In humans, prenatal exposure to phenytoin may increase the risks for congenital malformations and adverse developmental outcomes.
Appropriateness of antiepileptic drug level monitoring. Reference Range, Interpretation, Collection can be used to correct the phenytoin level. The strength of recommendations and the level of evidence for individual studies are rated using criteria developed by the Evidence-Based Medicine Working Group http: Slow metabolism may be caused by limited enzyme availability and lack of induction; it appears to be genetically determined.
Therapeutic drug monitoring—antiepileptic drugs.
Phenytoin is an antiepileptic drug with several pharmacologic actions, including ion conductance, Na-K ATPase activity, synaptic transmission, and neurotransmitter release; the antiepileptic effects of phenytoin are thought to be primarily related to its action at the sodium channels during depolarization, preventing repetitive neuronal firing. Periodic measurement of serum phenytoin concentrations may be valuable in the management of pregnant women as a guide to appropriate adjustment of dosage [see Dosage and Administration 2.
Toxic symptoms can affect the mouth, cardiovascular and nervous systems, and the eyes and include:. What do blood levels show?
In acute overdosage the possibility of other CNS depressants, including alcohol, should be borne in mind. In these trials, which had a median treatment duration of 12 weeks, the estimated incidence rate of suicidal behavior or ideation among 27, AED-treated patients was 0. It is therefore suggested that phenytoin not be administered concomitantly with an enteral feeding preparation.
Subscribe to this RSS feed. Accordingly, at the first sign of acute toxicity, serum levels should be immediately checked. Reference Range Phenytoin is used as both an abortive and preventive medication in seizure management. This article was last modified on February 20, The modified date indicates that one or more changes were made to the article.
There have also been reports of coarsening of facial features, systemic lupus erythematosus, periarteritis nodosa, and immunoglobulin abnormalities. Phenytoin is available in many formulations, including extended-release capsules. C, based on expert opinion. The increased risk of suicidal thoughts or behavior with AEDs was observed as early as one week after starting drug treatment with AEDs and persisted for the duration of treatment assessed.
In this case, alternative therapy should be an anticonvulsant drug not belonging to the hydantoin chemical class. Similarly, if there is a history of hypersensitivity reactions to these structurally similar drugs in the patient or immediate family members, consider alternatives to Dilantin.
Inform patients that certain over-the-counter medications e. To view content sources and attributions, please refer to our editorial policy. Your healthcare provider may give you and your baby medicine to prevent this.