away if the victim has fallen, experienced a seizure, is having trouble breathing, or cannot be roused. To report an overdose, dial 1-800-222-1222 for the poison control hotline. Information is also available online at https://www.poisonhelp.org/help. Uncontrollable eye movements, loss of coordination, slow or slurred speech, blurred vision, fatigue, uncontrollable shaking of a part of the body, nausea, or vomiting, as well as dizziness, fatigue, irregular heartbeat, chest pain, or shortness of breath, are all signs of overdosing.
Do not freeze the liquid. However, you should not flush this medication down the toilet. Instead, using a medication take-back program is the best way to get rid of your medication. As many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and are simple for young children to open, it is crucial to keep all medications out of sight and out of reach of children. Keep this medication out of the reach of children and tightly closed in the original container. If you are unable to participate in a take-back program, visit the FDA's Safe Disposal of Medicines website at http://goo.gl/c4Rm4p for more details. Keep it at room temperature and out of the bathroom and away from light, excessive heat, and moisture. To find out about take-back programs in your area, speak with your pharmacist or the garbage/recycling department in your city. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them.
If you have: Call your doctor for medical advice about side effects. Typical negative effects of phenytoin include: If you exhibit symptoms of an allergic reaction to phenytoin, such as hives, difficulty breathing, swelling of the face or throat, or a severe skin reaction, such as fever, sore throat, burning in the eyes, skin pain, or a red or purple skin rash that spreads and blisters and peels, seek emergency medical attention. Effects of phenytoin in more detail Inform your doctor of any new or escalating symptoms, including any changes in mood or behavior, anxiety, panic attacks, trouble sleeping, or feelings of impulsivity, hostility, agitation, aggression, restlessness, hyperactivity (mentally or physically), increased depression, or suicidal or self-harming thoughts. If you experience a severe drug reaction that affects multiple body parts, seek medical attention. Skin rash, fever, swollen glands, muscle aches, extreme weakness, unusual bruising, and yellowing of the skin or eyes are a few symptoms that can occur. There may be other side effects; this is not a comprehensive list. You may report side effects to FDA at 1-800-FDA-1088. problems with balance, coordination, or muscle movement, as well as drowsiness, confusion, slurred speech, abnormal eye movement, or sluggishness. Any skin rash, regardless of how minor; fever, chills, sore throat, swollen glands; red or swollen gums, mouth sores; easy bruising, unusual bleeding, purple or red spots under your skin; or liver problems, including loss of appetite, upper stomach pain, dark urine, clay-colored stools, and jaundice (yellowing of the skin or eyes).
Alcohol can change the amount of phenytoin in the serum. Steer clear of alcohol. Food lessens irritability and improves bioavailability. Preferably 2 hours before or after taking antacids. Avoid taking with antacids. Consume with food. Reduced absorption may result from taking this medication with antacids.
Tell your doctor if you are taking delavirdine (Rescriptor) and request an ingredient list from your pharmacist. If you are allergic to phenytoin, other hydantoin medications like ethotoin (Peganone) or fosphenytoin (Cerebyx), any other medications, or any of the ingredients in phenytoin, let your doctor and pharmacist know before taking phenytoin. Inform your doctor and pharmacist of all prescription and non-prescription drugs, vitamins, dietary supplements, and herbal products you are taking or plan to take. Your doctor will probably advise you not to take phenytoin if you are taking this medication.
What is unique about the elimination of phenytoin?
Phenytoin has unique pharmacokinetics. At therapeutic levels, elimination follows first-order kinetics. In the upper therapeutic and toxic range, elimination changes from first-order to zero-order kinetics due to saturation of the hepatic hydroxylation system.
How is phenytoin absorbed?
The absorption of phenytoin was studied in man. It is concluded that phenytoin absorbed from the intestine is recirculated via the bile, so that blood levels do not accurately reflect absorption. Phenytoin is loosely bound to serum proteins and is found in red cells in concentrations similar to those in plasma.
Where is phenytoin metabolized?
Phenytoin is metabolized primarily in the liver by CYP2C9 and CYP2C19 to 5-(4-hydroxyphenyl)-5-phenylhydantoin, which is glucuronidated and excreted.
Is phenytoin metabolized by CYP2C9?
Phenytoin is one of the commonly prescribed drugs in children for seizure control. CYP2C9 may be involved in 80–90 % of metabolism of phenytoin and therefore polymorphisms in CYP2C9 may result in significant reduction in the metabolism of phenytoin and can enhance clinical toxicity of the drug [2–4].
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